The Medical Council of Canada Qualifying Examination (MCCQE) Part II is scored independently of the MCCQE Part I. To be awarded the Licentiate of the Medical Council of Canada (LMCC), you must pass both the MCCQE Part I and Part II.
The MCCQE Part II consists of 13 objective structured clinical examination (OSCE) stations. Of the 13 stations, twelve are scored stations and one is a non-scored station that is pre-tested and evaluated for future use. On exam day, stations are not identified as scored or non-scored, and candidates are encouraged to do as well as they can on every station.
The MCCQE Part II is a criterion-referenced exam. This means that candidates who meet or exceed the standard will pass the exam regardless of how well other candidates perform on it.
How the OSCE stations are scored
Objectivity is achieved using standardized guidelines for exam administration, the training of physician examiners and of standardized patients, and the use of predetermined scoring instruments for OSCE stations.
OSCE stations are scored by physician examiners using a checklist of tasks (see sample OSCE cases section below and patient-encounter probe and physical examination station sections below). In almost all stations, the physician examiners also score selected rating scale items related to the candidate’s interactions with the patient. For example, the physician examiners may be rating the candidate on “Questioning Skills” and/or “Organization of Physical Examination” and/or “Rapport with Person”.
Couplet stations consist of a patient encounter scored by a physician examiner, paired with a task such as:
- Reviewing a patient chart
- Interpreting XRays or ECGs
- Answering written questions related to the encounter
You may be asked to complete these tasks before or after the patient encounter. Written questions are scored by physician examiners following the exam. For examples of the patient-encounter probe questions and the correct answers, view patient-encounter probe for the history-taking station or the physical examination station.
You are expected to demonstrate appropriate, ethical and professional behaviour. When filling out the physician examiner checklist, physician examiners are asked whether your performance was unsatisfactory and to specify the reason(s) for the unsatisfactory performance. Physician examiners must also answer the question: Did this candidate demonstrate a lapse in professional behaviour? If answering “yes”, the physician examiners must then elaborate on the observed lapse.
How the MCCQE Part II total scores and subscores calculated?
Each station is worth the same as every other station. Your total score is the average of your station scores.
The total score is adjusted via a statistical process called “linking” to reflect the level of difficulty of the stations experienced by candidates on a given exam date. Your linked total score is reported on a scale ranging from 50 to 950.
Subscores are calculated by converting the items associated with each domain to a percentage. These items include those found on the checklists, rating scales, and written or oral questions across the 12 counting stations. There are four domain subscores reported on the MCCQE Part II: Data Acquisition, Problem Solving and Decision Making, Patient/Physician Interaction, and C²LEO (the Considerations of the Cultural-Communication, Legal, Ethical, and Organizational aspects of the practice of medicine).
How the MCCQE Part II pass score is established
Every few years, the Medical Council of Canada (MCC)brings together a panel of Canadian physicians to define an acceptable level of performance and establish the pass score for the MCCQE Part II through a standard setting exercise. The panel then recommends its pass score to the Central Examination Committee (CEC) for approval. (The CEC, composed of physicians and medical educators from across the country, is responsible for awarding pass/fail results to MCCQE Part II candidates.)
The most recent standard-setting exercise was conducted in spring 2015.
The panel recommended a pass score of 509. This pass score was approved by the CEC and has remained in place since the spring 2015 session. The pass score will remain in place until the next scheduled standard setting exercise occurs, for the fall 2018 examination.
How the MCCQE Part II pass/fail decision is made
Your final MCCQE Part II result is based solely on where your total score falls in relation to the pass score. A total score equal to or greater than the pass score is a pass; a total score less than the pass score is a fail. This means all candidates who meet or exceed the pass score will pass the MCCQE Part II regardless of how well other candidates perform.
How your MCCQE Part II score can be used to assess relative performance
Using the spring 2015 MCCQE Part II results, a scale of 50 to 950 was established to have a mean of 500 and a standard deviation of 100. Results from the spring 2015 session and subsequent exam sessions are reported using this scale, allowing us to compare candidate performance across sessions beginning with the spring 2015 session. This means that a score of 600 is one standard deviation above that of the group mean from spring 2015.
How MCCQE Part II results are presented
The Statement of Result (SOR) includes the candidate’s final result and total score, as well as the examination pass score. Additional information about a candidate’s subscores and comparative information is provided on the Supplemental Feedback Report (SFR) in graphic form. The total score is reported on a standard-score scale ranging from 50 to 950. In contrast, the score profile in the SFR displays a candidate’s subscores and indicates a candidate’s relative strengths and weaknesses in four areas. As a result, total scores cannot be compared to the score profile in the SFR as both are reported on different scales. A sample of the SOR and a sample of the SFR, containing mocked-up, random data, depict how information is presented to exam candidates. Both the SOR and the SFR are made available through the candidate’s physiciansapply.ca account.
Sample OSCE cases and score sheets
You can take a look at the following station examples, which each feature the score sheets used for the station:
- A 10-minute history-taking and physical examination station
- A 10-minute management station
- A 10-minute history-taking station
- A history-taking couplet station
- A physical examination couplet station
In addition to the checklists, the physician examiners are asked to rate selected patient interaction rating scale items related to the clinical encounter.