Medical Council of Canada



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 10 OSCE stations. There will be no pilot stations for the September 2020 NAC Examination. The pilot stations will be replaced with wait stations.

The NAC Examination is a criterion-referenced exam. This means that a candidate’s performance will be compared against the established performance standards and not the performance of other candidates.

How OSCE stations are scored

OSCE stations are scored by Physician Examiners (PEs). Examiners observe your interactions with Standardized Patients (SPs) 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
  • Diagnosis
  • Data interpretation
  • Investigations
  • Management
  • Communication skills
  • Physical examination (assessed in a modified format)

Each station is worth the same as every other station. The total score is calculated as the average of the ten station scores.

Standardized guidelines are used for exam administration, the training of PEs and SPs, and the use of predetermined scoring instruments for the NAC Examination.

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What result is reported

For the September 2020 NAC Examination, no total score or subscores will be reported. Only three categories of results are reported to candidates: fail, pass, and pass with superior performance.

For more information, please refer to FAQs.

How the NAC Examination performance standards are established

The Medical Council of Canada (MCC) will bring together a panel of Canadian physicians to define the performance standards for differentiating between “fail”, “pass” and “pass with superior performance” through a standard-setting exercise. Standard setting is a process used to define an acceptable level of performance and to establish a cut score for one or more target levels of performance. The standard setting panel will recommend the cut scores for approval to the NAC Examination Committee (NEC). The NEC is composed of physicians and medical educators from across the country and is responsible for awarding the NAC Examination results to candidates.

All candidates who meet or exceed the cut score for “pass” will be granted a “pass” status, and all candidates who meet or exceed the cut score for ”pass with superior performance” will be granted a “pass with superior performance” status regardless of how well other candidates perform.

Please note that as total scores will not be reported to candidates, the established cut scores will not be published.

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How the NAC Examination result is presented

Each candidate receives a Statement of Results (SOR). The SOR includes your final result which is reported as one of the three categories: fail, pass or pass with superior performance.

The SOR is made available through your account shortly after you receive your final result.

Prior to September 2020, additional information about domain subscores and comparative information was provided on the Supplemental Information Report (SIR) in graphic form. However, for the September 2020 NAC Examination session, subscores will not be reported. Therefore, SIR will not be provided to candidates.

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