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The MCCQE Part 1 is the Canadian medical licensing examination — required for all physicians (Canadian graduates and IMGs) seeking independent practice in Canada. **Major 2025 format change**: the Clinical Decision Making (CDM) component has been permanently removed. The exam is now 230 MCQs in a 6.5-hour appointment. MCCQE Part 2 was permanently cancelled in 2021. An AI-adaptive question bank mapped to the MCC Examination Objectives and Canadian guidelines.
Full MCCQE Part 1 bank, AI Tutor and timed mocks — $29/month or $99/year. All paid exam banks included.
From 2025, the exam is 230 MCQs only; the Clinical Decision-Making component has been removed.
6.5-hour Prometric appointment, scheduled in MCC session windows after application approval.
The MCCQE Part I application fee is C$1,500. Candidates schedule within MCC/Prometric windows; eligibility-window extensions and appeals have separate MCC fees. Confirm the 2026 sitting and booking dates on the official awarding-body page before booking.
Approximate distribution across the MCC Examination Objectives. The MCCQE Part 1 emphasises clinical presentations and physician activities (CanMEDS) rather than specialty silos. iatroX adaptive sequencing maps to the MCC Objectives.
Drawn from the MCC Examination Objectives, Canadian clinical guidelines (Canadian Diabetes Association, Canadian Cardiovascular Society, Canadian Family Physician), and item density in iatroX.
CanMEDS roles in practice — each MCQ tests not just medical knowledge but how a physician acts as Communicator, Collaborator, Health Advocate, Professional. Questions often require choosing the most appropriate next step that integrates clinical and professional considerations.
Canadian Diabetes Association (Diabetes Canada) algorithm — Type 2 diabetes management, A1C targets (≤7.0% generally, individualised), SGLT2i and GLP-1 for CV/renal protection, screening intervals, sick day rules. Differs slightly from US/UK in drug choice sequencing.
Canadian Cardiovascular Society — ACS management, AF anticoagulation (CHADS₂ score in Canadian practice continues alongside CHA₂DS₂-VASc), heart failure GDMT, statin indications by Framingham/Canadian Cardiovascular Risk Score
Indigenous health and cultural safety — recognised as a core CanMEDS Health Advocate competency. Truth and Reconciliation Commission recommendations applied to clinical practice. Recognising historical trauma, intergenerational effects, and barriers to care.
Public health Canada — vaccination schedules (NACI recommendations), Canada's Food Guide framework, social determinants of health, harm reduction approaches (supervised consumption sites, opioid agonist therapy)
Mental health and addictions — Suicide risk assessment frameworks, Canadian opioid agonist therapy (methadone, buprenorphine/naloxone), substance use disorders, screening for unsafe alcohol use (AUDIT-C)
Time management for 230 MCQ format — 160 minutes for 115 questions = ~83 seconds per question. The new format requires stamina training under exam conditions. Block-by-block pacing matters.
Sample type questions — common 2024-2026 exam themes include sepsis bundles, opioid use disorder management, cancer screening intervals (Canadian Task Force on Preventive Health Care), maternal health (Canadian SOGC guidelines), Indigenous health scenarios
Observations from recent MCCQE1 candidates (Canadian graduates and IMGs). Verify against current MCC Examination Objectives and Canadian clinical guidelines.
Candidate-reported observations — not official guidance.
A pragmatic phased approach used by recent MCCQE1 passers under the 2025/2026 format. Stamina training under the 230-MCQ format is central.
A live item from the iatroX bank. Try it before launching a full session.
69-year-old former smoker with copd presents with increased dyspnoea and purulent sputum. He is using accessory muscles; saturation is 86% on room air and venous CO2 is elevated. Which of the following is the most appropriate next step?
Why iatroX is built differently for MCCQE Part 1.
Every iatroX item is tagged to a blueprint topic, so your performance dashboard mirrors the structure of the exam itself.
The engine surfaces your weakest topics first, in real time, instead of marching you through a static syllabus.
Incorrect items return at increasing intervals to interrupt the forgetting curve and lock knowledge into long-term memory.
Timed full-length simulations that mirror the official exam structure under realistic conditions.
One iatroX subscription includes the MCCQE Part 1 bank, the Socratic Tutor inside supported sessions, and every other premium iatroX exam bank.
Cancel anytime · 7-day money-back guarantee on annual
The Clinical Decision Making (CDM) component was permanently removed. The exam is now 100% multiple-choice questions: 230 MCQs in two blocks of 115. Total appointment time reduced from 9 hours to ~6.5 hours including an optional 45-minute break. The MCC found that CDM did not meaningfully distinguish passing from failing candidates. Resources mentioning CDM cases are outdated.
Four sessions per year. The January-February 2026 session ran 20 January to 17 February 2026. Additional sessions in April-May, August-September, and October 2026. Once your application is approved, you receive a 12-month window to schedule via Prometric. Registration is first-come, first-served.
MCCQE Part 2 (the clinical skills OSCE-style exam) was permanently cancelled in 2021. Today, the requirements for full Canadian medical licensure are: pass MCCQE Part 1 + complete a residency program + pass your specialty board exam (CCFP for Family Medicine; RCPSC for other specialties).
The MCCQE Part I application fee is C$1,500. Eligibility-window extensions, appeals, rescheduling and score-report services carry separate MCC fees, so candidates should confirm the full fee schedule before booking.
Up to 4 attempts. After 3 unsuccessful attempts, you must wait one year before your 4th attempt. A 5th attempt requires special permission from the MCC. Plan first-attempt preparation thoroughly to avoid the timing impact on CaRMS residency match applications.
Both are MCQ-format clinical exams pitched at the start of postgraduate training. The MCCQE Part 1 tests Canadian guidelines and CanMEDS framework explicitly (including Indigenous health and cultural safety). USMLE tests US guidelines and US practice norms. Both serve their respective licensing pathways and are not interchangeable. Some candidates sit both.
Yes. A single iatroX subscription (£29/month or £99/year for UK users; $29/$99 elsewhere) includes the MCCQE Part 1 bank alongside CCFP, RCPSC IM/EM, NDEB-AFK, and every other premium iatroX exam bank. No add-ons or per-exam fees.
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Reviewed by Dr Kola Tytler MBBS CertHE MBA MSt MRCGP · Last reviewed 12 May 2026
See our methodology and editorial policy.