Comparison of examinations required for dental license in Japan and China：considerations on the training of dental professionals under the background of globalization

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This paper offers a comparative analysis of the dental qualification examination systems in Japan and China, focusing on their legal frameworks, examination structures, and evolving trends in dental education. Methods This study uses examination guidelines and score analyses from China's National Oral Practitioner Qualification Examination Committee and Japan's Ministry of Health, Labor and Welfare. Through literature and comparative research, it analyzes recent reforms in oral practitioner exams in both countries and explores future trends in oral physician talent training, focusing on examination content, cognition, and priorities. Results Through the study of the current status and future development trends of the examination system in China and Japan, it is found that although the qualification standards and examination forms are different, they are all guided by job competency and examine the clinical diagnosis and treatment ability and the basic requirements for physician access. In the context of globalization and aging society, increasing comprehensive health management and preventive health care to cope with the aging society, the application of traditional Chinese medicine in oral treatment, and international health issues accompanying medical globalization will become future development trends. Conclusion The findings suggest that while both countries share similar competency standards, there is potential for harmonizing licensure procedures and examination formats to support a more globally interconnected dental workforce. 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F1000Research 2026, 15 :448 ( https://doi.org/10.12688/f1000research.173878.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Comparison of examinations required for dental license in Japan and China：considerations on the training of dental professionals under the background of globalization [version 1; peer review: 1 approved with reservations] Huan Tang https://orcid.org/0009-0009-4358-3019 1 , Kejai Zhang 1 , Wei Wang 1 , Zhendong Wang 1 , Bin Yan 1 Huan Tang https://orcid.org/0009-0009-4358-3019 1 , Kejai Zhang 1 , [...] Wei Wang 1 , Zhendong Wang 1 , Bin Yan 1 PUBLISHED 27 Mar 2026 Author details Author details 1 Department of Orthodontics, The Affiliated Hospital of Stomatology, Nanjing Medical University; State Key Laboratory of Cultivation Base of Research, Prevention and Treatment for Oral Diseases; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China Huan Tang Roles: Conceptualization, Funding Acquisition, Writing – Review & Editing Kejai Zhang Roles: Data Curation, Formal Analysis Wei Wang Roles: Investigation, Supervision, Validation Zhendong Wang Roles: Writing – Review & Editing Bin Yan Roles: Funding Acquisition, Supervision OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background The global landscape of dental education is evolving rapidly, driven by the increasing mobility of dental professionals and the growing demand for standardized qualifications across borders. This paper offers a comparative analysis of the dental qualification examination systems in Japan and China, focusing on their legal frameworks, examination structures, and evolving trends in dental education. Methods This study uses examination guidelines and score analyses from China's National Oral Practitioner Qualification Examination Committee and Japan's Ministry of Health, Labor and Welfare. Through literature and comparative research, it analyzes recent reforms in oral practitioner exams in both countries and explores future trends in oral physician talent training, focusing on examination content, cognition, and priorities. Results Through the study of the current status and future development trends of the examination system in China and Japan, it is found that although the qualification standards and examination forms are different, they are all guided by job competency and examine the clinical diagnosis and treatment ability and the basic requirements for physician access. In the context of globalization and aging society, increasing comprehensive health management and preventive health care to cope with the aging society, the application of traditional Chinese medicine in oral treatment, and international health issues accompanying medical globalization will become future development trends. Conclusion The findings suggest that while both countries share similar competency standards, there is potential for harmonizing licensure procedures and examination formats to support a more globally interconnected dental workforce. READ ALL READ LESS Keywords Clinical skill test/ examination for dental licensing examination；Dental education; Globalization Corresponding Author(s) Bin Yan ( [email protected] ) Close Corresponding author: Bin Yan Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2026 Tang H et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Tang H, Zhang K, Wang W et al. Comparison of examinations required for dental license in Japan and China：considerations on the training of dental professionals under the background of globalization [version 1; peer review: 1 approved with reservations] . F1000Research 2026, 15 :448 ( https://doi.org/10.12688/f1000research.173878.1 ) First published: 27 Mar 2026, 15 :448 ( https://doi.org/10.12688/f1000research.173878.1 ) Latest published: 27 Mar 2026, 15 :448 ( https://doi.org/10.12688/f1000research.173878.1 ) Introduction The evolution of dental practice qualification examination and the international movement of dental professionals highlight a rapidly transforming landscape in global dental education. 