By Dr. Bilal Akil, MD — Emergency Medicine, Schulich School of Medicine & Dentistry, Western University · founder of mccQbank
Short answer: the MCCQE (formerly MCCQE Part I, often searched as “MCCQE1”) is a 6.5-hour appointment. It has 230 multiple-choice questions in two sections of 115, with up to 2 hours 40 minutes per section and an optional 45-minute break between them. That works out to about 1 minute 23 seconds per question (MCC: exam day).
Checked against mcc.ca on 16 October 2026.
How long is the MCCQE? The exact breakdown
The MCC describes each 6.5-hour appointment as including (MCC: exam day):
| Part of the appointment | Time |
|---|---|
| Check-in, then a tutorial on the exam software and a test-security video | Before the first section |
| Section 1: 115 multiple-choice questions | Up to 2 h 40 min |
| Optional break | 45 min |
| Section 2: 115 multiple-choice questions | Up to 2 h 40 min |
| Optional survey | At the end |
Each section’s 115 questions include pilot questions, also called pre-test items. Each question has three to five options and one best answer. Within a section you can move freely between questions and flag them to come back to (MCC: multiple-choice questions). The MCC doesn’t describe it as adaptive. Because you can move back and forth freely within a section, it doesn’t work like an adaptive test.
What changed in 2025
Through the October 2024 session the exam was a 9-hour appointment that included a Clinical Decision-Making (CDM) section of 38 cases. From April 2025 the MCC removed CDM, shortened the appointment to 6.5 hours and split the MCQs into two sections of 160 minutes (MCC update; MCC: changes in 2025). Any guide that mentions CDM, or a morning section of up to 4.5 hours, describes the old exam.
Pacing: 1 minute 23 seconds a question
Each section is 160 minutes for 115 questions, which is about 83 seconds per question. To keep five minutes at the end for flagged questions, aim for about 81 seconds a question (155 minutes ÷ 115). In practice:
- Check at the halfway point. You should be past question 57 by about 80 minutes in.
- Don’t get stuck. Flag a question you can’t settle within about two minutes, answer your best guess, and move on. The MCC says there is no penalty for incorrect answers, so never leave one blank (MCC: multiple-choice questions).
- Keep five minutes at the end of each section to revisit flagged questions.
When time runs out
The exam software warns you 30, 15 and 5 minutes before the end of each section, and if a question is slow to load the timer pauses until it appears, so no time is lost. Once you submit a section, or its time runs out, you can’t go back to it, and any question left unanswered is marked incorrect. The exam ends when you submit the second section or run out of time; the completion notice on screen and by email doesn’t include your score or result (MCC: exam day).
Exam day: what to expect
- The break is optional, but take it. The MCC says that during the break you can get to food, drinks, your phone and medication (MCC: exam day). Eat something, even if you feel fine. The break starts when you submit section 1, and section 2 starts automatically after 45 minutes; ending the break early gives you no extra exam time, and you need to allow time for the security check-in on the way back.
- Notes: you get a dry-erase board for working during the exam.
- Unscheduled breaks: you can step out during a section for food, drinks or medication, but the clock keeps running, and the security check to get back in takes about 3 to 5 minutes (MCC: exam day).
- Build stamina beforehand. Do at least two full practice sittings of 2 × 115 questions, timed, with the 45-minute break. The MCC’s own $1 Preparatory Examination is a full 230-question paper and works well as one of them.
If you have a test accommodation
If the MCC approves an accommodation that gives you extra time, that time is allocated to both MCQ sections (MCC: exam day). Request it in your exam application and allow for processing: applications that include an accommodation request can take up to 9 weeks once all requirements and supporting documents are in (MCC: eligibility and application).
How long the whole process takes
The exam is one day; getting to it takes longer. You apply through a physiciansapply.ca account (a one-time $150 set-up fee; the MCCQE application is $1,500; MCC fees), and you can’t book a date until the application is accepted. Once accepted, you have a 12-month eligibility window to schedule and write the exam. You can extend it once, by another 12 months, for a $120 fee, but only when it is within 60 days of expiring (MCC: scheduling). Scheduling for each session opens about 5 months before it starts, first come, first served, and students can apply up to 15 months before their expected graduation (MCC: eligibility and application).
How long do results take?
Results come out 4 weeks after the last day of the January, August and October sessions, and 5 weeks after the April session. The long August to October 2026 session releases results in three batches (MCC: results). Details by session are in MCCQE results 2026.
Frequently asked questions
How many questions are on the MCCQE1?
230 multiple-choice questions in two sections of 115, including pilot questions. Each has three to five options and one best answer (MCC: multiple-choice questions).
How many breaks are there?
One optional 45-minute break between the two sections. You can also take unscheduled breaks, but the clock keeps running during them.
Does an MCCQE1 pass expire?
The MCC’s MCCQE pages give no expiry date for a pass. What residency programs and regulators check, and how the LMCC fits in, is covered in how long the MCCQE is valid.
How long does it take to get MCCQE1 results?
4 weeks after the last day of the January, August and October sessions, and 5 weeks after the last day of the April session. Results for the extended August to October 2026 session come in three batches, each due 4 weeks after its last exam date (MCC: results).
How many times can you take the MCCQE1?
Up to 4 times. After a third attempt you must wait 1 year from receiving that result before you reapply, and you can’t retake the exam once you have passed (MCC: eligibility and application). Starting the exam counts as an attempt, even if you can’t finish it (MCC: exam day).
Is the MCCQE1 hard?
For the MCC’s 2025–26 year, the first-attempt pass rate was 91% for Canadian graduates and 48% for international graduates. Our pass-rate breakdown has the detail.
Want to practise at exam pace? Try 30 free MCCQE questions, no payment method needed.
