Medical Council of Canada


If you took the September 2018 NAC exam, please click here. Please note that the information below applies to the March 2019 and future NAC exam sessions.


The National Assessment Collaboration (NAC) Examination uses a series of Objective Structured Clinical Examination (OSCE) stations to assess International Medical Graduates’ (IMGs) readiness for entrance into a Canadian residency program.

The NAC Examination consists of 12 OSCE stations. Of the 12 stations, two are non-scored pilot stations that do not count towards your total score. The pilot stations are not identified on the exam; you should try to do as well as you can on every station.

The NAC Examination 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 OSCE stations are scored

OSCE stations are scored by Physician Examiners (PE). Examiners observe your interactions with Standardized Patients (SP) and score your performance on each station according to a standardized scoring instrument that includes a checklist of tasks, answer key to oral questions, and rating scales that are designed to assess up to seven competencies.

These competencies include:

  • History taking
  • Physical examination
  • Diagnosis
  • Data interpretation
  • Investigations
  • Management
  • Communication skills

Objectivity of scoring is achieved through the use of standardized guidelines for exam administration, the training of PEs and SPs, and the use of predetermined scoring instruments for OSCE stations.

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How the NAC Examination total scores and subscores are 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 300 to 500.

To calculate subscores, the seven assessed competencies are grouped into the following three broad domains that reflect a physician’s scope of practice:

  • Assessment and diagnosis
  • Management
  • Communication Skills

Subscores are calculated by converting the items associated with each domain to a percentage score. These items include those found on the checklists, oral questions, and rating scales across the 10 scored stations.

NAC Examination subscores are presented graphically to indicate your relative strengths and weaknesses in each of the domains.

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How the NAC Examination 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 NAC Examination through a standard-setting exercise. The panel then recommends its pass score to the NAC Examination Committee (NEC) for approval. The NEC is composed of physicians and medical educators from across the country and is responsible for awarding pass/fail results to the NAC Examination candidates.

The next standard-setting exercise for the NAC Examination will be conducted in April 2019, and the new pass score will be posted on this web page in May 2019. The new pass score will be applied to the March 2019 NAC Examination and to subsequent sessions.

How the NAC Examination pass/fail decision is made

Your final NAC Examination result (e.g., pass, fail) 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 and 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 NAC Examination regardless of how well other candidates perform.

How your NAC Examination score can be used to assess relative performance

Following the results release of the March 2019 NAC Exam in May 2019, we will publish the new pass score, mean, and standard deviation of the March 2019 exam session.

Your total score is reported as a scaled score ranging from 300 to 500. The mean and standard deviation will be established using the results from the March 2019 session. Results from the March 2019 and subsequent sessions will be reported using this scale, allowing you to compare candidate performance across sessions beginning with the March 2019 session.

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How NAC Examination results are presented

The Statement of Results (SOR) includes your final result and total score, as well as the examination pass score. The March 2019 SOR will be available through your account, two weeks after you receive your final results.

Additional information about domain subscores and comparative information will be provided on the Supplemental Information Report (SIR).

The total score is reported on a scale ranging from 300 to 500. In contrast, the score profile in the SIR will display a candidate’s subscores on a percentage scale. As a result, total scores cannot be compared to the subscores in the SIR as each is reported on a different scale.

A sample of the SOR and a sample of the SIR, containing mocked-up, random data, which depict how information is presented to exam candidates will be available soon.

Both the SOR and the SIR will be available through your account approximately two weeks after you receive your final results.

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