1 Both Japan and China, despite their differing cultural contexts and educational models, have recognized the importance of establishing robust dental qualification exams. The National Examinations for Dentists (NED) in Japan, launched in 1954, and China's annual dental qualification exams since 1999, share the common objective of ensuring that dentists possess the necessary skills and knowledge for effective practice. 2 , 3 The globalization of dental education is multifaceted. 4 , 5 One aspect is the increasing number of dental students who pursue education and career opportunities across borders. The growth of international health courses and cross-border learning through digital media have further expanded this trend. This interconnectedness has also facilitated the migration of dental professionals between countries, which is referred to as “global interconnectedness”. 6 , 7 As patients travel abroad for treatment, the need for globally recognized qualifications and standardized licensure requirements becomes more pressing. 8 With the rapid development of information technology and the proliferation of online education, there is now the potential to transcend traditional boundaries in dental education. Educational technologies can create opportunities for global learning, where students can access resources, attend international courses, and collaborate with peers from various parts of the world. There will be a trend of transcending time and space in talent training. 9 However, despite these global trends, there are significant variations in dental education systems and licensure requirements between countries. Different licensure requirements limit the globalization, operation and survival of dental practice and education worldwide. 8 , 9 Therefore, understanding the differences in the examination systems of dental practice in different countries in the context of globalization will help to continuously improve and develop dental practice examination system. While China and Japan have similar basic standards for dentist competency, their examinations and licensure procedures differ in structure and content. This study provided a comparative analysis of the qualification examination for dental practitioners based on the authors’ experience with both NED and China dental practice qualification system. By examining the educational frameworks and the systems in place for evaluating dental practitioners in both nations, this paper will explore potential reform ideas aimed at improving the qualification examination system and further enhancing the training of dental talents in response to globalization and evolving dental care demands. Methods The study was approved by the Ethical Committee Department of the Affiliated Hospital of Stomatology, Nanjing Medical University (PJ2025-095-001). Informed consent for participation in this study was waived by the Ethical Committee Department of the Affiliated Hospital of Stomatology, Nanjing Medical University, because the research involved the analysis of existing, anonymized data, and the study presented no more than minimal risk to the participants. This study involved a comprehensive literature review and comparative analysis to examine the dental practice qualification examinations in China and Japan, focusing on recent reforms and trends in the training of oral practitioners. The materials and methods employed in this study are outlined below: Literature retrieval and data extraction The Chinese, Japanese, and English literature were searched by the same researcher, who ensured that the relevant sources were up to date and comprehensive. The literature review process involved identifying research articles, policy papers, official announcements, and examination outlines related to dental practice qualification systems in China and Japan. Databases: Major academic and professional databases such as PubMed, Google Scholar, CNKI (China National Knowledge Infrastructure), and Japanese government websites were used for data retrieval. Comparison of examination standards The latest NED (National Examination for Dentists) question standards, issued by Japan’s Ministry of Health, Labor, and Welfare in 2024, were used for comparison with the newly revised Chinese Oral Practitioner Examination Outline in 2024. Examination results and pass rates The study used the 2024 NED pass rate data provided by the Ministry of Health, Labor, and Welfare of