Medical Council of Canada

MCC Evolution

Assessment Evolution

The Assessment Evolution (AE) initiative was created to inform our key stakeholders about the changes directed by the Blueprint exercise to enhance our examinations. Key information that has been part of our dedicated AE communications effort can be found on this page.

About the initiative

As the delivery of health care to Canadians evolves, so too must our nation’s medical professionals’ competencies. The Medical Council of Canada (MCC) administers examinations to all medical graduates wishing to practise in Canada.

Our examination program underwent significant changes that took effect in 2018 and 2019. This process of change is called the MCC Assessment Evolution initiative.

 

The benefits of change

The MCC Assessment Evolution initiative was undertook to provide these benefits:

  • Modernize MCC exams to better address patient population health issues and the psychosocial aspects of care
  • Ensure that physician critical core competencies, knowledge, skills and behaviours for safe and effective patient care in Canada are being appropriately assessed at the two decision points: entry into residency and entry into independent practice
  • Expand preparatory materials and enhance these to feature more in-depth content
  • Continue to align MCC examinations with best practices in medical education and assessment

How the changes came to be

The modifications to MCC exams were an extensive undertaking, involving in-depth consultations with stakeholders across the medical community, including medical professionals, medical educators and students as follows:

  • In October 2011, the MCC published the report Recalibrating for the 21st century: Report of the Assessment Review Task Force. The report outlines the future vision for the MCC and proposes a series of recommendations, including one addressing MCC examination blueprints; and
  • The final Blueprint is the result of an evidence-based and collaborative approach. It was unanimously approved by the MCC’s Council, comprising medical regulatory authorities in each province and territory, universities across Canada as well as student and resident representatives, in September 2014.

Affected MCC examinations

The changes enhanced the following four MCC examinations and reflected the changing health-care needs of Canadians:

  1. The Medical Council of Canada Qualifying Examination (MCCQE) Part I – assessing both Canadian and international candidates for entry into residency.
  2. The Medical Council of Canada Qualifying Examination (MCCQE) Part II – assessing both Canadian and international candidates for entry into independent practice.
  3. The Medical Council of Canada Evaluating Examination (MCCEE) – provided screening for international medical graduates (IMGs) interested in practising in Canada. This exam was phased-out in 2018 and is no longer offered.
  4. The National Assessment Collaboration (NAC) Examination – assessing IMGs for entry into residency.

The MCCQE Part I and Part II are the assessment components of the Licentiate of the Medical Council of Canada (LMCC) for both Canadian and international candidates.

 

What changed?

Fundamentally, what changed is what the MCC exams measure. The MCC is now basing its Qualifying Examinations on a new Blueprint, with greater focus on the following:

  • Health promotion, illness prevention, and psychosocial factors
  • Communication with patient families and with other professionals and colleagues in addition to being able to collect data from the patient, make a diagnosis, and manage care

Additionally, the following general aspects of MCC’s exams have been affected:

  • Changes to exam structure, including exam sequencing, requirements, and content
  • Phase out of the MCCEE; the last session was November 2018
  • Rating changes and new standards
  • Changes to how exams can be challenged and to the eligibility requirements
  • Increased complexity in some of the competencies to be assessed

Changes specific to the MCCQE Part I included:

  • Increased frequency
  • New vendor delivery model
  • Improved, international access as of 2019

Canadian students & graduates

Assessment overview

Beginning in 2011, the MCC has exhaustively examined its assessment process, collaborating with all medical regulatory authorities, faculties, certification colleges, and other stakeholders.

This process identified areas for improvement, including:

  1. Examination content that is better aligned with current health-care needs and medical school curricula.
  2. The need for more opportunities to take and retake the MCCQE Part I.
  3. Additional preparatory material for the MCCQE Part I and Part II.

The new MCC assessment Blueprint and the Assessment Evolution initiative addressed all three concerns.

Important information

Canadian medical students or graduates had to expect the following changes starting in 2018 and 2019:

  1. Changes to both the MCCQE Part I and Part II to align with the new Blueprint. Specifically, a greater focus is now placed on health promotion, illness prevention, and psychosocial factors – as well as communication with patient families, with other professionals, and with colleagues.
  2. A new passing standard was implemented as of the spring 2018 MCCQE Part I and fall 2018 MCCQE Part II sessions.
  3. More opportunities to take and retake the MCCQE Part I starting in 2019 – four to five times per year versus the previous frequency of twice a year. It is also offered in vendor centres around the world in multi-week windows.
  4. New preparatory material.
MCC Assessment Evolution timeline

Preparatory material

As candidates were preparing to take the new Qualifying Examinations based on the Blueprint, they were supported by new preparatory material, including:

  • A multiple-choice questions test and clinical decision making test – new, enhanced examinations, including content related to multiple-choice and clinical decision making. Each test represents a sampling of the MCCQE Part I.
  • Preparatory Examinations (PE) – complete MCCQE Part I test forms that simulate the exam experience, and provide candidates with question-level feedback.
  • Orientation self-study program on topics such as communication and cultural competency as well as the ethical, legal, and organizational aspects of medicine.

The orientation self-study program is available on physiciansapply.ca, while the multiple-choice questions test, clinical decision making test and Preparatory Examinations are available on the Preparation resources pages.

Assessment Evolution for Canadian students and graduates

Dr. Claire Touchie, Chief Medical Education Advisor at the Medical Council of Canada (MCC), describes the changes to the MCC examination program. This video explores the key elements of the MCC’s Assessment Evolution and describes how the examinations have been affected or changed. Canadian medical students and graduates can also learn about the preparatory materials available and key dates of this evolution.

