By Dr. Bilal Akil, MD — Emergency Medicine, Schulich School of Medicine & Dentistry, Western University · founder of mccQbank
Short answer: A NAC OSCE fail means your total score fell below the pass score of 577 on the 500–700 scale. You can take the NAC Examination a maximum of 3 times, whether you passed or failed before, but never in consecutive sessions, and only your most recent result stays valid (MCC, NAC eligibility and application). With sessions in the spring and fall, that means waiting about a year: under that rule, a September 2026 candidate cannot sit the next session, in May 2027.
Everything below was read on the Medical Council of Canada (MCC) and CaRMS websites on 10 November 2026. Results for the September 2026 session are due in late November 2026, so if you are reading this while you wait, the rules here are the ones that will shape your next twelve months.
What a fail on the NAC actually means
The MCC’s NAC results page sets out how the result is decided:
- Your total score is the average of your 10 scored station scores. The exam has 12 stations, and 2 are pilot stations that don’t count.
- The total is reported on a scale from 500 to 700, and the pass score is 577.
- The exam is criterion-referenced: anyone at or above the standard passes “regardless of how well other candidates perform.” In other words, a fail reflects a gap against a fixed standard, not a strong cohort.
- Results arrive about 8 weeks after the session, as a Statement of Results (SOR) with your total and the pass score, and a Supplemental Information Report (SIR) with subscores.
The MCC’s score interpretation guidelines also explain what the pass score is for: it “is intended to screen IMGs who are not ready for entry into a residency program.” For a breakdown of the scale, including what 602 or 622 means, see our guide to NAC OSCE scores and results.
The retake rules, in the MCC’s words
Three rules on the eligibility page decide your next move:
- Three attempts in total. “You can take the NAC Examination a maximum of 3 times, regardless of if you passed or failed your previous attempt(s).”
- No back-to-back sessions. “The NAC Examination cannot be taken in consecutive sessions.” The MCC’s own example: a candidate who took the May 2024 exam “will only be able to retake it in May 2025 or later.”
- The latest result is the only one that counts. “Only your most recent result on the examination remains valid indefinitely and does not expire.”
The MCC’s reconsideration page, which covers all MCC exams, adds a fourth point that matters on exam day: once you begin the exam, “it will count as an attempt, even if you are unable to finish.”
Your next session: a decision table
The table applies those rules to the situations we see most often. The “what to do” column is our reading, not MCC advice.
| Your situation | What the MCC rules mean | What to do |
|---|---|---|
| Failed the September 2026 session (first attempt) | You cannot sit May 2027, the next session. The MCC had not listed a September 2027 session when we checked. 2 attempts remain. | Plan for a fall 2027 sitting and watch the MCC scheduling page for its dates. |
| Failed a May session | The September session that follows is consecutive, so the earliest retake is the next May. | Use the year for structured station practice before you reapply. |
| Failed a second time | One attempt remains, ever. | Sit the last attempt only when your timed practice is consistently at the standard. |
| Passed earlier, thinking of retaking for a higher score | The new result replaces the pass, even if it is a fail. | Weigh the risk carefully: the MCC leaves it “up to the candidate.” |
| Something went wrong on exam day | Reconsideration is only possible if you reported it within 7 days of the exam. | See the reconsideration section below before your 15-day window closes. |
When the next sessions run
The MCC’s NAC scheduling page says the exam is “offered in limited exam centres twice a year, in the spring and fall (typically in May and September).” The only future session listed on 10 November 2026 was Saturday 1 May 2027, with applications open from 18 November to 9 December 2026 at 11:59 p.m. ET and results in late June 2027. Centres for that session are Edmonton, Winnipeg, Hamilton, London, Ottawa (also in French), Toronto, Windsor, Saskatoon and Dublin, Ireland.
That May 2027 session is the right one for a first-time candidate, or for anyone whose last sitting was before September 2026. It is closed to anyone who sat in September 2026. Our page on NAC OSCE dates for 2027 tracks each deadline as the MCC publishes it.
