If you would like to learn how to prepare for the MCCQE Part II, you’ve come to the right place. In addition to medical theoretical knowledge, this examination will test your readiness for independent medical practice. In this blog, you will learn what the MCCQE Part II is, what to expect on the test day, what kind of OSCE stations you will encounter, and how to prepare for this challenging practical exam!
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What is the MCCQE Part II?
The MCCQE Part II is an objective structured clinical examination that is one of the last steps in your journey to becoming a licensed and independent physician in Canada. The exam consists of a series of clinical stations. The stations assess your ability to apply medical knowledge, demonstrate clinical skills, develop investigational and therapeutic clinical plans, as well as demonstrate professional behaviors and attitudes at a level expected of Canadian physicians. The MCCQE Part I and MCCQE Part II form two components of the Licentiate of the Medical Council of Canada (LMCC), which, in turn, is one of the prerequisites for licensure and entry into independent practice in Canada. If you would like to learn how to prepare for MCCQE Part I, make sure to read our blog.
Eligibility and Application Process
The MCCQE Part II is normally held twice a year on a weekend in May and in October. You will complete the examination over the course of one day. To be eligible to take the MCCQE Part II, you must meet the following conditions:
The above criteria mean that the MCCQE Part II is typically completed during or after residency training, in contrast to Part I, which is typically completed prior to the beginning of residency training.
If you meet these criteria, you may start the process of applying to take the MCCQE Part II. Firstly, you must add your name to a pre-application list during the designated pre-application period through your physiciansapply.ca account. If you’re invited to apply for the exam, you will receive an invitation asking you to choose up to three exam centers in order of preference. The MCC will do their best to accommodate your choices, but if you choose only one center, it is unlikely that you will be assigned to it. The exam is typically delivered in facilities like universities, simulation centers, hospitals, medical clinics, etc. It is recommended that you choose testing facilities near you, in your province, or areas that you feel confident you will be able to travel to. You can take the exam in either English or French at a center that offers the exam in the chosen language.
What to Expect on the Exam Day
Before the exam day, you will receive an Entrance card and a Candidate Confidentiality Agreement and Code of Conduct form via an Exam Package in your physicansapply.ca account. You must print off this card, print and complete the form, and bring them with you on the exam day. When you arrive at the exam center, you will leave all your belongings at the registration desk to be stored until after you complete the exam. You will be provided with two important items:
What to Expect at the OSCE Stations
Undoubtedly, your performance at the Objective Structured Clinical Examination (OSCE) stations will demonstrate your readiness to become an independent physician. To get ready for this examination, you should review our ultimate guide for how to prepare for an OSCE. Remember, unlike its counterpart MCCQE Part I, this clinical exam tests your practical skills and abilities. A physician examiner (PE) will be present in each station to assess your performance. In an exam station, you may be required to perform one or more of the following:
- Elicit a history
- Describe a focused physical examination. In other words, instead of mimicking a physical exam, you will describe verbally to the physician examiner what maneuvers you would perform and what you would be looking for
- Manage/resolve a patient problem
- Assess and manage an urgent or emergent situation
- Counsel a patient and/or family member(s)
- Answer oral or written questions (extended match multiple-choice questionnaire)
- Summarize and present findings to an examiner or colleague
- Read or reference materials pertaining to the patient’s situation, such as articles, charts, test results, medical lists or summaries
- Interact with physicians or other healthcare professionals
If you finish a station early, you must remain inside the station quietly and wait for a signal to leave. If you remember something more that you would like to do, you may re-engage the standard patient at any time before the final signal, except for in stations with oral questions. In stations with questions, the physician examiner will ask you one to three brief questions after the first warning signal, so you are not allowed to continue interacting with the standard patient after the first warning signal. Remember, you may not leave the station early – you may leave the station only after the final signal sounds and move to the next one.
The ID badge you will be given when you register for the exam will indicate your first station. After you complete it, you will proceed to the remaining stations in numeric order, that is, if your first station is #3, you will continue to stations #4,# 5, #6, and so on. You are not allowed to talk outside the rooms or between stations, but keep in mind that the exam staff is there to guide you and answer your questions during the exam. You will have two minutes to move from one station to the next and read the posted instructions. When you hear the signal, enter the room, confirm your candidate code with the examiner, and proceed to your task.
What is assessed in the stations?
- Obtaining a focused history
- Verbalizing a physical examination
- Managing an acute patient problem
- Organizing a discharge
- Discussing goals of care
- Delivering difficult news
- Dealing with forgetful or angry patients
- Providing advice
- Interacting with colleagues
- Addressing conflicts within the health-care team
OSCE Stations
In the stations, you will be presented with problems related to 10 clinical scenarios. Be aware that you are expected to complete 12 stations, 2 of which are wait stations that do not contribute to your final score. There are 2 types of stations in the MCCQE Part II: 14-minute stations and 6-minute paired stations.