 

 

FAQs

How are the changes benefiting Canadian students & graduates? 

  1. The MCCQE Part I is offered more frequently than it previously was. Candidates who challenge and fail the examination have more opportunities to retake it.
  2. Canadian medical students are able to retake the exam if they fail while still in the graduating year of their medical school.
  3. The exams continue to reflect evolving Canadian medical practice and medical school curricula.

What was the plan or strategy for the content changes to the Qualifying Examinations?

It is called the Blueprint. Think of it as the basic plan that we used to build the future of MCC testing on. Testing requirements are now defined by Physician Activities and Dimensions of Care.

Testing requirements chart

How was the new Qualifying Examination content tested?

The MCC continues to apply its existing standards, guidelines, and expertise to the development of new content. In this case, the new examination content was tested before it was launched in 2018. Content was assessed in the following ways:

  • New items were piloted within the MCCQE Part I but were not identified as such. Items that did not perform well were excluded from the scoring – this is true for all questions regardless of whether they are new.
  • New clinical stations were included in the MCCQE Part II but were not identified to the candidate as pilot or test stations. The results on these stations did not count towards the candidate’s score.
International students & graduates

Assessment overview

Beginning in 2011, the MCC has exhaustively examined its assessment process, collaborating with all medical regulatory authorities, faculties, certification colleges, and other stakeholders.

This process identified areas for improvement, including:

  1. The need for more opportunities to take and retake the MCCQE Part I.
  2. The need to simplify and streamline the evaluation process for IMGs.
  3. Additional preparatory material for the MCCQE Part I and Part II.
  4. A re-examination of the purpose and mandate of the NAC exam.

The MCC assessment Blueprint and the Assessment Evolution initiative addressed all of these concerns.

Furthermore, on March 31, 2015, the Government of Canada (Foreign Credentials Recognition Program – Labour Market Integration) announced the approval of $6.7 million over 3.5 years to the MCC for Streamlined and Equitable Assessment for Foreign-Trained Physicians. This funding supported an international and more flexible delivery of the MCCQE Part I, starting in 2019.

Important information

The transition to the internationally delivered MCCQE Part I involved several important changes.

A pass on the MCCEE is no longer required for IMGs to be eligible for the MCCQE Part I. Starting with application to the 2019 MCCQE Part I, IMGs can now apply to the MCCQE Part I directly, without a pass on the MCCEE. The MCCEE is no longer offered; the last session was November 2018. Other changes included:

  1. More opportunities to take and retake the MCCQE Part I – four to five times per year versus the previous frequency of twice a year. It is also offered in vendor centres around the world in multi-week windows.
  2. New preparatory materials.
  3. Changes to both MCCQE Part I and Part II to align with the Blueprint. Specifically, there is greater focus on health promotion, illness prevention and psychosocial factors – as well as communication with patient families, with other professionals, and with colleagues.
  4. A new passing standard implemented as of the spring 2019 MCCQE Part I and fall 2018 MCCQE Part II sessions.
MCC Assessment Evolution timeline

Preparatory material

To mitigate the higher level of difficulty compared to the MCCEE, IMGs were supported by new preparatory material. The new material included:

  • A multiple-choice questions test and clinical decision making test – new, enhanced examinations, including content related to multiple-choice and clinical decision making. Each test represents a sampling of the MCCQE Part I.
  • Preparatory Examinations (PE) – complete MCCQE Part I test forms that simulate the exam experience, and provide candidates with question-level feedback.
  • Orientation self-study program on topics such as communication and cultural competency as well as the ethical, legal, and organizational aspects of medicine.

The orientation self-study program is available on physiciansapply.ca, while the multiple-choice questions test, clinical decision making test and Preparatory Examinations are available on the Preparation resources pages.

 

Assessment Evolution for international students and graduates

Dr. Claire Touchie, Chief Medical Education Advisor at the Medical Council of Canada (MCC), describes the changes to the MCC examination program. This video explores the key elements of the MCC’s Assessment Evolution and describes how the examinations have been affected or changed. Internationally trained students and graduates can also learn about the preparatory materials available and key dates of this evolution.

 

 

FAQs

How are the changes benefiting IMGs? 

Benefits include:

  • A streamlined evaluation process for IMGs.
  • The MCCQE Part I is offered more frequently than it previously was. Candidates who challenge and fail the examination have more opportunities to retake it.
  • Additional preparatory material is available.

What was the plan or strategy for the content changes to the Qualifying Examinations?

It is called the Blueprint. Think of it as the basic plan that we used to build the future of MCC testing on. Testing requirements are now defined by Physician Activities and Dimensions of Care.

Testing requirements chart

How was the new Qualifying Examination content tested?

The MCC continues to apply its existing standards, guidelines, and expertise to the development of new content. In this case, the new examination content was tested before it was launched in 2018. Content was assessed in the following ways:

  • New items were piloted within the MCCQE Part I but were not identified as such. Items that did not perform well were excluded from the scoring – this is true for all questions regardless of whether they are new.
  • New clinical stations were included in the MCCQE Part II but were not identified to the candidate as pilot or test stations. The results on these stations did not count towards the candidate’s score.

The MCC is committed to:

  • Playing a significant role in the streamlining and simplification of assessment pathways
  • Working closely with medical regulatory authorities and educators to continue to reflect medical curricula
  • Collaborate with partners to assure Canadians that our physicians have the most current knowledge, best practices, and procedures
  • Continue to conduct rigorous research on the most advanced methods of physician assessment