ORE Part 2 has entered a new era

You are no longer assessed against Preparing for Practice. The framework is now The Safe Practitioner.

Why it matters: this is not a rename. "Communication" has become "Interpersonal Skills", and "Management and Leadership" has been replaced by "Self-management" — the domain that covers your own time-keeping, insight, and knowing your limits. In the OSCE the domains are now scored individually, so the wording is the mark scheme, not a preamble.

A fifth grade — Borderline — has been inserted into the scale

Why it matters: the old scale forced an examiner who was undecided to round up or down. The new one lets them park you, and a parked candidate is then resolved by the standard-setting method — not by the examiner's gut. Medical Emergencies uses Clear Pass / Borderline Pass / Borderline Fail / Clear Fail as before, but the combination rule for those grades is new and brutal. See the ME section.

Watches are banned. So are smart devices and AI-enabled wearables.

What to do: practise every timed exercise without a watch on your wrist. In the DTP you still get the colour-coded clock face; in the Manikin the room clocks are no longer described in the guidance at all, so do not build a plan that depends on glancing at your own watch.

Arrive on your allotted time. Late means you do not sit.

What to do: the six-week window for reasonable adjustments is the one with a hard deadline you can miss months in advance. Diarise it the day you book.

Two new sections in all four papers: Irregularities, and Examination Regulations

What to do: if a handpiece fails, an actor goes off-script, or a station overruns, say so on the day. Walking out and complaining afterwards is now explicitly too late. And the recall groups people post in after the exam are, in the Consortium's own words, a breach of regulations.

Your examination may be recorded

Why it matters: mostly it does not change what you do — but it does mean professionalism lapses in the room are reviewable after the fact rather than resting on one examiner's memory.

The "UK undergraduate" benchmark did not disappear — it moved

Why it matters: when four documents drop a reassuring sentence at once it is easy to assume the bar has been raised. It has not. The standard is unchanged — it has simply been relocated from the station guidance into the specification that governs the whole exam, where it now applies to Part 1 and Part 2 alike. Aim at a safe, minimally competent UK graduate, exactly as before.

Three conditions added to the examinable list, and "fitting" is now "epilepsy"

What to do: the three scenarios you draw come from a question bank built on this list, so your odds of drawing something you have never rehearsed just rose. Prepare FAST and the stroke pathway; sepsis — red flags and the recognition-to-999 route in a dental setting, which is why the new guidance now cites the RCUK Quality Standards; and the deteriorating patient, which is an ABCDE assessment question in disguise. Rehearse ABCDE out loud until it is automatic — it is the spine of all three.

Oxygen in the published asthma answer is now 15 L/min, not 10 L/min

What to do: say 15 L/min. This is the one number in the whole ME paper that has visibly moved, and it is in the only worked example the Consortium publishes. Keep saying "via a spacer" and "4–6 activations" — the detail has been dropped from the printed answer, but it is still correct practice and still scores.

Resuscitation guidelines: 2015 → RCUK 2025

What to do: revise from the current RCUK site, not from a course handout dated 2015 or 2021. The Quality Standards reference is new in both places it appears and is where the sepsis and deteriorating-patient expectations live.

The pocket mask now has a one-way valve and a filter — and dropping them no longer voids your ventilations

What to do: the penalty has softened from losing the ventilation marks outright to being marked down on one aspect — but do not treat that as slack. Two components now have to stay in place instead of one, and mouth-to-mouth is still explicitly unacceptable in a healthcare setting. Handle the mask as an assembly: valve on, filter in, neither comes off.

You now need both examiners to pass you. One Borderline drags the whole scenario down.

Why it matters: two Borderlines is a fail. There is no averaging up. Unchanged and still decisive: the three scenarios and the BLS carry equal weight, there is no compensation between them — you must pass the scenarios and the BLS separately — and there is compensation between the three scenarios.

Both examiners now question you. There is no silent one taking notes.

What to do: stop budgeting your eight minutes as five-questions-times-three. The count is no longer fixed, so pace by clock, not by question. And you are being marked by whoever is speaking as well as whoever is not — address both examiners.

The published asthma answer swapped its numbers for descriptions

Do not read this as permission to drop the numbers. The examiners are told to reward answers that centre on clinical management, and a candidate who says "respiratory rate above 25, heart rate above 110" has given the description and the threshold. Keep the figures; just do not be thrown if the examiner accepts the qualitative answer from the person before you.

Nobody will tell you when you are halfway through

What to do: with no halfway prompt and no watch on your wrist, the 8-minute oral and the 5-minute BLS have to be paced by rehearsal. Practise BLS to a five-minute timer until the shape of it is muscle memory.

The shape of the paper is exactly as it was

Reassurance: your rehearsal structure survives intact. It is the content list, the oxygen figure, the guideline year and the mask that moved.

