CSAs/IMGs: Canadian Medical Exams to write before applying to CaRMS

Hi everyone!

Hope your summer is going well! What’s keeping you busy? Any fun adventures? My husband and I recently did an Alberta road trip and hiked up to Sentinel Pass. It was difficult but AMAZING! I will be posting up pictures from our hike and road trip in the near future so please check back if you’re interested!

I have recently received several emails from IMGs who wanted to know what exams to take before applying for CaRMS. I thought it would be helpful to make a post on this from the information I have gathered. Please also check out the MCC website.

Please note before you read on: I am not an expert at this. I am in the same boat as you trying to match into a Canadian residency program. It is difficult finding information about how to prepare for the Canadian matching process so I hope this information helps you.

In this post I do not share or discuss examination content in any way. 

Eligibility Criteria for CaRMS – https://www.carms.ca/match/r-1-main-residency-match/eligibility-criteria/

What Canadian examinations do CSAs/IMGs need before applying to CaRMS?

  1. MCCEE (being phased out): multiple choice examination that tests you on pediatrics, obgyn, psychiatry, internal medicine (adult medicine), surgery, population health and Canadian ethics. This information is from the MCC website.

Cost: $1820

Dates: Last session for the EE will be November 2018 (EE is being phased out and starting November 2019 the QE1 will be the score programs will consider).

Resources: I wrote this examination after I took the USMLE CK many years ago and the preparation for my USMLE Step 2 CK helped me immensely for my EE prep. I focused on using USMLE World questions, Toronto Notes and USMLE Secrets Book.

Check this page out: Preparation Resources

2. NAC-OSCE: a clinical examination with a patient actor and an examiner in the room. You will have to perform either history taking and/or physical examination on the patient and answer the examiner’s questions. Tests you on medicine, pediatrics, obgyn, psychiatry, surgery. This information is from the MCC website.

Cost: at the moment $2 470 (expensive much?? yikes!)

Dates and Locations: see here

Resources: I am retaking this examination because I was not happy with the score I received in 2014 (this was the first time I took it). At that time I took my NAC exam after my USMLE CS and thought it was enough preparation. The difference was in the Step 2 CS you either get a pass/fail, whereas in the NAC you get A SCORE. My prep? Rereading Toronto Notes. I have a study group to practice with. I am attending an online class with Medical Training Express for practice and more cases. I am also working on clinical traineeships to apply my knowledge in real practice with patients. I do not know if this will be enough for me but I am hoping for the best.

3. MCCQE1 (mandatory when applying to CaRMS November 2019): Two part examination where the morning session will be MCQ and the afternoon session will be fill in the blanks (clinical decision making component). Tested on pediatrics, obgyn, psychiatry, internal medicine (adult medicine), surgery, population health and Canadian ethics.

Cost: at the moment $1 105

Dates and locations: Initially were were only able to take this exam twice a year. As of April 2019 it will be increased to 4 times a year. Also, I believe you will be able to take the exam in various centres around the world so you don’t have to fly to Canada for the exam. I am not sure when this will begin though. More information on MCC site-> Click here

Resources: I prepared for this exam using Toronto Notes, the online Medical Training Express class, USMLE World questions. I kept my studying limited to these because otherwise I get overwhelmed easily with too many resources. Check out the MCC for advise too: click here

4. MCCQE2 (not mandatory for many programs). I do not plan on taking this before I get into residency so best if you go to the MCC page directly for this information.

5. IELTS (mandatory, TOEFL will no longer be accepted) with a minimum score of 7 in each component. You do not need to take this exam if (taken from the CaRMS website):

For Ontario:

Candidates for whom their primary and secondary, or medical school education was conducted in English, the Ontario medical schools will accept Language Proficiency Attestations as follows:

-Primary and secondary education: Mailed directly from the Senior Academic Administrators of both schools to the program confirming that all of the candidate’s primary and secondary education was conducted completely in English 

-Medical school: Mailed directly from the Dean of the candidate’s medical school confirming that the language of instruction and patient care was conducted completely in English  OR

-World Directory of Medical Schools Language Option – If the instruction and the language of patient care at the undergraduate medical school was conducted completely in English or French, then a candidate can submit to the Program a copy or printout of the World Directory of Medical Schools website listing the medical school which clearly states that the language of instruction is English.