Japan. Similarly, the 2024 Chinese Oral Practitioner Examination results analysis data were accessed from the National Medical Examination Center. These results allowed for a direct comparative analysis of the pass rates, which serve as an indicator of how well the examination systems align with the professional competencies required for dental practice. In general, literature research and comparative research methods were used to carefully review the materials, analyze the Chinese and Japanese oral practitioner examinations and their reforms in recent years, and explore the reforms and trends in the future training of oral physicians from the aspects of examination content, examination cognition, and examination focus. Results 1. Legal provisions and registration conditions The Japanese dental practitioner qualification examination is strictly governed by the “Dentist Law”, which outlines the legal framework for becoming a licensed dentist in Japan. 10 The following key articles from the law define the eligibility criteria and registration conditions for the National Examination for Dentists (NED): Article 2: To be officially recognized as a dentist in Japan, an individual must pass the National Examination for Dentists (NED) and obtain a dentist qualification certificate issued by the Minister of Health, Labor and Welfare. Article 11: To be eligible to sit for the NED, applicants must meet at least one of the following conditions: 1. Domestic Academic Route: Complete a regular dental course at a Japanese university accredited under the School Education Law (Law No. 26 of 1948) and successfully graduate. 2. Preparatory Route with Clinical Training: Successfully pass the NED preparatory examination, followed by more than one year of clinical training that focuses on oral hygiene diagnosis and treatment. 3. Foreign Graduates or Overseas Qualifications: Graduate from a foreign dental school or hold a foreign dentist qualification, and receive official recognition from the Minister of Health, Labor and Welfare that their academic qualifications and clinical competencies are equivalent to or exceed the standards of the first two domestic routes. These provisions clearly emphasize the importance of formal education, clinical experience, and official government recognition for maintaining the high standards expected in Japan’s dental profession. The inclusion of a pathway for foreign-trained dentists indicates Japan’s openness to international qualifications, but also highlights the stringent review process to ensure equivalency in education and clinical competency. Moreover, in line with the recommendations from the Dental Practitioners Council, the Dental Practitioners Act was partially amended on May 28, 2021. The key changes include: Eligibility for the National Examination: Passing the common examination is now a requirement to be eligible for the national dental examination. Clarification on Clinical Training: It is legally confirmed that students who pass the common examination can engage in clinical practice under the supervision of a licensed dentist. The specific articles of the law were updated: Article 11, Section 1: Specifies that students must pass a common exam as defined by the Ministry of Health, Labour, and Welfare before beginning clinical practice. Article 17, Section 2: Allows students to perform dental procedures under the supervision of a dentist during their clinical training. The Chinese oral practitioner examination is primarily governed by the “Practicing Physician Law of the People's Republic of China”, which lays out the legal framework for obtaining the necessary qualification to practice as a dentist in China. 11 Below are the key provisions and conditions based on this law: Article 8 of the law specifies the structure of the physician qualification examination and outlines the two main components of the exam: Practical Skills Test: This test assesses the hands-on abilities of candidates in performing essential dental procedures. 11 Comprehensive Medical Written Test: Only those who pass the practical skills test are eligible to sit for the comprehensive written test, which covers a broad range of theoretical medical knowledge and dental science. Eligibility Criteria for Applicants: The following are the basic requirements for individuals seeking to apply for the oral practitioner qualification: Undergraduate and Above: Candidates must hold a bachelor’s degree or higher in a related medical field from an accredited institution. In addition, they must have completed at least one year of practical work in a medical or health institution under the supervision of a practicing physician. Secondary Vocational and Practicing Assistant Path: Alternatively, candidates who have a degree in a related medical field from a secondary vocational school, have obtained a practicing assistant physician's license, and have worked for five years in a medical or health institution are also eligible to apply for the oral practitioner examination. 