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Exam day

What to expect on the day you take the NAC Examination.

Registration

If you are more than 15 minutes late for registration, you may be denied entry to the examination.

To ensure the integrity and security of the exam, on exam day when you arrive at the registration desk, you must disclose all items that you are taking into the exam. These items must be presented for an unobtrusive visual inspection. This inspection can be done at the registration desk, or it can be done in a more private location.

Items you must bring with you to the exam

  • Plain white lab coat with no university or hospital crest (you may cover with tape)
  • Stethoscope
  • Printed copy of your Entrance Card
    Approximately two weeks following centre assignment, we will send you a message in your physiciansapply.ca account with your exam package, including information on how to view and print your Entrance Card. You must bring a printed copy of your Entrance Card to gain admission on exam day.
  • Printed and completed copy of the Candidate Confidentiality Agreement form found in your physiciansapply.ca account

Personal items on exam day

Items that do not need advance notice

You will be permitted to bring a small nut-free, low to no smell and noise-free snack in a zip lock bag and a clear plastic bottle of water to be carried in your lab coat pocket. Eating the snack you brought is permitted before or after the examination.

Other items are also pre-approved to bring into the exam area.

  • medication (pills, capsules, lotion)
  • EpiPen®
  • nitro spray
  • inhaler (puffer or pump)
  • glucometer, hearing aids, insulin pump (with no electronic transmitting capabilities)
  • lozenges (unwrapped to reduce noise during the exam)
  • menstrual products
  • medicated oral or nasal spray
  • lip balm
  • eyeglasses
  • crutches
  • cane
  • face mask

Items that require test accommodations

Some items require a test accommodation to be brought into the secure exam area.

  • any medical device that requires smartphone or transmitting technology
  • medical assistive equipment
  • breast pump
  • mobility aids (scooter, wheelchair, chair)
  • syringes/needles

Items not permitted in the secure exam area

Certain items are not allowed in the exam area. You must hand in these items to exam staff at registration. Staff will store these items until after the exam. As storage space is limited, bring as few of these items as possible.

  • masks that have exhalation valves or vents
  • mouth shields
  • coat
  • keys
  • wallet
  • purse
  • documentation of any kind
  • communication, electronic and/or image capturing devices, including cellphones, smartphones, tablets and other mobile devices
  • watches of any kind (digital, analogue, smartwatches)
  • writing materials (pens, pencils, paper)
  • tissues (available on site)
  • large bags
  • reflex hammer

Duration of the NAC Examination

Please expect to be at the exam centre for about four hours. Your time at the centre includes candidate registration and orientation, candidate exam which is comprised of 12 stations (approximately three hours), and deregistration where candidate will return exam material prior to leaving. There are no scheduled breaks during the 12 stations.

Speaking to anyone other than the site staff during your exam is prohibited.

Accessing exam centres

The exam is delivered in facilities such as universities, simulation centres, hospitals, and medical clinics. You may be asked to take the stairs or walk certain distances while at the exam centre.

If you are unable to take the stairs or walk certain distances, please let us know by sending a message through your physiciansapply.ca account.

Confidentiality: do not reveal examination material or content

As part of the exam process, you agree not to disseminate or reveal to others the examination materials and content. This means that you cannot discuss or disclose exam content (including patient portrayals and findings, oral questions, cases) at any time in any way before, during or after the examination ends.

Examples of breaches in confidentiality include, but are not limited to:

  • Comparing patient responses with your colleagues
  • Sharing content with exam candidates
  • Posting information online

All NAC Examination materials, including the content and questions comprising the NAC Examination, are protected by copyright and are to be kept confidential. You must not disseminate, reproduce, share or reveal to others the exam materials and content, in whole or in part, at any time in any way, even after the exam ends. Comparing exam content and question themes with your colleagues, sharing content with future exam candidates and posting content online are considered breaches of confidentiality.

Any breach of the NAC Terms and Conditions will be considered irregular behaviour for which MCC may take appropriate action, in accordance with the NAC Terms and Conditions you accepted at the time of application.

The MCC actively monitors breaches of confidentiality and will seek disciplinary and legal measures against candidates who disclose examination content. Agreeing to maintain confidentiality and then breaking that confidentiality by disseminating exam content is considered a highly unprofessional act. Breaking confidentiality and disseminating exam content can lead to being denied a final result on the examination and being reported to regulatory authorities and other medical organizations as well as being barred from taking MCC exams in the future.

