The Licence in Dental Surgery (LDS) remains an important route for overseas-qualified dentists seeking registration to practise dentistry in the UK.
However, 2026 has brought significant changes to the LDS examination structure, assessment approach, capacity and fees. These changes are particularly important for international dentists planning their route to UK registration.
The most notable development is the redesign of LDS Part 2, where the previous unseen-case component has been replaced by a Structured Clinical Reasoning (SCR) examination. The revised assessment is designed to assess clinical reasoning, diagnosis, treatment planning and professional competencies against the General Dental Council's (GDC) current expectations for safe practice.
At the same time, the Royal College of Surgeons of England (RCS England) is substantially increasing LDS exam capacity. In 2026, 1,000 Part 1 places are being made available to new candidates, with 2,000 Part 1 places per year planned from 2027.
This article explains the latest LDS exam changes, what is known about pass-rate trends, how the revised assessment works and what international dentists should consider when preparing for the LDS in 2026 and beyond.
What Has Changed in the LDS Exam in 2026?
The LDS has undergone important changes in 2026, particularly at Part 2.
The main developments include:
- LDS Part 2 now includes a Structured Clinical Reasoning (SCR) examination.
- The SCR has replaced the previous unseen case examination from the June 2026 diet.
- Part 2 continues to include a 12-station OSCE assessing communication and clinical skills.
- The SCR consists of six 20-minute structured clinical reasoning cases.
- The revised assessment is aligned with the GDC's Safe Practitioner Framework.
- LDS exam capacity is being substantially expanded.
- 1,000 Part 1 places are available in 2026.
- RCS England plans to provide 2,000 Part 1 places annually from 2027.
- Exam fees are being restructured, with higher fees applying to examinations from September 2026 onwards.
One important point: there is no reliable publicly published national LDS pass-rate series comparable with the GDC's ORE results data. Therefore, candidates should be cautious about online claims suggesting a specific LDS pass percentage.
What Is the LDS Exam?
The Licence in Dental Surgery (LDS) is a three-part examination route offered by the Faculty of Dental Surgery at the Royal College of Surgeons of England.
For eligible overseas-qualified dentists, successfully completing the LDS can provide a route towards UK dental registration.
The current examination consists of:
Part 1 → Part 2 → Part 3
Candidates must complete the required stages within the applicable rules and meet the relevant registration requirements.
The GDC confirms that overseas-trained dentists who pass the LDS or ORE may also need to complete additional training before working in the NHS, depending on their circumstances.
Why Has the LDS Exam Changed?
The assessment has been updated to reflect modern expectations of safe dental practice.
The current LDS regulations state that the examination assesses competencies set out in the GDC's Safe Practitioner Framework.
This is important because the modern assessment is not simply about testing whether a candidate can recall clinical facts.
Candidates increasingly need to demonstrate that they can:
- Apply clinical knowledge
- Communicate effectively
- Make appropriate clinical decisions
- Diagnose problems
- Develop treatment plans
- Consider patient needs
- Demonstrate professionalism
- Manage clinical situations safely
The revised Part 2 structure is designed to separate different assessment objectives so that clinical skills and clinical reasoning can be assessed more directly.
What Has Changed in LDS Part 2?
The biggest change for candidates is the replacement of the previous unseen-case component.
From the June 2026 LDS Part 2 examination, the assessment includes:
1. Objective Structured Clinical Examination (OSCE)
The OSCE contains:
- 12 stations
- Approximately 7 minutes per station
- Assessment of communication and clinical skills
2. Structured Clinical Reasoning (SCR)
The new SCR component consists of:
- Six cases
- 20 minutes per case
- Direct interaction between candidate and examiner
- Assessment of diagnosis, management and treatment planning
The SCR has replaced the previous unseen-case examination.
This change means candidates need to prepare not only for what they know, but also how they explain and defend their clinical reasoning.
What Does the New Structured Clinical Reasoning Exam Test?
The SCR is particularly important because it introduces a more interactive assessment format.
Instead of simply reviewing an unseen case and providing an answer, candidates discuss clinical cases directly with examiners.
This can require candidates to demonstrate:
- Clinical assessment
- Differential diagnosis
- Treatment planning
- Risk assessment
- Clinical decision-making
- Patient-centred care
- Communication
- Professional judgement
The RCS England guidance explains that the new structure allows the assessment to cover a wider range of skills and learning outcomes, particularly reasoning, professionalism and self-management.
