In October 2018, the Medical Council of Canada (MCC) launched the latest update to the Medical Council of Canada Qualifying Examination (MCCQE) Part II, the second exam taken by candidates as a condition of becoming licensed to practice medicine in Canada.
In a recent blog post published on the website of the Canadian Medical Association Journal, the MCC’s Executive Director, Dr. Maureen Topps, notes that while some people in the medical community have challenged the value of the MCCQE Part II, consultation and research show that the exam continues to be a crucial assessment tool that helps prepare physicians for successful practice.
The MCC was created in 1912 to address the need for a national qualification for medical licensure. Today, the MCC continues to meet that need under the direction of a council that includes registrars and representatives from each provincial and territorial Medical Regulatory Authority (MRA), a senior faculty representative from each of Canada’s 17 medical schools, four public members and four members representing students and residents.
In 1990, Canada’s MRAs requested that the MCC implement a national clinical skills examination, which marked the beginning of the MCCQE model. Since then, the MCC has regularly updated the exams. The latest update followed a strategic review of the MCC’s assessment processes, which was done to ensure that the purpose, objectives and structure of the exams align with what stakeholders need, both now and for the future.
The review, which was led by 12 representative stakeholders and included extensive consultation, culminated in a new assessment Blueprint that describes what clinicians and stakeholders expect from candidates. Following an evidence-based approach, it identifies the competencies that physicians will be expected to demonstrate at two decision points: entry into residency (assessed in the MCCQE Part I) and entry to private practice (MCCQE Part II).
The updated MCCQE Part II assesses the knowledge, skills and behaviours that all physicians practising in Canada should be able to demonstrate, regardless of specialty. It covers two broad categories: Dimensions of Care across the medical continuum and Physician Activities, including Assessment and Diagnosis, Management, Communication and Professional Behaviours.
These competencies aren’t just “nice-to-haves” — they are critical competencies in today’s health-care environment. The complexity of patient needs is increasing while service delivery involves a greater number of players, from other health-care professionals to patients and their family members. Providing high-quality patient care simply isn’t possible without being able to communicate effectively with others.”
Dr. Maureen Topps,
Executive Director and CEO, MCC
The MCC examinations are the only independent, objective assessments in Canada that evaluate these skills, making them a key component of professional accountability. The model is similar to the approach used in other professional disciplines, where there is a common standard that must be met before a license is granted.
Previous research has shown that MCCQE scores can be significant predictors of the quality of medical care provided by candidates in the future. Ongoing research led by Dr. André De Champlain, Director of Psychometrics and Assessment Services at the MCC, continues to explore this relationship. Preliminary results from the team’s recent analysis of data from the College of Physicians & Surgeons of Alberta found that candidates who failed the MCCQE Part II on their first attempt, on average, prescribed two-plus opioids and two-plus benzodiazepines to 30 per cent more patients than passing candidates.1
The team will soon publish further work about their analysis, but these early results suggest that there is a continuing link between exam performance and professional outcomes, which may generate further opportunities to ensure that candidates have the support and mentoring they need to succeed.
The originally published blog post by Dr. Topps can be found post on the CMAJ website.
 De Champlain, A.F., Qin, S., Tian, Ashworth, N., Kain, N., & Wiebe, D. (2018, October). Do National Licensing Examination Scores Predict Patient Complaints as well as Physician Opioid and Benzodiazepine Prescribing Patterns? A Collaboration between the Medical Council of Canada and the College of Physicians & Surgeons of Alberta. Paper presented at the meeting of the International Association of Medical Regulatory Authorities, Dubai, United Arab Emirates.