14-minute encounter stations (T stations) – 8 rooms
There will be 8 14-minute stations, 7 of which will count towards your final score. The 8th station will be a wait station. These stations will consist of encounters with standardized participants (SPs) such as physicians, nurses, and other healthcare professionals. In most stations, you will be assessed and scored based on your interaction with the SP. Before any of 7 simulation stations, you will be given two minutes to read the instructions posted by the door of the station. After two minutes, a signal will let you know to enter the room. You will have 14 minutes inside the room. A warning signal will sound at the 13-minute mark. A final signal will sound at the end of your allotted time in the station. After this final signal, you must leave the room and go to the next station on your track. You will have 2 minutes to relocate and read the next instructions. Remember, there is no content connection between different stations, so once you complete one, do not dwell on it. You may be asked to start at any of the 8 stations, including the wait station.
6-minute paired stations (C stations) – 4 rooms
You will go through 4 stations, one of which will be a wait station that will not count towards your final score. The three replicate-stations will be comprised of 2 6-minute components in any combination:
- The encounter component will consist of encounters with SPs. In most cases, you will be scored based on your interaction with the SP. The PE will be a physician or a highly trained non-physician.
- The non-encounter component consists of a reading task or responding to one or more extended match questions
In some non-encounter components in the paired stations, you may be asked to answer extended match questions. Read the questions carefully before you answer. Do not fill in more bubbles than specified in the question and wait until the start of the station before writing on the sheet. You will be given two minutes to read the instructions posted by the door before the encounter and non-encounter components. After the two minutes, the signal will sound for you to enter the room. You will have six minutes in the room. A warning signal will sound at the five-minute mark and a final signal will sound at the end of the station. After the final signal, you must leave the room and go to the next station. You will have two minutes to get to the next station and read the instructions for it.
You must remember that following the instructions is absolutely essential. Before you enter the station, read the instructions carefully as they provide information about the setting, the patient, and the task. Make sure to pay attention to the verbs in the task – these will indicate what kind of actions you will need to perform to receive credit. In a combined history/physical examination station or a management station, i.e. performing tasks that are necessary to take care of a patient’s problem, it is up to you to prioritize tasks. Instead of doing the physical examination, tell the examiner what you would do and what findings you would be looking for. For example, you could describe your actions in the following way: “I would assess the patient’s grip strength looking for weakness in the right hand.” As you already know, the instructions for each station are posted next to the door and are available inside each room. The instructions will provide you with the patient’s name and age, the presenting problem, the setting, i.e. family practice or emergency department, and the type of station this is, i.e. management or a counseling station. Vital signs, test results, and/or elements of the family history may also be provided. You can take notes while you are waiting to enter the station. Remember, you will have a notebook that is given to you at the registration. You can jot down any questions or notes you may have about the patient or the problem, so you do not forget them as you enter the room.
The following is an example of station instructions:
Instructions: 2 mins
Task: 6 mins
Examiner oral questions: 0 mins
This station includes a physical examination component with physical distancing measures in place.
Jonathan Johnson, a 65-year-old man, presents to your office because he has been experiencing abdominal pain. In the next 6 minutes:
- Take a focused and relevant history
- Tell the examiner what physical examination maneuvers you will perform and explain what you would be looking for. The examiner will provide you with related findings.
Do not touch the patient. When you enter the station, please confirm your candidate code to the examiner.
Notice that the key word in these instructions is focused. This means that you are expected to obtain a focused and relevant, rather than full, history and to also be selective about which physical examination maneuvers you would perform and what you would be looking for when assessing the patient’s abdominal pain.
In some stations, props will be provided either inside or outside the room or both. When you are provided with lab results, normal values will also be available for your reference. Be aware that you are expected to know doses of commonly prescribed medications. However, in some stations, reference pages from the Compendium of Pharmaceuticals and Specialties (CPS) may be provided. You may encounter a variety of other props in any given station, so please do not write on/in them and leave them in the room when you exit.
Get more tips for how to prepare for your MCCQE Part 2:
How is MCCQE Part II Scored?