For international dentists, this means memorising model answers alone is unlikely to be sufficient preparation.
Has LDS Part 1 Changed?
LDS Part 1 remains a written assessment consisting of two papers, Paper A and Paper B.
The papers use Single Best Answer (SBA) questions and assess knowledge and its application across areas including:
- Clinically applied dental science
- Clinically applied human disease
- Clinical dentistry
- Law and ethics
- Health and safety
Candidates must pass both papers at the same sitting.
If either paper is failed, the candidate must resit the complete Part 1 examination rather than carrying the passed paper forward.
Candidates currently have a maximum of four attempts at Part 1.
What About LDS Part 3?
Part 3 remains the final stage of the LDS pathway.
Candidates who successfully complete Part 2 can progress to Part 3, subject to the applicable eligibility requirements.
Part 3 assesses practical and clinical competence and is therefore very different from the knowledge-focused Part 1 examination.
Candidates should avoid preparing for the LDS as if all three stages require the same study strategy.
Part 1 = knowledge and application
Part 2 = clinical skills, communication and reasoning
Part 3 = practical clinical competence
A staged preparation strategy is therefore essential.
What Are the Latest LDS Exam Pass Rates?
This is one of the most important areas where candidates need to be careful.
RCS England does not currently provide a publicly available LDS pass-rate dataset comparable to the GDC's published ORE sitting-by-sitting pass rates.
As a result, claims such as:
"The LDS pass rate is X%"
should not automatically be treated as official statistics.
Recent reports in the dental press have highlighted candidate concerns about a particularly low pass rate in a recent LDS Part 2 sitting. However, RCS England has not publicly released the pass-rate figure, so those reports cannot independently establish an official percentage. RCS England has stated that the redesigned assessment remains aligned with the published syllabus and GDC framework and that the changes do not represent a deliberate increase or decrease in the pass standard.
This distinction is extremely important when discussing LDS pass-rate trends.
Why Are Candidates Talking About Lower LDS Pass Rates?
The concern appears to be linked primarily to the redesigned assessment and the experience of candidates sitting the new format.
The change from unseen cases to structured clinical reasoning requires candidates to demonstrate their thinking directly to examiners.
That can create a different preparation challenge.
A candidate may have strong theoretical knowledge but struggle to:
- Explain a diagnosis clearly
- Justify a treatment plan
- Prioritise treatment
- Discuss risks
- Adapt their answer when questioned
- Communicate clinical reasoning concisely
This does not necessarily mean that the examination has become "harder" in terms of the required standard.
Rather, the skills being assessed and the way candidates demonstrate them have changed.
RCS England has stated that the assessment remains set against the relevant professional standards and published syllabus.
LDS Pass Rate vs ORE Pass Rate: Why You Should Not Compare Them Directly
Candidates researching UK registration often compare the LDS and ORE.
However, pass-rate comparisons can be misleading.
The GDC publishes ORE pass-rate data. For example, the average ORE Part 1 pass rates in 2025 were 73% in April and 75% in August, while ORE Part 2 pass rates ranged from 66% to 76% depending on the sitting.
There is no equivalent publicly reported LDS dataset that allows a like-for-like comparison.
Therefore, candidates should not conclude that one pathway is automatically "easier" because of an isolated pass-rate figure found online.
The exams also have different:
- Structures
- Assessment methods
- Eligibility requirements
- Capacity
- Preparation requirements
- Candidate populations
The better question is:
Which route is appropriate for your circumstances, and how well do your skills match the assessment format?
LDS Exam Capacity Is Increasing Significantly
One of the biggest positive changes for international dentists is the expansion of exam places.
RCS England announced in March 2026 that:
- 1,000 LDS Part 1 places would be available to new candidates in 2026.
- Part 2 and Part 3 capacity would also increase.
- From 2027, 2,000 Part 1 places per year are planned.
This represents a substantial expansion compared with previous capacity.
The GDC has also highlighted the expected increase in LDS capacity as part of a broader strategy to increase routes into UK dental registration.
This could create more opportunities for internationally qualified dentists who previously faced difficulty accessing examination places.
More Places Do Not Mean Easier Exams
This distinction is crucial.