2. Question content and format 2.1 Examination guide Both NED and China’s oral practitioner qualification examination have undergone significant revisions over the years to adapt to evolving healthcare needs and international trends. The NED examination system is regularly revised every four to five years. The most recent revision was announced in 2023 by Japan's Ministry of Health, Labor, and Welfare, incorporating several key changes to keep up with evolving global healthcare trends. The outline points out a new focus was added to address the role of Chinese medicine in treating elderly patients and individuals with systemic diseases, as well as international health issues accompanying the globalization of medical care. In addition, knowledge will increase not only in the oral field, but also in areas related to systemic diseases and traditional Chinese medicine. In addition to the current provision system that mainly focuses on oral outpatient treatment, the oral health care services previously provided will also be expanded to medical care for inpatients and people recuperating at home, with more emphasis on the community comprehensive care system and multidisciplinary collaboration. In 1999, China established and implemented the physician qualification examination system, promulgated the physician qualification examination outline for the first time, and revised it four times in 2002, 2009, 2013 and 2019. In order to comprehensively consider the new requirements for the basic qualities of doctors in the new era, and to re-examine the positioning of dentists with job competency as the orientation, the new outline was revised in 2023. The new outline has been increased from the original five parts to six parts. Among them, the medical humanities comprehensive has added the “Medical Waste Management Regulations” and deleted the “Maternal and Child Health Law and Its Implementation Measures”; the content and concepts of the medical ethics part have been revised; in addition, the new outline emphasizes the comprehensive clinical application of stomatology and the prevention of oral diseases. Adhere to prevention first and the integration of medical and prevention, and pay attention to the theory and skills of clinical prevention services and population health management. Emphasize “infection and control in oral health care” and highlight occupational protection and environmental disinfection. 2.2 Exam format and question types NED does not involve practical skills test. The NED is a written examination held over two days, with a total of 360 questions divided into four units. The total possible score is 560 points, and each unit consists of 90 questions, with a duration of 135 minutes per unit. It includes compulsory questions (80 questions, a total of 80 points), general questions (180 questions, a total of 180 points), and clinical field questions (100 questions, 3 points each, a total of 300 points). The passing standard for compulsory questions requires more than 80% correct answers. The passing standard for general questions and clinical questions is determined by the average score and standard deviation. NED question types include: Type A, Type X2, Type X3, Type X4, Type XX, Type LA, calculation problems and sequence problems. Each question type likely has its specific purpose, testing different aspects of dental knowledge, from theoretical understanding to practical application in clinical scenarios. 12 , 13 The Chinese Stomatological Practitioner Examination is divided into a practical skills test, which is held in June every year.this test involves multiple stations where candidates demonstrate their hands-on clinical skills in a simulated environment. Passing this practical skills test is a prerequisite to taking the written exam. The written test takes 2 days and is divided into 4 units; each unit is two hours. The written test is all in the form of multiple-choice questions. The total number of questions is about 600. A total score of 360 or above is considered a pass. 2.3 Cognitive level of the exam Generally speaking, in evaluating the cognitive demands of dental qualification examinations, educational theory typically divides cognitive levels into three classes, reflecting the depth of processing required to answer questions. The first type of question is a memory question to recalling facts and definitions. The second type of question is an understanding question to grasping meaning, interpreting data, or identifying relationships. The third type of question is an application question to applying knowledge in clinical or problem-solving contexts. The NED is intentionally structured to reflect a progressive cognitive model, with distinct question categories aligning with different cognitive levels. We believe that the compulsory questions in NED belong to the first type of questions, which can be answered by simply memorizing the questions of previous years and basic knowledge. General questions refer to questions that do not specify conditions such as gender and age, and test knowledge about a given topic such as a disease or pathology, which belong to the second type of questions. Clinical questions, on the other hand, require specific conditions such as the patient's gender, age, and actual cases to test the problem-solving and thinking abilities cultivated through clinical training. They belong to the third type of questions. The proportion of NED is 14% for the first type, 32% for the second type, and 54% for the third type. In the analysis report of the Chinese Oral Practitioner Examination, taking 2021 as an example, the memory type accounts for about 12%. The understanding type accounts for about 39%, while the application type questions account for about 49%. 