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NDHCE format & blueprint
200 multiple-choice questions, two back-to-back sections that lock when you submit, and a content map weighted heavily toward clinical care.
The format at a glance
| Total questions | 200 multiple-choice |
|---|---|
| Scored (operational) | 170 |
| Unscored (experimental) | 30 — piloted, don’t count, indistinguishable to you |
| Structure | 2 sections × 100 questions, 2 hours each |
| Break | Mandatory 15-minute break between sections |
| Navigation | Once you submit a section you cannot return to it |
| Question types | Independent items and case-based sets (a scenario + linked questions) |
| Media | Some items include radiographs and clinical photos |
| Answer choices | Four options; no penalty for wrong answers — never leave a blank |
| Languages | English and French |
Why the two sections are “locked”
The exam is split into two 100-question halves with a compulsory 15-minute break between them. Once you submit the first section, you cannot go back to it — so any question you flagged to revisit has to be resolved before you submit. Plan your time to leave a review pass within each section, not for the end of the exam. Because 30 of the 200 items are hidden pilots and scoring is scaled, there is no fixed “number you can miss” — details on the scoring page.
Independent vs case-based questions
Two item styles appear. Independent questions stand alone. Case-based sets open with a scenario — a client’s history, chart data, probing depths, sometimes a radiograph or clinical photo — followed by several linked questions. The practical rule candidates repeat: read the entire case before answering any of its questions, because later details often change the best answer to an earlier one.
The blueprint: seven domains
From the May 2026 sitting, the exam maps to the 2021 Entry-to-Practice Canadian Competencies for Dental Hygienists. Each domain contributes a range of scored items:
| Domain | Share of scored items |
|---|---|
| A — Professionalism | 5–11% |
| B — Evidence-informed Practice | 2–8% |
| C — Communication | 2–8% |
| D — Collaboration | 11–17% |
| E — Practice Management | 5–11% |
| F — Prevention, Education & Health Promotion | 17–23% |
| G — Clinical Therapy | 37–43% |
How you’re tested: cognitive levels
| Level | Share of scored items |
|---|---|
| Knowledge (recall) | 10–20% |
| Application | 55–65% |
| Critical thinking | 20–30% |
Roughly 80% of the exam is application and critical thinking, not memorization. This is the single most common lesson from candidates who had to retake it — practise applying concepts to scenarios rather than reciting facts. See the prep guide.
Turning the blueprint into a study plan
- Weight your hours by the domains. Spend the most time on Clinical Therapy and Prevention/Education, then Collaboration.
- Drill cases, not flashcards. The application-heavy design rewards scenario practice.
- Self-assess against the 2021 competencies to find your weak domains, then target them.
Contextual variables
Items reflect the real Canadian population: a client’s age or gender may be specified when clinically relevant, cultural context is included without stereotyping, and practice setting is named only when it matters. Expect items set in clinical, community-health and administrative contexts alike.
Last reviewed: 4 August 2026 · Figures from the FDHRC NDHCE overview (Jan 2026). Verify at fdhrc.ca.