Increased exam capacity does not mean a lower pass standard.
The purpose of increasing places is to allow more eligible candidates to sit the examination.
The GDC has specifically emphasised that the expansion of international registration routes must maintain patient safety and professional standards.
Therefore, candidates should not interpret increased LDS capacity as an indication that the examination will become easier.
The standard remains important.
LDS Exam Fees Are Also Changing
Candidates should also consider the financial implications.
RCS England's current information shows that the LDS is undergoing a pricing restructure, with increased fees applying to examinations from September 2026 onwards.
For example, the listed 2026 Part 1 fee is:
- June 2026: £900
- October 2026: £1,025
The listed Part 2 fee is:
- June/July 2026: £1,575
- September/November 2026: £1,793
Fees and examination dates can change, so candidates should always check the current RCS England examination page before budgeting or booking.
The total cost of the LDS journey will also include preparation, travel where applicable, documentation and other registration-related expenses.
What Does This Mean for International Dentists?
The changes create both opportunities and challenges.
The opportunity
More examination capacity means more eligible overseas dentists may have an opportunity to progress towards UK registration.
The challenge
The revised assessment requires candidates to prepare for a broader range of competencies, particularly clinical reasoning and professional communication.
International dentists should therefore avoid treating the LDS as purely a theoretical examination.
How Should Candidates Prepare for the New LDS Format?
A strong preparation strategy should reflect the actual assessment format.
For Part 1
Focus on:
- Core dental sciences
- Clinical dentistry
- Human disease
- Law and ethics
- Health and safety
- Single Best Answer questions
- Application of knowledge
Practice questions should be used to identify knowledge gaps rather than simply memorising answers.
For Part 2 OSCE
Candidates should practise:
- Communication
- History taking
- Explaining treatment
- Clinical decision-making
- Patient-centred communication
- Professional scenarios
- Time management
Practising aloud is particularly useful.
For the New SCR
Candidates should practise explaining:
What is your diagnosis?
What other diagnoses would you consider?
What further information would you need?
What treatment options are available?
Why would you choose this option?
What are the risks and benefits?
How would you explain this to the patient?
This type of preparation is more closely aligned with the interactive nature of the new assessment.
Why Clinical Reasoning Matters More Than Memorisation
One of the biggest lessons from the redesigned LDS Part 2 is that candidates need to demonstrate reasoning, not simply recall.
For example, knowing that a particular treatment is available is different from explaining:
- Why it is appropriate
- When it should not be used
- What alternatives exist
- What risks it carries
- How patient factors influence the decision
- How the treatment should be explained to the patient
This is closer to the type of decision-making expected in clinical practice.
The Importance of the GDC Safe Practitioner Framework
Candidates preparing for the LDS should understand the professional framework underpinning the assessment.
The current LDS regulations state that the examination assesses competencies from the GDC's Safe Practitioner Framework.
This means candidates should consider more than technical dentistry.
Preparation should also include:
- Professionalism
- Patient safety
- Communication
- Ethical decision-making
- Clinical judgement
- Self-management
- Appropriate escalation
- Working within competence
This broader approach is particularly important for internationally qualified dentists adapting to UK professional expectations.
How Many Attempts Are Allowed?
Under the current LDS regulations:
- Part 1: maximum of 4 attempts
- Part 2: maximum of 3 attempts
- Part 3: maximum of 3 attempts
All three parts must be completed within the applicable five-year currency period.
Candidates should also understand that an attempt limit does not guarantee an examination place.
RCS England states that places are allocated on a first-come, first-served basis, subject to eligibility, and candidates are not guaranteed a place every time they apply.
This makes preparation and booking strategy particularly important.
What Is the Biggest LDS Change Candidates Should Know?
If you remember only one change, remember this:
LDS Part 2 has moved from unseen cases to Structured Clinical Reasoning.
The new SCR format involves direct interaction with examiners and assesses diagnosis, management and treatment planning.
This means candidates need to become comfortable thinking clinically, explaining their decisions and communicating their reasoning under examination conditions.
What Do the LDS Changes Mean for UK Dental Recruitment?
The changes are also relevant to dental practices and recruiters.
The GDC expects international registration capacity to increase substantially through both the ORE and LDS routes. The regulator has suggested that the number of internationally qualified dentists joining the register could increase significantly over the coming years.