3. Comparison of pass rates Based on the test score data provided by the Ministry of Health, Labor and Welfare of Japan and National Medical Examination Center of China the pass rates of new graduates in the past four years were compared and analyzed, see Table 1 . Table 1. The pass rates of new graduates of China dental Examination and NED. Number of China practical examination Practical examination pass rate Number of comprehensive examination Comprehensive examination pass rate Overall pass rate Number of Japanese NED examination NED examination pass rate 2021 8069 93.38 7459 77.42 71.57 2103 80.2 2022 8680 93.02 7992 71.65 65.97 1999 77.1 2023 8753 92.69 8054 76.71 70.58 1919 77.3 2024 9375 92.74 8643 85.51 78.83 1962 81.5 Discussion The globalized nature of modern healthcare, coupled with the increasing demand for high-quality dental care, makes it essential to understand the training strategies and qualification examinations for dental practitioners across different countries. Through a comparative study of the syllabus, current status and future development trend of the National Examination for Dental Practitioners in China and Japan, combined with the current oral medicine education and Qualification Examination model of Dental Practitioners in China, this paper explores the reform ideas for further reforming and improving the Qualification Examination system for Dental Practitioners and the training of dental talents under the background of globalization. The examination format and qualification standards between China and Japan are different. Differences in examination format: NED has no clinical practice ability, which may be related to their undergraduate oral medicine education. While clinical knowledge is tested through scenarios, there is no hands-on assessment of clinical skills or direct patient interaction. This may be due to the structure of Japan's undergraduate dental education. 12 , 14 , 15 Before entering clinical internship in the sixth year, undergraduates need to take CBT and OSCE before clinical internship. The current Qualification Examination for Dental Practitioners in Japan cannot fully evaluate the clinical diagnosis and treatment ability after the sixth year of clinical internship. To ensure fair and consistent assessments across the dental education system in Japan, The OSCE reform focuses on creating a standardized and reliable way to evaluate dental students' clinical skills. This includes improving evaluator training, establishing clear criteria for evaluation, and standardizing the use of simulated patients. The reforms are currently being tested through trial projects in Japan. 16 , 17 On the other hand, in terms of exam format，China transitioned to computerized exams in 2017, while Japan has yet to implement computer-based examinations. Examination system for foreigners: The qualification examination systems for foreign dental practitioners in both Japan and China have distinct rules and procedures that are tailored to ensure that foreign-trained dentists meet the standards required to practice within each country. NED allows those who hold foreign dental practice qualifications or graduate from foreign dental schools to take the NED examination after passing the NED preparatory examination. The preparatory examination focuses on Japanese diagnosis and treatment ability and clinical practice ability. China currently stipulates that foreigners who have obtained academic qualifications in China and Chinese citizens who have obtained academic qualifications abroad can take the dental practitioner examination. However, for those who hold foreign academic qualifications or foreign dental practice qualifications, if they are invited or employed to engage in clinical diagnosis and treatment activities in medical institutions in China for no more than one year, they should undergo corresponding assessments and registration before they can engage in relevant diagnosis and treatment activities. In 2023, both China and Japan revised the outlines of their dental practice examinations, introducing new content that reflects the growing needs and challenges in the healthcare sector, particularly in response to aging populations, globalized medicine, and interdisciplinary collaboration. These updates highlight the countries' shared priorities in enhancing the competency of dental professionals and adapting to global health trends. Pointing out the addition of the following contents: 1. Content related to the use of traditional Chinese medicine by the elderly and people with systemic diseases. 2. Add content on changes in dental treatment due to changes in disease structure such as aging. 