Should you ask for a reconsideration?
Only in narrow cases. The MCC’s reconsideration and appeal page covers exam-day incidents: extenuating circumstances, such as acute illness backed by official documents, and procedural irregularities in how the exam was delivered. The conditions are strict:
- You must have reported the incident to the MCC through your physiciansapply.ca account within 7 days of the exam, even if the exam provider said it would report it.
- Your request goes in through your account within 15 calendar days of receiving your result, with the subject “Reconsideration of final result.”
- You cannot request reconsideration “based on the content of the examination,” and “a pass or additional marks cannot be granted.”
- The two possible outcomes are no change, or a No Standing, which “does not count as an exam attempt.”
- The process is “anticipated to take approximately 11 weeks.” A reconsideration decision can be appealed within 30 days; the MCC’s fee page lists the appeal fee for the NAC at $1,200 (fees are subject to change).
If you simply had a bad day without a reported incident, reconsideration is not open to you. Your energy is better spent on the next attempt.
What a fail means for CaRMS
CaRMS’s R-1 eligibility criteria say an international medical graduate must “have written and passed” the NAC Examination and the MCCQE, adding that “some provinces may allow exceptions to either exam.” Its summary of MCC examination requirements lists the exams accepted in place of the NAC: the former MCCQE Part II in Newfoundland and Labrador and Ontario, and the LMCC in Newfoundland and Labrador. Quebec also lists a separate exception for its particular stream: an IMG already training in Canada or the United States has no MCC examination requirements for that match. CaRMS notes that the criteria on this page are from the 2026 match and that updated 2027 provincial criteria will be posted in the coming months.
The dates set the rest. The 2027 match has two Match Days: 2 March 2027 for the first iteration and 20 April 2027 for the second. There is no NAC session between September 2026 and May 2027, and May 2027 results come in late June. So if you failed in September 2026 and hold none of those alternative exams, you will not have a NAC pass before either 2027 Match Day; that is our arithmetic from the MCC and CaRMS dates. In our reading, for most candidates in that position the realistic target is a later match. Our CaRMS 2027 timeline for IMGs lists every deadline in order.
How to use the year before your retake
- Read the SIR, then look past it. Subscores group the seven competencies into assessment and diagnosis, management, and communication skills. The MCC’s score interpretation guidelines say subscores are “not as reliable as total scores” and are provided as formative feedback, so treat a low domain as a lead to test in practice, not a verdict.
- Practise under timed conditions. Stations are scored by physician examiners with a checklist, oral questions and rating scales. Timed practice with a partner who scores you on a checklist is the closest rehearsal; our 12-week NAC OSCE study plan lays it out week by week.
- Budget for the next sitting. The NAC application fee is $3,320, and the MCC charges an extra $1,500 if you are assigned to the Dublin centre.
- Keep the MCCQE moving. CaRMS lists both exams as basic eligibility criteria for IMGs, with some provincial exceptions, and the MCC says you can take them in the order you prefer.
Frequently asked questions
How many times can you take the NAC OSCE?
A maximum of 3 times, whether you passed or failed your earlier attempts. A No Standing granted through reconsideration does not count as an attempt.
How long do I have to wait to retake the NAC after failing?
You cannot sit the next consecutive session. Because the exam runs in the spring and fall, the earliest retake is usually the same season a year later.
What score do you need to pass the NAC OSCE?
577 on the 500–700 scale, in place since May 2023. A score of 577 or higher is a pass.
Does a fail replace an earlier NAC pass?
Yes. The MCC says only your most recent result is valid, so retaking after a pass carries the risk of ending on a fail.
Can I appeal a NAC OSCE fail?
Not on the content of the exam. You can request reconsideration only for an exam-day incident you reported within 7 days, and the best outcome is a No Standing, not a pass.
If you are preparing for the MCCQE while you wait for your next NAC sitting, try 30 free questions in English or French.
