By Dr. Bilal Akil, MD — Emergency Medicine, Schulich School of Medicine & Dentistry, Western University · founder of mccQbank
Yes. The clinical decision-making (CDM) component is gone. Since the April 2025 session the exam has been multiple-choice only: 230 questions in two sections of 115, inside a 6.5-hour appointment. If you are studying from notes, forum threads or question sets made before 2025, this is the change that matters most. Here is what changed, when it changed, and what it means for how you prepare.
One note on the name first. As of 1 April 2026 the MCC calls the exam simply the MCCQE, and says there are “no changes to the examination itself” (MCC name update, 1 April 2026). Older material, including the title of this post, still says MCCQE Part I. It is the same exam. We explain the rename in MCCQE Part I is now “MCCQE”.
The old exam and the new one, side by side
Every row below comes from the MCC’s own pages, listed under the table.
| Old format (last sat October 2024) | New format (from April 2025) | |
|---|---|---|
| Question types | Multiple-choice questions plus a CDM component: 38 cases with short-menu and short-answer write-in questions | 230 multiple-choice questions only |
| MCQ layout | One MCQ section | Two sections of 115 questions |
| Exam appointment | 9 hours | 6.5 hours |
| Longest stretch before a scheduled break | Up to 4.5 hours (the morning section) | 2 hours 40 minutes (one section) |
| Time per question | Less: the MCC says the new format gives more time for each question | About 1 minute 23 seconds on average |
| Score scale | 100 to 400 (mean 250, standard deviation 30, set on the April 2018 session) | 300 to 600 (mean 450, standard deviation 30, set on the April 2025 session); pass score 439 |
Two things did not change. The MCC says the multiple-choice questions continue “to assess critical knowledge and clinical decision-making” (MCC, February 2024), so decision-making is still examined, now in MCQ form. And the result is still criterion-referenced: you pass if your score meets or exceeds the pass score, however other candidates perform (MCC results page).
How the switch happened
| Date | What the MCC did |
|---|---|
| 13 June 2023 | Announced a new MCCQE Part I model “to be implemented as of April 2025”, with the CDM component removed and the MCQs split into two sections (MCC). |
| 7 February 2024 | Confirmed the details: 230 MCQs, two sections of 160 minutes, an optional 45-minute break, and a 6.5-hour appointment in place of 9 hours (MCC). |
| October 2024 | Last session in the 9-hour format. The MCC extended it by 14 days and said results were expected in mid-December 2024. |
| December 2024 | A new Preparatory Examination (PE) and PE-Lite, aligned with the shorter exam, were scheduled for release. |
| January 2025 | No session. The MCC dropped the January 2025 session to prepare the switch, and added extra dates to the April 2025 session instead. |
| April 2025 | First session in the new format. Its results were used to set the new score scale (MCC). |
| July 2025 | A panel of 23 physicians recommended the new pass score of 439, which the MCC’s Exam Oversight Committee approved. |
| 1 April 2026 | MCCQE Part I renamed MCCQE, with no change to the exam (MCC). |
What the new format means for your preparation
If your study plan was built around the old exam, these are the adjustments I would make.
- Practise in real blocks. Each section is 115 questions in 2 hours 40 minutes, which the MCC works out at about 1 minute 23 seconds per question (MCC exam day). Do some of your practice as full, timed 115-question blocks so the pace feels normal before exam day.
- Never leave a question blank. You can flag questions and come back to them within a section. Once you leave a section you cannot return to it, and unanswered questions are marked incorrect.
- Stop drilling write-in answers. The short-menu and short-answer write-in questions were removed. Old CDM cases can still teach clinical reasoning, but work them as multiple-choice questions.
- Don’t compare old scores with new ones. The MCC says scores from before 2025 “cannot be directly compared” with scores from 2025 on. A score on the old 100–400 scale tells you nothing about the 439 pass score. What 439 means is covered in our guide to the MCCQE passing score.
- Plan your break. The 45-minute break is optional and starts when you submit the first section. You must leave the exam room, and you can have food, drinks, medication and your phone. Unscheduled breaks come out of your exam time, and the security check to get back in takes an estimated 3 to 5 minutes. The full exam-day sequence is in how long the MCCQE is.
- Calibrate with the MCC’s own forms. The MCC sells a full-length Preparatory Examination (230 MCQs) for $400, a $1 PE with a different question set, and the half-length PE-Lite (115 MCQs) for $250, each with timed and self-paced modes (MCC preparatory products). It also released 55 free MCC-style practice questions in July 2025. When to use them is covered in when to buy the MCC mock tests.
Want to see how you do on MCQ-only practice? Try 30 free questions on mccQbank.
Quick answers
Is there still a CDM section on the MCCQE?
No. Since April 2025 the exam has no short-menu or short-answer write-in questions. Decision-making is tested through the 230 multiple-choice questions.
How long is the MCCQE now?
The appointment is 6.5 hours: sign-in and a tutorial, two MCQ sections of 2 hours 40 minutes each, an optional 45-minute break between them, and an optional survey at the end (MCC exam day).
I wrote the old exam. Can I compare my score with the 439 pass score?
No. The old scale ran from 100 to 400 and the new one runs from 300 to 600, and the MCC says pre-2025 scores cannot be directly compared with 2025 and later scores (MCC results page).
Are the MCCQE Part I and the MCCQE the same exam?
Yes. The MCC renamed it on 1 April 2026 and says there are no changes to the examination itself.
When do results come out?
Four weeks after the last day of the January, August and October sessions, and five weeks after the last day of the April session. The extended August to October 2026 session is released in three batches, each four weeks after the last exam date in that batch (MCC results page).