For British Columbia:

Complete details of the English Language Proficiency requirements can be found on the College of Physicians and Surgeons of BC website:  https://cpsbc.ca/files/pdf/REG-ELP.pdf 

6. Exams that are specific to province and mandatory:

Clinical Assessment Program for UBC – open to all CSAs and IMGs in Canada, they give out 200 spots for this exam. This one day OSCE examination is mandatory if you want to apply to any of University of British Columbia’s residency programs. You can only apply to get into this exam if you have a NAC and MCCEE score completed. These two scores determine whether you get in.

For Alberta residents – they have to pass the Alberta International Medical Graduate Program

Quebec – Apart from the Montreal site, for the other hospitals you will need to prove that you are fluent in speaking French. I believe you will need to sit and pass a French examination to prove this: https://etscanada.ca/en/tfitm-test-de-francais-international

This is all the information I have for now! Should I come across more updated information as we get closer to CaRMS applications I will just update this page 🙂

Hope this was helpful! Goodluck!

Peace, Love and Happiness always

9 thoughts on “CSAs/IMGs: Canadian Medical Exams to write before applying to CaRMS

Add yours

    1. I agree and every year/every two years the cost of writing these board exams just gets more expensive!
      I really feel for those CSA/IMG medical professionals who are trying to get into the system and are scraping together $$ to pay for these exams and take care of their families at the same time. 😦
      Thank you for your wishes Farrah 🙂

      Liked by 1 person

  1. Hello! Just discovered your blog. Great blog! Now that the MCCEE is been phased out, what exact order should an IMG take the exams? MCCQE1 before NAC OSC?

    Liked by 1 person

    1. Hard to say what order an IMG should take the exam because you require both to apply to programs for CaRMS.
      1) The knowledge for both is somewhat the same, what you study for one you can use for the other. Only that for the NAC you need to know your physical examinations.
      2) Maybe work off of what your strengths to determine what to take first? Do you do better with communication, showing empathy, speaking and doing physicals on patients? Then you may not require much time to prepare for the NAC and you will score high on this.
      3) If you are weaker with the multiple choice exams then take more time to study for this before taking it.
      4) Another factor as to when to take one first versus the other is the expense – NAC costs more than the QE1. Some people need to take longer to save up for the NAC and take the QE1 first instead.

      These are my two cents 🙂 Someone else may have better advice than me! Good luck with the boards!


  2. Hi, just discovered your blog. I am struggling trying to pass qe1, I have taken it thrice. I think my absolute lack of clinical experience is a factor. Do you honestly think medical express training will help?

    Liked by 1 person

    1. Hi Ava, thank you for your message. I understand the struggles to pass the QE1 exam. Been there, done that. It is one of those exams you are not really sure what is the most relevant topics to be tested. Unlike the USMLEs that have many resources for us to use, the Canadian board resources are limited. I signed up for the “live class” Medical Training Express because I needed someone to guide me on the high yield topics for this examination and they did just that. It was expensive but worth it because it got me through the exam. I felt confident walking in to take the exam after attending this course because I felt prepared.


    2. Canadaqbank was all I did for 2 months. Complete the qbank stone cold and focus more on all other specialties first and then medicine last. My exam which I passed first attempt was heavily on all specialties of primary care but least on internal medicine. But the CDM part was more of internal medicine , psychiatry and surgery for me. I feel canadaqbank was okay as that’s what I used for mccee and qe1 as am not someone who can sit and read a book or prep for long. It’s all about solving as many good questions as possible and and learning from it in my opinion. As for NAC osce, I used Dr Basil notes that I borrowed from a friend but it can be downloaded online for free I have heard.


  3. Hi – Nice blog. I have a question regarding preparation of MCCQE1. I was looking into training options and came across so many training institutes including Medical Training Express. What are your recommendations regarding Medical Training Express ? Have you heard about MDWorld ?


    1. Yes I took MTE for my NAC OSCE and also my MCCQE1 prep. I found it useful and helpful for both. The only thing I would advise is that because it is taught online, there is no physical exam practice for the NAC OSCE course. I used their notes to practice my physicals with study partners. I have not heard of MDWorld and don’t know of anyone who had taken their courses, sorry.


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