3. Promote relevant content such as community comprehensive care system and multidisciplinary collaboration, and focus on the theory and skills of clinical preventive services and population health management. 4. Content on the maintenance and improvement of oral function and dental treatment of dietary dysfunction. 5. Emphasize “Infection and control in oral health care related to medical safety, shock response, professional ethics, etc.” 6. International health issues accompanying the globalization of medicine. It can be seen that in order to cope with the current aging society and globalized medicine, the trends of the Chinese and Japanese oral physician qualification examination reforms are consistent and can learn from each other. In addition, it is worth mentioning that the recent study demonstrating that GPT-4 could successfully pass both the US INBDE (Integrated National Board Dental Examination) and the UK ORE (Overseas Registration Exam) highlights a pivotal shift in the role of artificial intelligence (AI) in dentistry. As GenAI continues to advance, it could revolutionize knowledge acquisition, decision-making, and patient management in dentistry. Traditional exams that focus on memorization of static knowledge may need to evolve to assess dynamic competencies, such as the ability to integrate AI tools into clinical reasoning. Practical exams and assessments may increasingly involve the use of AI technologies to simulate clinical scenarios. 18 , 19 Conclusion In summary, the examination systems for dental practice in Japan and China, though rooted in different educational and cultural traditions, share common goals. As the global dental landscape becomes more interconnected, there is a pressing need to explore how these systems can be harmonized to facilitate greater mobility of dental professionals and improve global health outcomes. Data availability The datasets supporting the findings of this study are derived from publicly available sources. The original data can be accessed from: Japanese Ministry of Health, Labour and Welfare (MHLW): https://www.mhlw.go.jp/english/ Chinese National Medical Examination Center: http://www.nmec.ort.cn./ The data are made available by these government entities as public information. Although not explicitly tagged with a standard open license, their publication policies permit reuse for academic and research purposes, aligning with the principles of open data. As this study utilizes data collected and aggregated from multiple public domain sources, a specific DOI for the combined dataset was not created. The data are freely accessible without any embargo or login restrictions via the provided links. References 1. Schleyer T, Eaton KA, Mock D, et al. : Comparison of dental licensure, specialization and continuing education in five countries. Eur. J. Dent. Educ. 2002; 6 (4): 153–161. PubMed Abstract 2. Heo SM, Kim KJ, Kawamura M, et al. : Comparison of the dental education systems in Korea and Japan. Int. Dent. J. 2004; 54 (2): 70–72. PubMed Abstract 3. Komabayashi T, Zhu Q, Jiang J, et al. : Education of dentists in China. Int. Dent. J. 2006; 56 (5): 272–276. PubMed Abstract 4. De Vries J, Murtomaa H, Butler M, et al. : The global network on dental education: a new vision for IFDEA. Eur. J. Dent. Educ. 2008; 12 Suppl 1 : 167–175. PubMed Abstract | Publisher Full Text 5. Zarkowski P, Gyenes M, Last K, et al. : 5.1 The demography of oral diseases, future challenges and the implications for dental education. Eur. J. Dent. Educ. 2002; 6 Suppl 3 : 162–166. PubMed Abstract | Publisher Full Text 6. Balasubramanian M, Brennan DS, Spencer AJ, et al. : The 'global interconnectedness' of dentist migration: a qualitative study of the life-stories of international dental graduates in Australia. Health Policy Plan. 2015; 30 (4): 442–450. PubMed Abstract | Publisher Full Text 7. Balasubramanian M, Brennan DS, Spencer AJ, et al. : The international migration of dentists: directions for research and policy. Community Dent. Oral Epidemiol. 2016; 44 (4): 301–312. PubMed Abstract | Publisher Full Text 8. Ramírez de Arellano AB: Patients without borders: the emergence of medical tourism. Int. J. Health Serv. 2007; 37 (1): 193–198. PubMed Abstract | Publisher Full Text 9. Edwards G, Spooner M, Arnett R, et al. : Transnational medical education programmes and preparation for different country medical practice: A systematic review. Med. Educ. 2025; 59 (9): 924–937. PubMed Abstract | Publisher Full Text 10. Ministry of Health, Labor and Welfare of Japan. (In Japanese) (Lasted access May 2025) Reference Source 11. Chinese Society of Stomatology. (In Chinese) (Lasted access May 2025). Reference Source 12. Komabayashi T, Bird WF: Comparison of written examinations required for dental licensure in Japan and the United States: contents, cognitive levels, and cultural implications. J. Dent. Educ. 2005; 69 (8): 930–936. PubMed Abstract 13. Komabayashi T, Raghuraman K, Raghuraman R, et al. : Dental education in India and Japan: implications for U.S. dental programs for foreign-trained dentists. J. Dent. Educ. 2005; 69 (4): 461–469. PubMed Abstract 14. Wang CY, Wang N, Sun Y, et al. : National examinations for dentist in Japan and implications. Shanghai journal of stomatology. 