The MCCQE Part I Exam Guide
The Medical Council of Canada Qualifying Examination Part I (MCCQE Part I) is the licensing exam every physician training in Canada writes. This guide covers the exam format, the blueprint, scoring, when to write, and how to structure your prep.
By Dr. T. Roy · MD, CCFP
Exam format
MCCQE Part I is a one-day computer-based exam delivered at Prometric testing centres and via approved remote proctoring. The exam is split into two sections: a multiple-choice question (MCQ) section and a Clinical Decision Making (CDM) section.
The MCQ section presents single best-answer questions drawn from case-based clinical vignettes. The CDM section presents short cases followed by short-answer questions where you type in a response or select from a long list.
- ~210 MCQ questions in the morning section
- ~38 CDM cases in the afternoon section
- Total testing time is approximately 7.5 hours
- Passing standard is set at 226 (mean is calibrated to 250)
The blueprint
The MCCQE Part I blueprint is organised by two dimensions: the Medical Expert clinical presentations and the CanMEDS roles. Every question maps to one clinical presentation, and questions are balanced across all body systems.
MDReview's MCCQE1 bank is organised by body system so you can practise the way the exam is structured — cardiovascular, respirology, endocrinology, gastroenterology, nephrology, hematology, infectious disease, musculoskeletal, dermatology, neurology, psychiatry, obstetrics and gynaecology, pediatrics, and general surgery.
When to write
Canadian medical students typically write between April and June of their final year, after the CaRMS match and before residency starts. International medical graduates targeting the CaRMS main match should aim to have MCCQE1 results in hand well before the September application deadline.
A realistic 6-month plan
Six months is enough time to cover the full blueprint if you practise consistently. The plan below assumes 60–90 minutes of active practice per day.
- Months 1–2: 40 questions per day, cover one body system per week, focus on comprehension
- Months 3–4: 60 questions per day, mixed body systems, spaced repetition on missed items
- Month 5: 80 questions per day, timed 40-question blocks, add CDM cases
- Month 6: full-length mock exam, targeted review of weak topics, taper the week before the exam
Scoring and reporting
MCCQE Part I is scored on a scale calibrated so that the mean is 250 with a standard deviation of 25. The passing standard is 226. Score reports include your overall score, a pass/fail decision, and diagnostic feedback by dimension.
FAQ
How much does MCCQE Part I cost?
The MCC application fee is set annually and is typically in the CAD $1200–1500 range. Additional Prometric or remote proctoring fees may apply.
Is MCCQE Part I graded on a curve?
No. The passing standard is set through a criterion-referenced standard-setting process. The mean is calibrated to 250 but individual results are not curved.
Can I retake MCCQE Part I if I fail?
Yes. Candidates who fail may re-sit the exam a limited number of times per year, subject to MCC rules. Most successful retakers use the diagnostic feedback to focus their preparation.
Does MDReview cover both MCQ and CDM?
Yes. MDReview's MCCQE1 bank includes MCQ-style vignettes across every body system, plus CDM-style cases so you can practise both sections in the format they are delivered.
Ready to start practising?
MDReview turns this guide into daily practice: staff-authored vignettes, spaced repetition, and a full-length mock exam.