Open every station by stating your name and candidate number

What to do: this is the cheapest instruction in the entire rewrite and the easiest to forget under pressure at station 11 of 15. Bolt it to the front of your station routine now, in every practice run, so it survives the day: name, candidate number, then greet the patient.

New: you may be asked "What would you like to examine?" — and you must answer in two parts

What to do: rehearse naming examinations out loud in a fixed order — extra-oral, intra-oral soft tissues, hard tissues, periodontal, occlusion, special tests — with a one-line method for each ("I'd palpate the submandibular and cervical nodes bilaterally from behind"). Naming it is half the mark; describing the method is the other half. And ask permission every time: it is now written into the guidance, not implied.

Every station is now scored on three named SPF domains plus an overall judgement

What to do: a technically perfect station can now be marked down on a domain you did not realise was live. Before each practice station, ask which three domains it is testing. A consultation station is almost certainly clinical + interpersonal + professionalism; a station where you must finish inside five minutes and know when to stop is testing self-management.

Marking method: aggregated percentages → Borderline Regression

The numbers behind it, from the Examination Specification published on the same page: 16 marks per station, 240 marks in total across the 15 live stations. Read this carefully: each station now has its own cut-off, derived from how the examiners graded the candidates they judged borderline. The old sentence reassuring you that one bad station would not sink you has been removed, and the new document does not state a replacement compensation rule either way. Do not assume you can write off a station.

Twenty stations, fixed. Pilot stations and double stations are gone.

What to do: the maths is now knowable — 15 stations that all count, 5 breaks, 20 × 6 = 120 minutes. Every station you walk into is scored, so the old habit of wondering whether one was a pilot is dead. Build your practice circuits as 15-of-15.

The folder and the colour answer sheets have gone

What to do: the circuit is now overwhelmingly face-to-face rather than a mix of manned and paper stations. Weight your preparation accordingly — more talking, less silent form-filling.

Nine skill categories replaced by four station types

What to do: the old list told you what was tested; the new one tells you what the room looks like. The skills have not disappeared — they have been folded into the domains. Prepare by station type, and score yourself by domain.

The published example changed from a consent script to an open consultation

What to do: the example has moved from a scripted explanation to a cold-start consultation where you must reach a diagnosis and a follow-up plan inside five minutes. The old published mark grid is gone, so those eight rows are no longer a checklist you can drill — but the behaviours in it still map onto interpersonal skills and professionalism. Practise the toothache consultation to a five-minute timer and finish with a named diagnosis, a plan, and a review interval.

The "stay for the full five minutes" rule is no longer written down

Do not misread this. Nothing says you may now leave a station early, and with a fixed 20-station circuit everyone still moves together. Treat the five minutes as yours to use: if you finish, check your work, offer the patient a chance to ask questions, or summarise. Walking out early has never scored anything, and the removal of the sentence does not change that.

There is now a DTP Guidance Video — and it will not be played on the day

Where it is: orepart2.org.uk/dtp-guidance-video — linked from the Guidance page as "DTP Guidance Video (watch before attending the DTP exam)". It is a self-hosted MP4, no sign-in needed. This is the only place in the four documents where the Consortium points at required preparation outside the PDFs, and it explicitly closes the door on catching up at the venue.

Stage 3 now asks for a definitive diagnosis, not just a treatment plan

What to do: once the special investigations and radiographs come back, explicitly revise your provisional diagnosis into a definitive one and write it down. Candidates trained on the old paper go straight from artefacts to treatment options and never state the diagnosis a second time. That is now a named expectation.

Five graded areas, plus a separate global judgement on a five-point scale

Why it matters: the global judgement is a whole-performance impression that sits alongside the five itemised areas — so a candidate who ticks boxes without ever looking like a safe clinician can be marked down on the overall view. Aim for a coherent consultation, not five separately-optimised sections.

The radiographic report specification has been deleted — but you still have to write the report

This is the single most valuable thing on this page. The task has not changed — only the guidance that told you how to pass it. Use the old specification as your report template anyway: view · side · teeth present · bone level and quality · restorations · caries · other findings · film quality and faults. And keep reporting from the real radiograph, not the printed thumbnail on the form.

The cost guidance has gone. So has the artefact-checking instruction.

What to do: the exemption from quoting costs is no longer written down, so handle cost the safe way — relative, never absolute ("an implant is considerably more expensive than a denture"). And check your artefacts against what you were told to expect regardless; the instruction has gone, the risk of a missing cast has not.

Two examiners are now stated to be present for history taking

What to do: expect two people watching you take the history, and do not let a silent second examiner unsettle you. Everything else in Stage 1 is unchanged, including the rule that you may not examine the patient or their mouth.

