Medical Council of Canada

Multiple choice questions instructions to candidates

Multiple-Choice Questions – Instructions to candidates

On your exam, you will be provided with the following instructions:

This component of the examination is designed to assess your knowledge in the following general areas:

  • Internal medicine
  • Surgery
  • Pediatrics
  • Obstetrics and gynecology
  • Psychiatry
  • Population health and the considerations of the legal, ethical and organizational aspects of the practice of medicine

It is adaptive in that the level of difficulty of the examination is tailored to the ability level of each candidate.

Session structure and assessment process

The questions are arranged in a series of seven sections. Each section is balanced for content. If you perform very well within one section, you will have to respond, in the next section, to more difficult questions. If you perform poorly, you will receive questions that are slightly less difficult in the next section. Others will receive questions of similar ability in the next section. The differences in difficulty from one section to the next are small. The overall objective is to provide an optimal test for everyone.

A statistically ‘optimal’ test for each candidate would be a test in which you respond correctly to 50 per cent of the items. However, the overriding concern is that every candidate has an opportunity to demonstrate proficiency across the broad range of Objectives for the Qualifying Examination. Care is taken to make sure that all candidates receive a similar mixture of questions across content. Every candidate is presented with the same total number of questions. The difference between one set of questions and another is that each set of questions is tailored to the ability level of a given candidate.

In the first of seven sections, all candidates are presented with questions varying in difficulty in sets of four questions for each of the six major disciplines of medicine mentioned above. An additional set of four pilot questions is also presented. Therefore, each section has a total of 28 questions. Once a candidate has submitted his/her answers, these are scored immediately and a decision is made as to which difficulty level is most appropriate to administer in the next section. This decision may be different for each of the six disciplines of medicine. This type of decision is made following the submission of the answers for each of the first six sections.

Points are not deducted for incorrect answers, so you should always answer even when you are unsure. Once you have submitted your answers to a section, you will not be allowed to return to that section.

Each question is assigned a weight based on its difficulty and how well it separates between ability levels.