What the MCCQE is
The Medical Council of Canada (MCC) now calls this exam the MCCQE; it was formerly the MCCQE Part I. It is a one-day, computer-based exam of critical medical knowledge and clinical decision-making, delivered at Prometric test centres in Canada and in over 70 countries, in four sessions a year. The MCC says passing it is required for international medical graduates applying to Canadian residency.
Exam format at a glance
| Part of the exam | What to expect |
|---|---|
| Questions | 230 multiple-choice questions in 2 sections of 115 |
| Time | Up to 2 hours 40 minutes per section, with an optional break between them (up to 320 minutes of testing in total) |
| Scoring | Scores on a 300 to 600 scale (mean 450, standard deviation 30). The pass score is 439, set in July 2025 against a fixed standard. |
| Cost | $1,500 application fee (MCC fees page) |
| Unscored pilot items | The number is not published on the MCC pages we checked |
From April 2025, the MCC removed the Clinical Decision-Making component (short-menu and short-answer write-in questions). Critical knowledge and decision-making are now assessed with multiple-choice questions only, and scores from before 2025 (on a 100 to 400 scale) cannot be compared with 2025 and later scores. The number of answer options per real question is not stated on the MCC pages we checked; our questions have four options each.
The MCC blueprint
Questions follow the MCC Examination Objectives on a blueprint with two axes. The test specifications give these weightings, each plus or minus 5%:
| Dimensions of care | Weight | Physician activities | Weight |
|---|---|---|---|
| Health promotion and illness prevention | 20% | Assessment and diagnosis | 45% |
| Acute | 35% | Management | 35% |
| Chronic | 30% | Communication | 10% |
| Psychosocial aspects | 15% | Professional behaviours | 10% |
What our practice questions cover
Our 124 questions sit in eight sections. Roughly 29% are acute care, 26% chronic care, 16% health promotion, 11% psychosocial and 18% communication and professional behaviours, with assessment, management and communication running through the clinical vignettes.
| Section | What it covers |
|---|---|
| Health Promotion and Illness Prevention | Screening, immunization, risk factors and counselling |
| Acute Care: Adult Medicine and Surgery | Acute presentations in adults and surgical problems |
| Acute Care: Emergencies, Obstetrics and Paediatrics | Emergencies, pregnancy and acute problems in children |
| Chronic Disease Management | Long-term conditions, medications and follow-up |
| Chronic Care Across the Lifespan | Chronic care from childhood to older adults |
| Psychosocial Aspects and Mental Health | Mental health, substance use and social factors in care |
| Communication | Breaking news, consent conversations and working with patients and families |
| Professional Behaviours, Ethics and Canadian Law | Consent, capacity, confidentiality, duty to report and professionalism |
How to prepare
Read the MCC Examination Objectives and the blueprint, and plan your study around the weightings. Practise one section at a time and read every explanation, including the ones you got right, so you see why the other options are wrong. Then take full 115-question timed mocks to build the stamina for a 2 hour 40 minute section, and review your weakest sections between attempts.
Checked against Medical Council of Canada information on October 30, 2026. Last reviewed: October 2026.
Aptitude Tests Canada is an independent practice platform. We are not affiliated with or endorsed by the Medical Council of Canada or Prometric. Our questions are original practice questions, not real exam questions.
Practice questions with answers
Tap a question to see the correct answer and explanation.
A 62-year-old woman smoked one and a half packs a day for 25 years and quit 4 years ago. She is well. What does the CTFPHC recommend regarding lung cancer screening?
- Annual low-dose CT for up to 3 consecutive years
- Sputum cytology every 6 months
- Annual chest radiograph for 5 years
- No screening, because she quit smoking more than a year ago and her risk has returned to baseline
Answer: A, Annual low-dose CT for up to 3 consecutive years. She has about 37 pack-years (1.5 x 25) and quit under 15 years ago. The CTFPHC (2016) recommends annual low-dose CT for up to 3 consecutive years in adults aged 55 to 74 with at least 30 pack-years who smoke or quit less than 15 years ago, done in a centre with expertise.
A 58-year-old man has had 1 hour of crushing chest pain, with ST elevation in leads II, III and aVF. He is at a rural hospital where transfer for primary PCI would take about 3 hours. He has no contraindications to fibrinolysis. What is the best next step?
- Fibrinolysis within 30 minutes of arrival, then transfer
- Heparin infusion alone and arrange outpatient angiography in 2 weeks
- Wait for transfer for primary PCI
- Admit for serial troponins before choosing a reperfusion strategy
Answer: A, Fibrinolysis within 30 minutes of arrival, then transfer. CCS/CAIC STEMI guidance advises fibrinolysis, with a door-to-needle goal of 30 minutes, when primary PCI cannot be done within 120 minutes of first medical contact, followed by transfer to a PCI centre.
A 67-year-old woman is alert after a low-speed rear-end collision and has mild neck pain. She has no neurological symptoms. According to the Canadian C-Spine Rule, what is the next step?
- Soft collar and review in one week
- Cervical spine imaging
- Discharge without imaging, since it was a low-speed collision
- Test active neck rotation and clear her clinically if she can rotate 45 degrees
Answer: B, Cervical spine imaging. Age 65 or older is a high-risk factor in the Canadian C-Spine Rule and mandates imaging. The low-risk factor and range-of-motion steps are only used when no high-risk factor is present.