The College of Family Physicians of Canada is transitioning the written component of the Certification Examination in Family Medicine away from its traditional write-in format, in two clearly defined stages. Beginning April 2026, up to 25% of written cases will use MCQ or short-menu question formats. In 2027, all written cases will use MCQ and short-menu formats. This is a genuine, staged structural change, and candidates sitting in 2026 face a meaningfully different preparation task than those who will sit from 2027 onwards.
What remains true in 2026
It is important to be precise about what the 2026 sitting actually looks like, since it is not yet the fully transformed exam. Most cases in 2026 will still include traditional write-in responses, with only up to a quarter of cases using the new MCQ or short-menu format. This means 2026 candidates genuinely need to prepare for both response styles simultaneously, rather than assuming the transition is already complete.
Defining a short-menu question
A short-menu question presents a case and asks the candidate to select a specific number of appropriate responses from a provided list, for instance selecting three appropriate investigations from a longer set of options. This sits between a free-text answer, which requires the candidate to generate responses without any prompt, and a conventional single-best-answer MCQ, which requires selecting only one option. Short-menu format still demands genuine clinical judgement about which actions are appropriate and which are not, but does so through selection rather than open construction.
Why old SAMP preparation remains useful in 2026, but becomes less representative in 2027
For the 2026 sitting specifically, established write-in SAMP preparation approaches remain genuinely relevant, since the majority of cases will still use that format. Candidates should not discard traditional SAMP practice entirely for 2026. From 2027 onwards, however, that same preparation approach becomes progressively less representative of the actual examination, since the write-in format will no longer feature at all once the full transition completes.
How preparation providers and question banks need to adapt
Resources built entirely around the historical write-in format need genuine structural updates to remain useful through this transition, not simply a note acknowledging the change. A provider or bank that has not meaningfully incorporated MCQ and short-menu practice material, reflecting the CFPC's own published sample formats, is preparing candidates for an examination that is actively disappearing, in stages, over the 2026 and 2027 sittings.
Positioning MCQ practice accurately for the current transition
iatroX's MCQ-format practice is becoming increasingly relevant to the evolving written examination as the transition progresses, since MCQ and short-menu questions form a growing share of the actual paper. It is worth being direct, however, that MCQ preparation alone does not reproduce the complete 2026 examination, given that most cases that year will still require write-in responses. Candidates sitting in 2026 specifically need a genuinely hybrid preparation approach, covered in more detail elsewhere in this cluster, rather than relying on MCQ practice as a complete solution before the transition is finished.
An annual update box worth tracking
Given the staged nature of this transition, the most useful way to track it is a simple annual note: 2026 sittings feature up to 25% MCQ and short-menu cases, with the remainder in write-in format; 2027 sittings feature MCQ and short-menu cases exclusively. Candidates should confirm which sitting they are preparing for and adjust their preparation balance accordingly, rather than applying a single, static approach across both transition years.
Why the CFPC chose a staged transition rather than an immediate switch
It is worth understanding why this change is being introduced gradually rather than all at once, since that reasoning has practical implications for how seriously candidates should take the interim, hybrid 2026 sitting. A staged transition allows the College to validate the new formats against real candidate performance data before relying on them exclusively, and it gives preparation providers, training programmes and candidates themselves a genuine transitional period to adjust rather than facing an abrupt overnight change. This means the 2026 sitting is not simply a smaller-scale preview to be treated casually; it is a genuine, fully weighted examination in its own right, in which up to a quarter of the marks available will come from formats many established preparation resources have not yet fully adapted to.