2011; 20 (6): 658–661. PubMed Abstract 15. Ye CC, Zhang Y, Hiroaki K: Dental trainings in academia: A comparison of dental education systems between China, Japan, and the US. Chin J Stomatol Res. 2021; 15 (3). (In Chinese). 16. Moriyama N: A century of modern dental education in Japan: the history of the Tokyo Dental College. Bull. Hist. Dent. 1993; 41 (3): 97–101. PubMed Abstract 17. Kimura Y, Miyashira H, Hasegawa T, et al. : “Tooth examination” as a subject of OSCE for assessment of undergraduate students at the end of clinical dental education. J Jpn Dent Educ Assoc. 2004; 19 (2): 249–258. (In Japanese). 18. Liu M, Okuhara T, Huang W, et al. : Large Language Models in Dental Licensing Examinations: Systematic Review and Meta-Analysis. Int. Dent. J. 2025; 75 (1): 213–222. PubMed Abstract | Publisher Full Text 19. Kawahara T, Sumi Y: GPT-4/4V's performance on the Japanese National Medical Licensing Examination. Med. Teach. 2025; 47 (3): 450–457. PubMed Abstract | Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 27 Mar 2026 ADD YOUR COMMENT Comment Author details Author details 1 Department of Orthodontics, The Affiliated Hospital of Stomatology, Nanjing Medical University; State Key Laboratory of Cultivation Base of Research, Prevention and Treatment for Oral Diseases; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, 210029, China Huan Tang Roles: Conceptualization, Funding Acquisition, Writing – Review & Editing Kejai Zhang Roles: Data Curation, Formal Analysis Wei Wang Roles: Investigation, Supervision, Validation Zhendong Wang Roles: Writing – Review & Editing Bin Yan Roles: Funding Acquisition, Supervision Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 27 Mar 2026, 15:448 https://doi.org/10.12688/f1000research.173878.1 Copyright © 2026 Tang H et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Tang H, Zhang K, Wang W et al. Comparison of examinations required for dental license in Japan and China：considerations on the training of dental professionals under the background of globalization [version 1; peer review: 1 approved with reservations] . F1000Research 2026, 15 :448 ( https://doi.org/10.12688/f1000research.173878.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 27 Mar 2026 Views 0 Cite How to cite this report: Chau RCW. Reviewer Report For: Comparison of examinations required for dental license in Japan and China：considerations on the training of dental professionals under the background of globalization [version 1; peer review: 1 approved with reservations] . F1000Research 2026, 15 :448 ( https://doi.org/10.5256/f1000research.191731.r471752 ) The direct URL for this report is: https://f1000research.com/articles/15-448/v1#referee-response-471752 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 01 Apr 2026 Reinhard Chun Wang Chau , The University of Hong Kong, Hong Kong, Hong Kong Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.191731.r471752 Thank you. It was an interesting read. This reviewer has only some comments. 1. A detailed search strategy, keywords, date ranges, inclusion/exclusion criteria, or a PRISMA-style flow diagram were all missing from the manuscript. 2. Data extraction seemed to ... Continue reading READ ALL Thank you. It was an interesting read. This reviewer has only some comments. 1. A detailed search strategy, keywords, date ranges, inclusion/exclusion criteria, or a PRISMA-style flow diagram were all missing from the manuscript. 2. Data extraction seemed to be performed by only 1 person, without any dual review or inter-rater reliability. 3. Despite being named "globalization," the study was limited to two countries and relied almost exclusively on official guidelines and aggregated pass-rate data. There was no justification for excluding other Asian or global systems. 4. Pass rates were presented clearly but received no statistical treatment. 5. Cognitive-level breakdown was kind of approximate and subjective. There seemed to be a relative lack of quantitative content mapping. 6. It would be great to have a structured matrix or scoring rubric for the exam format and legal framework comparisons. 7. This reviewer would highly recommend performing a trend analysis of pass-rate divergence/convergence over time, and some subgroup analyses, like comparing local candidates and foreign candidates. 8. There needed to be a deeper evaluation of how outline revisions might have quantitatively shifted question distributions. 9. Professional English editing would be recommended. 10. Here are some references for the authors, as they mentioned GPT and dental licensing exams: -(refer to 1,2,3,4,5) Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? No Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly References 1. Chau R, Thu K, Yu O, Hsung R, et al.: Performance of Generative Artificial Intelligence in Dental Licensing Examinations. International Dental Journal . 2024; 74 (3): 616-621 Publisher Full Text 2. Chau R, Thu K, Yu O, Hsung R, et al.: Evaluation of Chatbot Responses to Text-Based Multiple-Choice Questions in Prosthodontic and Restorative Dentistry. Dentistry Journal . 