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. Eligible candidates can apply for the exam through the MCC during the designated application period, without an invitation or 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.
Application for the September 2026 TDM Examination is closed. Application for the January 2027 TDM Examination is expected to open in fall 2026. More information will be published in late summer.
Scheduling an exam appointment with Prometric will start at the end of July and will be on a first-come, first-served basis. Information on how to schedule your exam appointment with Prometric will be provided through your physiciansapply.ca account.
If you no longer want to take the TDM Examination after you have applied, you can request to withdraw your application. The withdrawal fee will apply.
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.
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.
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.
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.
You can read our TDM Examination multiple-choice and short-menu questions page for tips on how to answer MCQs and SMQs, including a sample case for each of these question types. You can also consult our freely available Canadian cultural resources to help you learn about important areas of focus in Canadian health care. We expect to have additional TDM Examination preparation resources available in late summer 2026.
To take the Therapeutics Decision-Making (TDM) Examination, you must be a graduate from:
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:
If you meet the eligibility requirements, you can apply for the TDM Examination between the application opening and closing dates of the specific session you would like to take the exam. If you do not already have a physiciansapply.ca account, you will have to create one.
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.
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.