The Medical Council of Canada (MCC) brings together a panel of physicians to set an acceptable level of performance and establish the passing score for the MCCQE Part II using a thorough standard-setting exercise. This process allows the council to define an acceptable level of performance for the exam. The panel will recommend the passing score to the Central Examination Committee (CEC) for approval. The CEC, composed of physicians and medical educators from across the country, is responsible for awarding pass/fail results to MCCQE Part II candidates. The established pass score will not be announced to the public. Additionally, your total score will not be reported to you – you will simply be notified whether you passed or failed the examination. Whether you pass or fail the exam will be based on where your total score falls in relation to the passing score. If your score is equal to or greater than the passing score – you pass, a total score less than the passing score is a fail. This means that all candidates who meet or exceed the passing score will pass the exam regardless of how the other candidates perform.
Each station in the MCCQE Part II is scored by examiners. They observe your interactions with the standardized participants and score your performance according to standards developed by the MCCQE test committee. Each examiner will have appropriate materials such as score sheets that include checklists of tasks and, in most cases, the rating scales. The objectivity of scoring is achieved using standardized guidelines for exam administration, the training of examiners and SPs, and the use of predetermined scoring instruments for OSCE stations.
How to Prepare for the MCCQE Part II
You should know that the creators of MCCQE Part II cases were guided by the Objectives for the Qualifying Examination. Use them as a guideline in preparation for your MCC exams. Go through each clinical presentation and carefully read the related objectives. If you feel your knowledge or skills in any areas are lacking, you should focus on improving it. The MCCQE Part II is based on common or critical patient presentations and interactions with colleagues, other health care professionals, and family members related to the Objectives. It might be a good idea to organize your study in a similar manner, rather than studying by disease or body system. By working from common or critical patient presentations from different disciplines, you will align your study during residency with the format of the examination. For each patient presentation, identify key diagnoses as well as the critical information needed for diagnosis (and to rule out the differential diagnoses) and for treatment. List the different parts of the physical examination, consider what investigations might be needed, and summarize key aspects of the initial management of each problem. Please visit this page to see a list of suggested reference materials for studying.
Exam Tips
Create learning objectives. Prior to studying, get a handle on what material you need to cover. Since the MCCQE Part II can cover material from a wide range of medical specialties, start keeping track of the presentations you see during different rotations by creating a log. Ensure you look at MCC’s website and create your own objectives based on their guidelines so you can begin studying early.
Start early. You must begin studying for this exam well in advance. You will be busy completing your residency and exam studying can fall by the wayside if you do not schedule it in. Begin studying at least 1 year in advance of your exam date by scheduling time every week to review material and meet your study group.
Form a study group. Forming a study group can often keep you on track with your exam preparations. Each group member can identify the objectives that they most need to study and focus on common or critical patient presentations. Consider having each member prepare common patient presentations that they understand well, keeping in mind differential diagnoses and the key features that help confirm the diagnosis. Also, create checklists, identify key investigation, and management plans.
Realistic simulations and professional feedback. Realistic simulations and feedback are the best way to practice. So, as you prepare for the exam with your study group, post scenarios to each other and practice answering while timing yourself. How well can you describe a physical exam? How strong of a history do you take? Can you collaborate with other healthcare team members by giving clear guidance and instructions? Try to also get expert feedback from a senior resident or staff physician and work on implementing the feedback they give you the next time you do a realistic simulation.
Read instructions carefully. You must read and re-read the instructions carefully before you enter the station. Use your notebook to write down any relevant information from the instructions. Don’t forget that the instructions are also available inside the room, so you can access them there as well. When you read the instructions pay special attention to what kind of actions the instructions are asking you to perform. Limit your actions to only what is being requested.
Pay attention to the setting and the time allotted. During the exam, you might be asked to assess or manage a patient with an urgent problem (a trauma, for example). You must personally prioritize what information and actions have the most urgency, given the patient information you read in the instructions and the time you’re given in the station. Make sure you do the most important tasks first, then you can go back to the instructions and get more information or make further orders.
Do not ignore the patient. The SP can provide useful information about the tasks you should perform in the station. Use a welcoming and natural conversational tone and an organized approach to taking a history. Start with general questions before moving to more close-ended questions. Remember, you're being scored on your interactions with the SPs, so you must demonstrate concern for your patients. If you appear indifferent, the SP is trained to react accordingly and give you less information. Introduce yourself to the SP as you enter the station to create a positive atmosphere. Polite and genuine greetings and goodbyes will leave a positive impression on the PE and the SP.
Use your notebook. Make notes during the interview to help you organize your thoughts and prevent you from forgetting details or questions you want to ask the patient.
Verbalize what you are doing. The examiner cannot read your mind, so if you're tasked with examining a patient, you will need to say out loud everything you would do during a physical exam. You do not need to justify what you are doing, just simply state it. The examiner is given findings to report to you, but they can only do so after you state which examinations you would do.