The special-investigations examples have been trimmed

What to do: both lists are explicitly non-exhaustive, so nothing is forbidden. Keep requesting a cracked tooth test when the history points at one — but justify it, because the guidance still insists you request "only investigations relevant to diagnosis and treatment planning", and an unjustified shopping list has always cost marks.

The published scenario is the same case, stripped of half its detail

What to do: practise on this exact case — it is the Consortium's own worked scenario and the clinical core is unchanged. But treat the old, fuller version as the better rehearsal: the medication list, the cola habit, the clenching and the gagging history are precisely the things a good history extracts, and the examiner's role-player brief will still contain material the printed example does not show you.

The clock, the four stages and the colour-coded forms are untouched

Reassurance: every timing drill you have already done still applies. Do not rebuild your DTP practice — extend it.

Stage 4 now has a published six-point structure — including "explain the diagnosis"

What to do: use these six as your running order in the last ten minutes — they are effectively a mark sheet the Consortium has published. Two are easy to drop under pressure: opening with the diagnosis (candidates jump straight to options), and maintenance (they cover risks but forget review and upkeep).

The written treatment plan must now contain five named elements

What to do: the substance is close to the old wording, but it is now five explicit headings — so write your plan under those five headings. It costs nothing, it guarantees you cannot omit one, and it makes the marker's job trivial. "Preventive advice and maintenance" is the heading candidates most often leave blank.

New exercise: all-ceramic crown preparation, with two different material specifications

Table scrolls sideways →

Table scrolls sideways →

What to do: learn these as a separate set — do not carry over the gold-crown numbers. Three things catch people: the taper is tighter (8°–12°), zirconia needs far less reduction than e.max, and zirconia explicitly forbids a feather or knife edge. Path of insertion and surface finish requirements are the same as the other crowns.

New exercise: Class II in composite — with a 2 mm increment rule

What to do: box dimensions match the amalgam Class II — gingival floor clearing the contact by ~0.5 mm, bucco-palatal clearance ~0.5 mm, occlusal lock ~2 mm deep. What is new is the technique marking: incremental placement in ≤2 mm layers, and the undesirable list now includes voids present and excess left on the margin or interproximally. Practise placing and curing in visible increments where an examiner can see you doing it.

Class I occluso-palatal: the lining moved from the pulpal floor to the axial wall

What to do: this is the only desirable-feature wording in the whole Manikin paper that changes where you physically put material, and it is one word buried in a table — which is exactly why it is worth knowing. The depth and width figures for this cavity are unchanged: ~2 mm deep, ~1.5 mm wide, parallel walls with rounded internal line angles.

Exceeds Standard has been softened from "all" to "all, or nearly all"

Why it matters: the top grade is now reachable without perfection, which matters because an Exceeds in a major exercise is what buys you compensation elsewhere. Meets, Below and Well Below keep their old definitions almost word for word — except that Well Below has dropped the line about the candidate being "unaware of the poor performance".

The compensation rule is now published — and the minor exercise cannot rescue a major one

What to do: spend your time proportionally. A brilliant minor exercise is worth far less than a solid major one, and if you must let something slip, it cannot be a major. Unchanged and still absolute: you must pass the Exercises and Safe Practice sections separately.

The instrument tray has been rebuilt — the gingival margin trimmer is gone

What to do: if your cavity technique depends on a gingival margin trimmer to finish the gingival floor of a Class II box, rebuild it now — the instrument is not on the published tray. Same for the American patterned probe, the ball burnisher and the flat fissure steel burs. You gain a second excavator, a Williams 14W and, usefully, a ruler. The high-speed bur list is unchanged: tungsten carbide 170, 330, 331, 331L, 56, 557 and diamonds L767C, L767VF, 170L, 260.8F, 120C, 285.5VF.

The entire exam-day briefing section has been deleted from the document

Read this carefully: nothing published says these practices have stopped. A skills lab still runs on hand-raising, still calls time, and still expects covered shoes. Treat the whole of the old list as live working practice — because the two items with real marks attached, preparing the wrong tooth and failing to stop when time is called, both still map onto Safe Practice and Professionalism, which are still separately assessed and still capable of failing you on their own.

Class II amalgam now says the caries may be mesial, distal, or both

What to do: the old paper already warned that a Class II "could be an MO or a DO or an MOD", but the instruction line now says it too. Rehearse the MOD — two boxes, two matrix considerations, one occlusal lock — to the same standard as a single-box MO. All box dimensions are unchanged.

Operating position, finger rests and infection control are word-for-word the same

Reassurance: the Safe Practice grade descriptors are also unchanged — Exceeds means appropriate position, correct finger rest and full infection control; Meets tolerates occasional lapses; Below and Well Below describe frequent lapses continuing "despite repeated warnings by the examiners".