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mccqe part 1 breakdown

2026 format: modernised mcq-only mccqe1, timing strategy, and the resource stack that actually works.

The MCCQE Part I has been modernised. In 2026, the “separate CDM section” is no longer the exam’s defining challenge — the exam is MCQ-only, and your performance depends on clinical reasoning under time pressure.

Critical update (April 2025 onward)

As of April 2025, the MCCQE Part I follows a new assessment model with the clinical decision-making (CDM) component removed and a shortened exam appointment. If your prep material is still “CDM-heavy,” it is outdated for the current format.

Current structure (MCQ-only)

The MCCQE Part I consists of 230 multiple-choice questions (MCQs) divided into two sections of 115 items, with timing set per section and an optional break between sections. Train timing explicitly.
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Step 1 — Learn the MCC style (not just the content)

MCC questions reward safe, guideline-consistent choices with Canadian practice assumptions. You must recognise what is being tested: diagnosis vs management vs next-best-step vs public health/legal/ethics.
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Step 2 — Build a tight resource stack

Core: a Canada-focused Q-bank + a single comprehensive reference (e.g., Toronto Notes). Supplement only for weak domains (OBGYN, paeds, psych, ethics, preventive care).
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Step 3 — Convert misses into rules

Every missed question becomes a rule card: “If X presentation + Y red flag → do Z next.” Review the rule cards daily; this is how you raise your floor.
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Step 4 — Simulation blocks

Do full timed blocks mirroring section length. Your goal is consistent pacing and reduced second-guessing. Flag-and-return discipline matters because once you leave a section you cannot return.
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Step 5 — Exam-day execution

Sleep, hydration, and break planning. Enter the exam with a time-per-question budget and a fixed approach for uncertainty: eliminate, choose, move on.
SourceMedical Council of Canada: Changes to MCCQE Part I in 2025 (official)
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SourceMCC: MCCQE Part I overview (official)
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SourceMCC: Exam day logistics (official)
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SourceMCC: MCQ section details (official)
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