Studying for the MCCQE Part I

Please note there is no longer a clinical decision-making (CDM) component to the MCCQE Part I. The content in the following article is unchanged from its original publication date and does not reflect this change.

A pass score on the Medical Council of Canada Qualifying Examination (MCCQE) Part I is a requirement to receive a Licentiate of the Medical Council of Canada (LMCC). Holding an LMCC is a part of the Canadian Standard for physicians, which are the qualifications required to be eligible for full licensure in every Canadian province and territory. The MCCQE Part I assesses a candidate’s critical medical knowledge and clinical decision-making ability at a level expected of a student who is completing a medical degree in Canada.

So, how can you best prepare for the MCCQE Part I?

This article offers a helpful guide for candidates who are preparing to take the MCCQE Part I, especially for those studying outside of Canada. It is not intended as an exhaustive resource. The article will provide a high-level explanation of the MCCQE Part I questions and scoring, the MCC Blueprint, the MCC Objectives and resources that the MCC has available.

MCCQE Part I questions and scoring

The MCCQE Part I is a one-day, two-part computer examination. The first four hours are dedicated to answering 210 Multiple-Choice Questions (MCQs). The final three-and-a-half hours are dedicated to 38 Clinical Decision-Making (CDM) cases, each with one to four questions per case. All the questions on the MCCQE Part I are developed by committees of practicing physicians from across Canada who are subject matter experts. The questions also undergo rigorous review to ensure accuracy and relevance to current medical practice.

Total scores are calculated by combining MCQs and CDM cases. For both MCQs and CDM cases, each correct answer is scored one point, and each incorrect answer is scored zero. Some CDM cases have questions that require multiple correct elements, allowing candidates to receive more than one point. For example, if a CDM case question has four elements, you could receive up to four points. The total score is calculated using both the questions’ individual scores and their level of difficulty. Your total MCCQE Part I score is reported on a scale from 100 to 400, relative to the pre-established pass score. Your final MCCQE Part I result (e.g., pass, fail) is solely determined by whether your score is higher or lower than that pre-established pass score.

MCC Blueprint and MCC Objectives

MCCQE Part I content is based on the MCC Blueprint and MCC Objectives. You can think of the blueprint as the framework for how the examination is assembled, including content weightings, while the objectives are the bank of topics that could be on the exam. Using these two documents as tools to structure your studies is one effective approach to preparing for the MCCQE Part I.

Blueprint

The blueprint outlines two broad categories on which performance is assessed on the MCCQE Part I:

• Dimensions of care, covering the spectrum of medical care
• Physician activities, reflecting a physician’s scope of practice and behaviours

The table below outlines the content weightings of the MCCQE Part I under these two broad categories. So, while you will be tested on all the dimensions of care and physician activities, you can expect to see more acute and chronic care questions than health promotion & illness prevention or psychosocial aspects questions. Similarly, you can expect to see more questions on assessment/diagnosis and management than on communication and professional behaviours.

Objectives

The objectives, on the other hand, describe the areas of proficiency expected of a medical graduate entering residency in Canada. Based on the CanMEDS framework, the objectives are organized into physician roles. The seven roles are medical expert, collaborator, communicator, health advocate, leader/manager, professional and scholar. Each of the objectives listed under each role can be tested on the MCCQE Part I. Reviewing them and mapping to the blueprint will help you cover the possible topics within the dimensions of care and physician activities that could be tested.

The medical expert role includes the most objectives. It is broadly outlined as the application of medical knowledge, clinical skills and professional behaviours when providing patient-centred care. It also covers clinical presentation/diagnosis; population health and its determinants; and legal, ethical and organizational aspects of medicine. In contrast, the other CanMEDS roles (collaborator, communicator, health advocate, leader/manager, professional and scholar) are each represented by fewer objectives. When planning your studies, you will need to allow for significant time to cover the medical expert objectives.

How to Map MCC Objectives to the MCC Blueprint

As mentioned above, one effective strategy to prepare for the MCCQE Part I is to map each objective to the blueprint. You can support this approach with notes from your medical courses, reference material and/or trusted, peer-reviewed sources such as textbooks and articles.

Let us look at an example of how the diabetes mellitus objective under the medical expert role could be mapped to the blueprint:

What are some of the types of questions you could be asked about a patient with diabetes?

• Under assessment/diagnosis in health promotion & illness prevention, a question could focus on screening for diabetes
• Under management and acute care, a question could focus on the initial management of a patient presenting with diabetic ketoacidosis
• Under communication and psychosocial aspects, a question could focus on counselling a patient who is unable to afford their medications and testing supplies

You can repeat this exercise for all the objectives. As you progress, you will find that not every objective will map to all categories of the blueprint. To aid in your studies, the MCC has created a PDF of all of the objectives under the medical expert role. In addition, you can find the list of all the objectives under each role online.

Resources from the MCC: Preparatory Products

In addition to the resources discussed and linked in the article, the MCC offers Preparatory Products for the MCCQE Part I. With more than 700 questions, divided into completely unique question sets, the MCC Practice Tests and Preparatory Examinations can help you test your knowledge, identify study focus areas, and get comfortable with MCQ and CDM question formats. All the questions are developed by the MCC undergoing the same rigorous process as the MCCQE Part I content and are also based on the blueprint.