The MCCQE: format and how to prepare
The MCCQE at a glance
The one-day computer-based exam: 230 multiple-choice questions in two 160-minute sections, scored 300–600 with a pass score of 439.
Last reviewed 2026-09-30
More detail
The Medical Council of Canada Qualifying Examination assesses the medical knowledge and clinical decision-making expected of a physician entering supervised practice in Canada. It is the MCC exam almost every IMG takes.
Format at a glance
| Questions | 230 multiple-choice questions (including unscored pilot items), one best answer, 3–5 options each |
|---|---|
| Timing | 2 sections of 115 questions, up to 160 minutes each (about 83 seconds a question), with an optional 45-minute break; a 6.5-hour appointment |
| Delivery | Computer-based at Prometric test centres in Canada and 70+ countries |
| Sessions | Four sessions a year; seats are first come, first served — check the MCC's scheduling page |
| Scoring | Scale of 300–600; pass score 439. No penalty for wrong answers |
| Fee | $1,500 (non-refundable) |
| Eligibility window | 12 months from acceptance to sit the exam; can be extended once by 12 months |
What changed in April 2025
The clinical decision-making (CDM) component was removed and the appointment shortened from 9 hours to 6.5. Many prep sites and older books still describe 210 MCQs plus 38 CDM cases — that format is gone. The exam is now 230 MCQs only.
What the questions look like
- Mostly short clinical vignettes ending in a question: the most likely diagnosis, the next best step, the most appropriate investigation or treatment.
- Pictures and data: photographs, diagrams, radiographs, ECGs, graphs and tables. Normal lab values are given in the question when you need them.
- You can move freely and flag questions within a section — but once a section is submitted, you can't go back.
What it covers
The MCC weights the exam by dimensions of care and physician activities rather than by discipline — assessment and diagnosis alone is about 45% of the exam. In practice every major discipline appears: internal medicine, surgery, pediatrics, obstetrics and gynecology, psychiatry, and population health and ethics.
Practise at the real pace
PassMCCQE's timed mocks run at about 83 seconds a question, like exam day.
Start practising freeFree demo exam across every discipline — no sign-up. Full bank from $49 CAD, one time.
How to prepare
- Use the MCC's examination objectives as your syllabus: they list the clinical presentations the exam is built on.
- Train the pace. 83 seconds sounds generous until the second section. Take at least two full timed mocks.
- Learn Canadian practice. Screening intervals, immunization schedules, consent, capacity, confidentiality and reporting duties are tested — and often differ from other countries.
- Review misses on a schedule. Spaced repetition beats rereading.
- Avoid "recalls". MCC exam content is confidential; using or sharing it risks your result.
Frequently asked questions
How many questions are on the MCCQE?
230 multiple-choice questions in two sections of 115, including unscored pilot questions. Each has one best answer and 3 to 5 options.
Does the MCCQE still have CDM questions?
No. The clinical decision-making component was removed as of April 2025, and the exam appointment was shortened to 6.5 hours.
How much does the MCCQE cost?
The application fee is $1,500 CAD and is non-refundable. Confirm the current fee on the MCC's fees page.
How many times can I take the MCCQE?
Per the MCC, a fail counts as an attempt, and after a third attempt you must wait one year before a fourth and final attempt. Check the MCC eligibility page for the current rules.