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Eligibility and application

Learn about the eligibility requirements and applying for the TDM Examination as an international medical graduate for entry to a PRA program.

The Medical Council of Canada (MCC) is now responsible for administering applications for the Therapeutics Decision-Making (TDM) Examination. Starting with the September 2026 exam session, candidates will apply for the exam through the MCC, without requiring approval from the Practice-Ready Assessment (PRA) programs. Before applying for the TDM Examination for admission to a PRA program, it is important to review the program’s requirements to determine your eligibility.

For more information about the changes coming into effect in September 2026, see New application model and eligibility criteria for the TDM Examination.

Important notice for candidates
planning to take the TDM Examination on September 23, 2026

Application for the September 2026 TDM Examination is expected to open on June 8 and close on June 28. An application form will be available on this page starting June 8 and will remain accessible until June 28. You will have to complete and submit the form online, as you will not be able to submit your application through your physiciansapply.ca account.

If you have not already done so, we recommend submitting your medical degree for source verification and ensuring your identity validity period is not expired in your physiciansapply.ca account as early as possible. This will help ensure timely processing of your exam application once the application period opens. If you do not have a physiciansapply.ca account, you will need to create one. 

If you plan to take the exam in September 2026, you can sign up to receive a notification when the application period opens.

Frequently asked questions
about applying for the TDM Examination 

Application for the September 2026 exam will open on June 8, 2026. You can sign up using the button on this page to receive a notification when the application period opens. Scheduling an exam appointment with Prometric will start at the end of July and will be on a first-come, first-served basis.

If you have not already done so, you can submit a source verification request for your medical degree and a copy of your acceptable identity document(s) in your physiciansapply.ca account as early as possible. This will help ensure timely processing of your application when the application period for the September 2026 TDM Examination opens.

A web form will be available on this page when application opens on June 8. To apply, you will need to complete and submit the form online, as you will not be able to submit your application through your physiciansapply.ca account. The form will be accessible until application closes on June 28.

No. The required documentation must be approved and the status of your medical degree must be “reviewed and accepted” in your physiciansapply.ca account for your exam application to be complete.

Most PRA programs in family medicine require passing the TDM Examination as part of their eligibility criteria. However, it is important to review the requirements of the PRA program of your interest to determine your eligibility to the program and confirm if passing the TDM Examination is part of their criteria.
You may also consult our eBook Physician Licensing in Canada that provides a summarized list of requirements from the medical regulatory authorities and PRA programs to apply for the practice-ready assessment pathway. The eBook includes a comparison table (p.35) that allows you to review the different requirements across all family medicine PRA programs.

Since candidates will apply for the TDM Examination directly with the MCC, approval from a PRA program will not be required. PRA eligibility is assessed separately by each provincial program.

Passing the TDM Examination alone does not confer eligibility for a PRA program; applicants must meet all program-specific criteria. Before applying to the TDM Examination, it is important to review the requirements of the PRA program you are interested in to confirm your eligibility.

To apply for the TDM Examination, you must have submitted your medical degree for source verification in your physiciansapply.ca account; there is no language testing or postgraduate training requirements. Eligibility for a PRA program, however, is determined separately by each program, and applicants must meet all program-specific criteria.

Before applying for the TDM Examination, it is therefore important to review the requirements of the PRA program you are interested in to confirm your eligibility.

Passing the MCCQE and/or the NAC Examination is not required to apply for the TDM Examination. However, before applying for the exam, it is important to review the requirements of the PRA program you are interested in to confirm your eligibility, as each provincial program determines applicants’ eligibility based on its own criteria. You may consult our eBook Physician Licensing in Canada that includes a comparison table to review the different requirements across all family medicine PRA programs.

Eligibility requirements

To take the Therapeutics Decision-Making (TDM) Examination, you must be a graduate from:

  • A medical school outside Canada that is listed in the World Directory of Medical Schools and identified by a Canada Sponsor Note indicating it is an acceptable medical school in Canada; or
  • A U.S. School of Osteopathic Medicine; or
  • A U.S. School of Allopathic Medicine

Limited exam attempts

As of September 2026, you can take the TDM Examination a maximum of 4 times, regardless of if you pass or fail the exam. Once you choose to start the exam, it will count as an attempt.

Exam attempts prior to September 2026 count towards the total limit. A No Standing does not count as an attempt; a fail result or a Denied Standing are considered attempts.

After three consecutive fail attempts, you will be required to wait 1 year from the time you receive the result before reapplying for your fourth attempt. This 1-year waiting period has been implemented to enable candidates to take the time to prepare for their fourth and final attempt, and it cannot be shortened or waived.

Candidates who receive a fail result are ineligible to apply to the consecutive examination session. For example:

Exam challenged

January 2026
June 2026

Ineligible session

June 2026
September 2026

Next eligible session

September 2026
January 2027

Accessibility and test accommodations

If you have a documented functional limitation and associated accommodation need, you may be able to receive test accommodations to take the TDM Examination (e.g., additional testing time, break time, access to assistive equipment, medication, breast pump, food). To request a test accommodation, you must identify it in your TDM application form. You also have to send your completed Request for test accommodations form and supporting documentation to [email protected] immediately after submitting your exam application.

If you apply for the September 2026 TDM Examination and require a test accommodation, we strongly encourage you to submit all the required test accommodation documentation as early as possible once the application period opens, to allow sufficient time for your request to be processed.

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