For dental practices, this could mean a larger pool of internationally qualified dentists entering the UK workforce.
However, passing the LDS is only one step.
International dentists may still need to:
- Complete registration requirements
- Meet right-to-work requirements
- Complete required additional training where applicable
- Understand UK clinical governance
- Adapt to UK professional expectations
- Secure suitable employment
- Develop familiarity with NHS or private practice systems
This creates opportunities for practices that have strong international dentist onboarding and mentoring processes.
What Should LDS Candidates Do in 2026?
Candidates should avoid relying on older LDS preparation materials without checking whether they reflect the current format.
Before preparing, confirm:
- The current LDS syllabus.
- The current candidate guidance.
- The current examination regulations.
- The latest Part 1, Part 2 and Part 3 formats.
- Current examination dates.
- Current examination fees.
- Eligibility requirements.
- Attempt limits.
- Current RCS England sample questions.
RCS England provides dedicated candidate guidance, syllabuses and sample questions for each stage.
LDS Exam Changes: Key Takeaways
The LDS pathway is changing significantly, but not necessarily in the way some online discussions suggest.
The key developments are:
- Part 2 has been redesigned.
- The previous unseen cases have been replaced by Structured Clinical Reasoning cases.
- The OSCE remains an important part of Part 2.
- The assessment is aligned with the GDC's Safe Practitioner Framework.
- LDS capacity is expanding substantially.
- 1,000 Part 1 places are planned for 2026.
- 2,000 Part 1 places per year are planned from 2027.
- Exam fees are being restructured.
- Official LDS pass-rate data is not currently published in the same way as ORE pass-rate data.
- Candidates should be cautious about unverified claims regarding recent LDS pass rates.
Final Thoughts
The LDS exam in 2026 is undergoing one of the most significant periods of change in recent years.
For internationally qualified dentists, the expansion of examination capacity is encouraging. More places could mean greater access to a UK registration pathway that has historically had limited capacity. RCS England plans to increase Part 1 capacity from 1,000 places in 2026 to 2,000 annually from 2027.
At the same time, candidates should not mistake increased capacity for an easier examination.
The revised LDS Part 2 places greater emphasis on structured clinical reasoning, communication and professional judgement. Candidates therefore need to prepare for the actual competencies being assessed rather than relying solely on memorisation or outdated preparation resources.
As international dentist registration becomes an increasingly important part of the UK's dental workforce strategy, the LDS is likely to remain an important pathway to watch.
For candidates, the best approach is simple:
Use the latest official guidance, understand the current exam format, prepare around clinical reasoning and check RCS England updates before booking.
Frequently Asked Questions
What is the LDS exam for dentists?
The Licence in Dental Surgery (LDS) is a three-part examination offered by the Faculty of Dental Surgery at the Royal College of Surgeons of England. It provides an examination route for eligible dentists, including overseas-qualified dentists, towards UK registration.
What changed in the LDS exam in 2026?
The most significant change is to Part 2. From the June 2026 diet, the previous unseen-case component was replaced by a Structured Clinical Reasoning (SCR) examination consisting of six 20-minute cases.
What is the LDS Part 2 pass rate?
RCS England does not currently publish a comparable, official sitting-by-sitting LDS pass-rate dataset. Recent reports have raised concerns about a low pass rate in a particular sitting, but the reported figure has not been independently verified through an official RCS England publication.
Is the LDS exam becoming harder?
The assessment format has changed, particularly in Part 2. RCS England has stated that the redesign does not represent a deliberate increase or decrease in the pass standard; rather, the assessment has been updated to reflect current professional standards and competencies.
How many LDS exam places are available?
RCS England announced 1,000 Part 1 places for new candidates in 2026 and plans to increase Part 1 capacity to 2,000 places per year from 2027. Part 2 and Part 3 capacity is also being expanded.
How many attempts are allowed for the LDS?
The current regulations allow up to four attempts for Part 1 and three attempts each for Parts 2 and 3. All three parts must be completed within the applicable five-year currency period.
Is the LDS easier than the ORE?
There is no reliable basis for saying that one route is simply easier. The LDS and ORE have different structures, assessment methods and candidate requirements. Candidates should compare the current eligibility criteria, exam format and preparation requirements before choosing a route.