2025; 13 (7). Publisher Full Text 3. Rokhshad R, Zhang P, Mohammad-Rahimi H, Pitchika V, et al.: Accuracy and consistency of chatbots versus clinicians for answering pediatric dentistry questions: A pilot study. Journal of Dentistry . 2024; 144 . Publisher Full Text 4. Rokhshad R, Mohammad F, Nomani M, Mohammad-Rahimi H, et al.: Chatbots for conducting systematic reviews in pediatric dentistry. Journal of Dentistry . 2025; 158 . Publisher Full Text 5. Rokhshad R, Khoury Z, Mohammad-Rahimi H, Motie P, et al.: Efficacy and empathy of AI chatbots in answering frequently asked questions on oral oncology. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology . 2025; 139 (6): 719-728 Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Dental Education, Artificial Intelligence I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Chau RCW. Reviewer Report For: Comparison of examinations required for dental license in Japan and China：considerations on the training of dental professionals under the background of globalization [version 1; peer review: 1 approved with reservations] . F1000Research 2026, 15 :448 ( https://doi.org/10.5256/f1000research.191731.r471752 ) The direct URL for this report is: https://f1000research.com/articles/15-448/v1#referee-response-471752 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 27 Mar 2026 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 Version 1 27 Mar 26 read Reinhard Chun Wang Chau , The University of Hong Kong, Hong Kong, Hong Kong Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Chau R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 01 Apr 2026 | for Version 1 Reinhard Chun Wang Chau , The University of Hong Kong, Hong Kong, Hong Kong 0 Views copyright © 2026 Chau R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you. It was an interesting read. This reviewer has only some comments. 1. A detailed search strategy, keywords, date ranges, inclusion/exclusion criteria, or a PRISMA-style flow diagram were all missing from the manuscript. 2. Data extraction seemed to be performed by only 1 person, without any dual review or inter-rater reliability. 3. Despite being named "globalization," the study was limited to two countries and relied almost exclusively on official guidelines and aggregated pass-rate data. There was no justification for excluding other Asian or global systems. 4. Pass rates were presented clearly but received no statistical treatment. 5. Cognitive-level breakdown was kind of approximate and subjective. There seemed to be a relative lack of quantitative content mapping. 6. It would be great to have a structured matrix or scoring rubric for the exam format and legal framework comparisons. 7. This reviewer would highly recommend performing a trend analysis of pass-rate divergence/convergence over time, and some subgroup analyses, like comparing local candidates and foreign candidates. 8. There needed to be a deeper evaluation of how outline revisions might have quantitatively shifted question distributions. 9. Professional English editing would be recommended. 10. Here are some references for the authors, as they mentioned GPT and dental licensing exams: -(refer to 1,2,3,4,5) Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? No Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly References 1. Chau R, Thu K, Yu O, Hsung R, et al.: Performance of Generative Artificial Intelligence in Dental Licensing Examinations. International Dental Journal . 2024; 74 (3): 616-621 Publisher Full Text 2. Chau R, Thu K, Yu O, Hsung R, et al.: Evaluation of Chatbot Responses to Text-Based Multiple-Choice Questions in Prosthodontic and Restorative Dentistry. Dentistry Journal . 2025; 13 (7). Publisher Full Text 3. Rokhshad R, Zhang P, Mohammad-Rahimi H, Pitchika V, et al.: Accuracy and consistency of chatbots versus clinicians for answering pediatric dentistry questions: A pilot study. Journal of Dentistry . 2024; 144 . Publisher Full Text 4. Rokhshad R, Mohammad F, Nomani M, Mohammad-Rahimi H, et al.: Chatbots for conducting systematic reviews in pediatric dentistry. Journal of Dentistry . 2025; 158 . Publisher Full Text 5. Rokhshad R, Khoury Z, Mohammad-Rahimi H, Motie P, et al.: Efficacy and empathy of AI chatbots in answering frequently asked questions on oral oncology. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology . 2025; 139 (6): 719-728 Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Dental Education, Artificial Intelligence I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Chau RCW. Peer Review Report For: Comparison of examinations required for dental license in Japan and China：considerations on the training of dental professionals under the background of globalization [version 1; peer review: 1 approved with reservations] . F1000Research 2026, 15 :448 ( https://doi.org/10.5256/f1000research.191731.r471752) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/15-448/v1#referee-response-471752 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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