Candidate disclosure obligations

Candidate obligations

If you have concerns about a conflict of interest involving your upcoming exam, you must contact the MCC before exam day by sending a message through your physiciansapply.ca account. If an actual, perceived, or potential conflict of interest with an administrative personnel, examiner or standardized participant (SP) comes to light during the exam, you must:

  1. Exit the station and inform site staff immediately. Staff will make every effort to provide alternate arrangements for you to complete the station before the end of your examination.
  2. Submit a message through your physiciansapply.ca account informing the MCC of the occurrence within 7 days of your examination.

Administrative personnel, examiners and SPs are subject to similar obligations. Unreported conflicts of interest, either actual or perceived, will be resolved at the discretion of the Chief Assessment Officer with the assistance of impartial MCC staff.

What is considered a conflict of interest?

Without limiting the circumstances in which a conflict of interest may arise, the MCC takes the view that a conflict of interest exists:

  • If the administrative personnel, examiner or SP is a family member of the candidate
  • If the administrative personnel, examiner or SP is or has been in a significant business or social relationship with the candidate, or is a professional colleague
  • If a conflict of interest relating to the candidate and such examiner or SP has been previously identified

Simply knowing or being known to an examiner or SP is not generally deemed a conflict of interest.

Reporting exam day incidents

The MCC recognizes that, in some instances, candidates may experience exam day incidents (procedural irregularities or extenuating circumstances, such as illness) that may negatively impact their performance on exam day.

If you choose to start the exam, it will count as an attempt, even if you cannot finish it.

It is important to notify site staff immediately of all exam day incidents.

In addition to notifying staff on exam day, all exam day incidents (procedural irregularities and extenuating circumstances) must be reported to the MCC through your physiciansapply.ca account within 7 days of your exam.

The MCC will not investigate exam day incidents reported more than seven days after your scheduled exam. Candidates who do not report incidents within the seven-day timeframe will not be eligible to request a reconsideration after results have been released. 

Candidate instructions

Candidate notebooks

One small notebook that you may use for writing notes while taking the examination will be provided. Use the space wisely in this notebook. No additional notebooks will be provided, and no pages can be added. The notes in the notebook will not be scored. Your ID label is attached to the notebook cover. This notebook must be returned intact at sign-out. No pages or parts can be torn or ripped out.

Read the instructions for each station carefully

The instructions for each station are posted next to the door and are available inside each room. The instructions provide the patient’s name and age, the setting (family practice clinic or emergency department), and the type of station. The presenting problem, vital signs, test results and/or elements of the family history may be provided. You can take notes while waiting to enter a station.

In a combined history/physical examination station or a management station (i.e., completing tasks that are necessary to manage the patient’s problem at that moment), it is up to you to prioritize the tasks.

When conducting a physical examination, you will also be asked to say to the examiner what physical examination manoeuvres you are doing, what findings you are looking for, and to describe any relevant findings.

Navigating the examination and duration

Signs will be posted to help you navigate the exam, and staff will always be nearby to provide directions.

Clocks will be provided in every station on exam day for pacing purposes. It is not intended to time the patient encounter.

Moving from station to station

A set amount of time (2 minutes) is allowed for moving to the next station and for reading the instructions. At the sound of the signal, enter the room, and proceed with the required task. You may choose to take extra time outside the room, for example in a station with longer instructions or a prop to review; however, the time allowed for the station is still 11 minutes from when the signal sounds, regardless of when you enter.

Performance in stations

In all stations, an examiner will be marking while you are interacting with the SP. In most cases, the examiner will be a physician. However, in some cases the examiner may also be another medical professional. All examiners are trained to use standardized scoring tools to observe and assess your performance.

In an exam station, you may be required to perform one or more of the following:

  • Elicit a history
  • Conduct a focused and relevant physical examination
  • Manage/resolve a patient problem
  • Counsel a patient and/or family members
  • Answer oral questions
  • Summarize and present findings to an examiner or colleague
  • Read or reference materials pertaining to the patient’s situation such as charts, test results, medication lists or summaries
  • Interact with physicians or other healthcare professionals

If you finish the patient encounter early, you must wait quietly. If you remember something more that you would like to do, you may re-engage the patient at any time until the 8-minute warning signal (for stations with oral questions) or at any time until the final 11-minute signal (for stations without oral questions).

In stations with oral questions, after the examiners begins to ask the questions at the 8-minute mark, you may not return to the patient encounter, even if there is time remaining before the end of the station. After the final signal sounds, you must leave the station and move to the next one. You may not leave early.

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