Focus on one station at a time. Once you complete a station, move on and forget about it. As I mentioned previously, the stations are not connected. Try your best not to ponder on how well you performed in the stations you already completed.
Ignore the examiner’s pencil and the checklist. Remember, some of the checklists will need to be finished once you leave the station. How often the examiner writes in the checklist is not an indicator of the quality of your performance.
FAQs
1. How do I apply to MCCQE Part II?
If you meet the eligibility requirements that I outlined above, you must add your name to the pre-application list through your physiciansapply.ca account at any time during the pre-application period. Starting in mid to late September, MCC will proceed with a random selection of candidates in their second year of residency and above (PGY-2+) from the pre-application list. Selected candidates will receive an invitation to apply for the exam.
Additional invitations to apply will be sent in September and October based on remaining available spaces. Please monitor your physiciansapply.ca account regularly for further updates.
2. My exam date is scheduled, but I can no longer attend the test. Can I reschedule or cancel my exam?
If you have applied to the MCCQE Part II and are no longer able to take the examination, you may withdraw your application. To do so, you must submit an exam withdrawal request through your physiciansapply.ca account by following these steps:
- Click on Examinations in the left panel.
- Click on Withdraw from an exam at the bottom of the center panel and follow the steps provided.
The refund provided may depend on when you request to withdraw. The amount of the refund will be indicated when you follow the above steps. Please ensure that you still wish to proceed with the withdrawal, with the refund indicated, before you complete the withdrawal process.
3. When and how will I receive my MCCQE Part II results?
About 12 weeks after your exam, you will receive a notification by email and a message in your physiciansapply.ca account stating that you can verify your final results, i.e. pass or fail, through your physiciansapply.ca account. One document will be uploaded to your account that will include your final pass or fail score.
4. How long is an MCCQE Part II pass result valid?
There are no time restrictions on a pass result for the MCCQE Part II, regardless of when or how long ago the exam was taken.
5. How many times can I take the MCCQE Part II?
You may take the MCCQE Part II a maximum of four times in a lifetime. A one-year waiting period will be required between the third and fourth attempts. After four attempts, in exceptional personal circumstances, you can request special permission for a fifth attempt. You may not retake the exam if you have passed the exam.
6. Is there a break during the exam?
There will be a brief break between the 14-minute encounter stations (T stations) and the 6-minute paired stations (C stations).
7. How can I make the best use of time outside the room?
When you’re waiting to enter the room, read the instructions twice and start forming a checklist of items you can sequentially go through in each station.
8. What if I don’t know the material at all?
Focus on the basics of taking a strong history and conducting a good physical examination.
9. What’s the best way to prepare?
Start by identifying the objectives you need to know for each clinical presentation and practice with your study group. You must be able to practice using the types of scenarios that may come up in your MCCQE Part II exam. While you practice with your colleagues, keep a log of any meaningful or educational patient encounter in a journal or in a Word document. Write down what happened, what you did, and the outcome. Review these with your study group to get a sense of what may come up on test day. Keep in mind that realistic, timed simulations and expert feedback, perhaps from a more senior resident or an attending physician, are the best way to hone your skills.
10. Why do I have to say what I am doing out loud?
To score highly in a station, you must voice the physical examination maneuvers that you would perform and what findings you would be looking for. In most cases, the physician examiner is given findings to report to you, but he or she can only do so after you state which examination you would do. Keep in mind, the examiners cannot read your mind, so in order to receive credit for the station, you must give details of your actions.
11. How far in advance should I begin preparing?
To prepare for MCCQE Part II, you will need to begin studying at least 1 year in advance, due to the amount of content that you must know. Slow, steady study and practice are better than cramming, so set aside time every week to meet with your study group so you stay on track.
12. Does every resident have to do the MCCQE Part II?
The requirements vary by specialty. Every resident should check with their licensing body, either the Royal College of Physicians and Surgeons or the Canadian College of Family Physicians, as to whether they must complete BOTH the MCCQE Part II and their respective specialty board examinations, to independently practice medicine.
13. How do I study for this exam if I am in a specialty that does few off-service (or non-core) rotations?
This can be quite tough! For example, you may be a dermatology resident and doing mostly those rotations that focus on your specialty. Now, you must go back and also review material from other fields of medicine while still doing all your core rotations! This is where studying in advance, having clear objectives, and reaching out to friends and colleagues will help. Do you feel weak in a particular area? Ask a resident in that specialty to sit down with you for an hour and ask them questions, or seek out an attending physician’s help. It’s your responsibility to ensure you feel comfortable with the material on the MCCQE Part II, so plan ahead and stick to your study schedule.
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