The ACJ exam: clinical judgement on cases
Last reviewed 2026-09-27
The Assessment of Clinical Judgement tests whether you can reach a diagnosis and make sound treatment decisions from a case history, dental charts, photographs and radiographs, and interpret radiographs on their own.
Format at a glance
| Questions | 120–150 single-answer and multi-answer multiple-choice |
|---|---|
| Timing | 5.5 hours with one scheduled 30-minute break |
| Question types | Case-based diagnosis, treatment planning and clinical decision-making; radiographic interpretation |
| Sittings | May and November |
| Passing standard | Test-equated, re-scaled score of 75 or more |
| Fee | $1,350 |
Partial credit on multi-answer questions
On multi-answer items you earn part marks for choosing some but not all of the correct answers, as long as you don't choose an incorrect one. A single wrong pick scores zero for that item. In practice, include an option only when you're confident it's correct. PassDental scores its case questions the same way.
The ACJ blueprint
| Blueprint area | Weight |
|---|---|
| Oral medicine / oral pathology, oral surgery | 28% |
| Pharmacotherapeutics, medically complex patients, medical emergencies | 22% |
| Periodontics | 15% |
| Cariology / restorative dentistry | 15% |
| Endodontics | 10% |
| Orthodontics, pediatric dentistry | 10% |
Prosthodontics isn't a separate line. It shows up inside restorative and treatment-planning cases.
Try a free ACJ-style case
Multi-part cases with histories, charts and radiographs, scored with NDEB-style partial credit.
Open a free caseFree questions in every blueprint area — no sign-up. Full bank from $129 CAD, one time.
How to prepare
- Learn a diagnostic framework for each discipline (pulpal and periapical terminology, the 2017 periodontal staging and grading, lesion differentials) and apply it the same way every time.
- Read radiographs systematically: location, borders, internal structure, and effects on neighbouring structures.
- For medically complex patients, always check medications, vital signs, bleeding risk and emergency readiness before treatment planning.
- NDEB publishes an ACJ questions-and-answers example document. Use it to understand the format.
Frequently asked questions
How is the ACJ scored?
Answers can carry different weights. On multi-answer questions you get part marks for some correct answers only if you select no incorrect answer. The pass mark is a test-equated, re-scaled score of 75.
Are there radiographs on the ACJ?
Yes. Case questions can include radiographs and clinical photographs, and there are dedicated radiographic interpretation questions.
How long is the ACJ?
About 5.5 hours, including one scheduled 30-minute break.