MCCQE1 Passing Score 2026: What 226 Means & What to Aim For
MDReview Editorial — written with input from Canadian residents and medical students.
The Medical Council of Canada publishes the MCCQE Part I passing score as 226. What most candidates don't realise is that 226 is a scaled score, not a raw percentage — and that the number CaRMS programs care about is not "did you pass" but "how far above the pass did you land."
This post explains how the MCCQE1 score is calculated, what a "good" score looks like for each downstream pathway, and how the retake and reporting rules actually work.
How MCCQE1 Scoring Works
Your MCCQE1 result comes back as a scaled score on a range that runs roughly 100–950. The pass mark is fixed at 226.
The scaled score is derived from your performance across two sections:
- Multiple choice questions (~210 items) — clinical vignettes with one best answer
- Clinical Decision-Making (CDM) (~38 cases) — short-answer questions with weighted marking, including negative marking on some cases for over-listing
Each section is equated across sittings so that a 226 in one cycle represents the same difficulty as a 226 in the next. The exam is criterion-referenced — you're being measured against a standard, not a percentile of your cohort.
What Your Score Report Shows
The MCC score report includes:
- Your total scaled score
- The pass/fail decision
- Sub-scores by dimension of care (four CanMEDS-aligned domains)
- Sub-scores by discipline (medicine, surgery, pediatrics, obstetrics/gynecology, psychiatry, population health/ethics)
The sub-scores are useful for retake diagnosis. If your total is close to the cutoff and one discipline is markedly below the others, you know where to focus.
What Score You Should Actually Aim For
Passing (226) unlocks the LMCC. But the score is visible to CaRMS programs, and it functions as one of the top three ranking factors for IMG applicants alongside reference letters and Canadian clinical experience.
| Goal | Target scaled score |
|---|---|
| Bare pass (LMCC only) | 226 |
| CaRMS-safe family medicine (IMG) | 250+ |
| CaRMS-safe most specialties (IMG) | 275+ |
| Competitive IMG file for competitive specialties | 300+ |
| Top-decile Canadian graduate | 320+ |
The distribution is heavily skewed toward the middle. Above 300 puts you well into the upper quartile. Below 240 places you in a pool where family medicine is the realistic ceiling for IMG applicants.
How the Pass Mark Is Set
The 226 pass mark comes from a modified Angoff standard-setting process — panels of Canadian physicians estimate the probability a minimally competent candidate would answer each item correctly, and the aggregate defines the cutoff. The MCC re-evaluates the standard periodically. It has been stable at 226 since the score scale was reset in 2018.
Retake Rules
- Up to four attempts total at MCCQE Part I
- Minimum wait between attempts is the next available sitting (roughly quarterly)
- Every attempt appears on your MCC transcript, which CaRMS programs can request
- Your best passing score is the one that appears on your LMCC certificate — but all attempts remain visible on the transcript
What to Do If You Fail
The MCCQE1 fail pattern for IMGs is almost always one of two shapes:
- Uniformly low across disciplines. You need more volume and a Canadian-blueprint bank. Aim for 10 more weeks of prep, 40 questions/day, and at least three full mocks.
- Cliff in one or two disciplines. You need targeted remediation on those systems plus dedicated CDM practice. Six weeks of focused work is usually enough.
Whichever pattern you're in, the highest-yield changes are the same: Canadian-blueprint qbank, timed mixed blocks (not tutored), and full-length mocks under real conditions.
Score Timing and What CaRMS Sees
MCCQE1 results are typically released 8 weeks after the sitting. If you're applying to CaRMS the same cycle, your score is on your CaRMS file automatically — you don't upload it. Programs see the numeric score, the pass/fail decision, and any prior attempts.
If your first attempt was a fail, plan on writing again at least 12 weeks before the CaRMS file deadline so the retake result posts in time.
How to Move Your Score Up
If your practice-exam average is in the 220s and your target is 260+, three interventions do most of the work:
- Switch to timed mixed blocks from tutored single-topic blocks. Simulates the real exam.
- Add dedicated CDM sessions. CDM is the single highest-leverage subsection because most candidates under-prepare for it.
- Take mocks under real conditions. Same time of day, same length, same seating.
MDReview's platform is built around these three: timed mixed vignettes on the Canadian blueprint, AI-graded CDM-style short answers, and full-length timed mocks in a single subscription.
FAQ
What is the passing score for MCCQE1?
226 on the scaled score. The scale runs approximately 100–950.
What is a good MCCQE1 score?
250+ is a competent pass, 275+ is competitive for most CaRMS specialties, 300+ is well above average. Only the top 10% or so of writers score above 320.
What is a good MCCQE1 score for IMGs?
Same absolute thresholds — 250+ for family medicine, 275+ for most specialties, 300+ for competitive files. IMG applicants are compared against a pool where the median matched IMG scores in the 265–285 range.
What is the pass mark for MCCQE1?
- It has been stable at that value since 2018.
How long do MCCQE1 results take?
About 8 weeks from the sitting date.
Can you retake MCCQE1 if you pass?
No. If you pass, that's your recorded score. There is no score-improvement retake option.
How many times can you fail MCCQE1?
The exam allows four total attempts. After four failures, you cannot write again.
Does MCCQE1 use negative marking?
The MCQ section does not use negative marking. Some CDM cases use weighted marking where over-listing (writing more answers than requested) reduces your score.
How long is MCCQE1 valid?
The pass does not expire for LMCC purposes. Some downstream applications (e.g. certain provincial licensing) may have their own recency requirements — check the specific program.