By Dr. Bilal Akil, MD – Emergency Medicine, Schulich School of Medicine & Dentistry, Western University · founder of mccQbank
Short answer: There is no MCCQE Part 2 any more. The Medical Council of Canada announced on June 10, 2021 that it was stepping away from delivering it (MCC announcement). For international medical graduates, the clinical-skills exam that fills the gap is the NAC Examination, which CaRMS lists as required in every province (its exam summary still shows the 2026-match criteria); Newfoundland and Labrador and Ontario still accept an old Part II pass in its place (CaRMS exam summary). Since January 26, 2026 the LMCC needs only a pass on the MCCQE and a verified medical degree.
Search Console shows people still typing “MCCQE Part 2”, “is there a part 2” and “when was it discontinued” into Google. The exam is gone, but the question behind those searches is a fair one: what took its place, and which exams does an international medical graduate need now to match, to enter a practice-ready assessment, or to be licensed? This post answers it route by route, from the MCC’s and CaRMS’s own pages.
What the MCCQE Part II was, and why it ended
The MCCQE Part II was the second of the MCC’s two qualifying exams; until 2021, a pass on it was part of the route to the LMCC. On June 10, 2021 the MCC confirmed that it was “stepping away from the delivery” of the exam, citing “the impact of the pandemic, and the unprecedented challenges associated with delivering a MCCQE Part II examination”. Its Council set new LMCC criteria the same week: an acceptable medical degree, a pass on Part I, at least 12 months of acceptable postgraduate clinical training, and source-verified credentials. The MCC added that “the LMCC is not a licence to practise medicine”: licences stay with the provincial and territorial regulators.
The second change came on January 26, 2026. The MCC dropped the twelve-month training requirement, so the LMCC now rests on two steps: a pass on the MCCQE (formerly the MCCQE Part I) and successful source verification of the medical degree (MCC, January 26, 2026). On April 1, 2026 the MCC renamed the MCCQE Part I to simply the MCCQE, and said “There are no changes to the examination itself” (MCC name update). Before 2021 the LMCC took two exams plus at least 12 months of postgraduate training; now it takes one exam and a verified degree. Our guide explains what the LMCC is and how you get it.
What replaced it, route by route
No single exam replaced Part II. The need to show clinical skills moved to different points, depending on your route.
International graduates applying to residency. The NAC Examination is the clinical-skills gate. The MCC describes it as a half-day OSCE of 12 stations, 2 of them unscored pilot stations, each 11 minutes long, held twice a year in spring and fall. The MCC states that IMGs “must take the NAC Examination to apply” to the CaRMS match. On CaRMS’s exam summary (it still shows the 2026-match criteria; 2027 criteria are not yet posted), the NAC is required in every province, with two exceptions that matter to anyone who sat the old exam: Newfoundland and Labrador accepts the MCCQE Part II or the LMCC in place of the NAC, and Ontario accepts the MCCQE Part II. In Quebec, the Collège des médecins no longer requires the NAC for MD equivalency, but Quebec’s medical schools still require it for residency. The application fee is $3,320 (MCC fees), and you can take the NAC a maximum of 3 times, never in consecutive sessions.
Physicians entering Practice-Ready Assessment. PRA programs run in nine provinces. Each offers a clinical workplace-based assessment of about 12 weeks under trained physician assessors, and each sets its own intake requirements, which may include exams (MCC PRA page). Most PRA programs use the Therapeutics Decision-Making (TDM) Examination in selection. The TDM is a computer-based exam at Prometric: 55 cases, about 110 to 140 questions, with 2027 sessions on January 13, June 16 and September 22, and a $2,850 fee (from the September 2026 exam). It tests therapeutics, not bedside skills, so it is not a Part II either. See our TDM guide.
Canadian graduates. CMGs write the MCCQE at the end of medical school, which the MCC calls “the national standard for medical schools across Canada”. CaRMS’s CMG summary does not list the NAC.
Which exams you need now
| Route | Required | Accepted instead |
|---|---|---|
| CaRMS R-1, IMG, Nova Scotia, New Brunswick, PEI | MCCQE + NAC | USMLE Steps 1 and 2 in place of the MCCQE |
| CaRMS R-1, IMG, Saskatchewan | MCCQE + NAC | USMLE Steps 1, 2 and 3 in place of the MCCQE |
| CaRMS R-1, IMG, Newfoundland and Labrador | MCCQE + NAC | MCCQE Part II or the LMCC in place of the NAC |
| CaRMS R-1, IMG, Ontario | MCCQE + NAC | MCCQE Part II in place of the NAC |
| CaRMS R-1, IMG, Manitoba, Alberta, British Columbia | MCCQE + NAC | None listed |
| CaRMS R-1, IMG, Quebec | MCCQE + NAC (required by the medical schools) | Special rules for some osteopathy graduates and the particular stream |
| Practice-Ready Assessment | TDM in most programs; other exams as each program sets; about 12 weeks of workplace-based assessment | Varies by program |
| LMCC | MCCQE pass + verified medical degree | No training requirement since January 26, 2026 |
Source: CaRMS R-1 Summary of MCC Examination Requirements, IMG tab (2026-match criteria, shown on the 2027-cycle page); MCC PRA, TDM and LMCC pages. Checked 9 November 2026. Programs change their criteria between cycles, so confirm with the program.
Three things people get wrong
“I passed Part I years ago. Do I need to do Part II now?” No. There is no Part II to sit. A Part I pass now meets the exam requirement for the LMCC on its own, together with a verified degree. If you applied for the MCCQE before January 26, 2026, the MCC issues your digital LMCC number on request for a $50 admin fee; if you applied after that date it is issued automatically at no cost.
“The MCCQE1 and the MCCQE are different exams.” They are the same exam. The April 1, 2026 rename changed the name only: 230 multiple-choice questions in two sections of 115 (MCC MCCQE page), a 300–600 reporting scale and a pass score of 439 (MCC results page). The MCC says the name it was called before, MCCQE Part I, may still appear during a transition period, and it refers to the same exam.
“Strong MCCQE scores mean I can skip the NAC.” They don’t. Outside the two Part II exceptions above, every province on CaRMS’s IMG summary requires the NAC, whatever your MCCQE score. With three lifetime attempts and no back-to-back sessions, a failed sitting can cost you a full match cycle, which is why timed station practice matters.
Planning the sequence
The MCC says you can take the NAC and the MCCQE “in the order that you prefer”. The constraint is the calendar. The MCCQE runs in four sessions a year at Prometric centres. The NAC runs twice a year, typically May and September, and results arrive about 8 weeks after the exam (NAC scheduling). For the next session, Saturday May 1, 2027, applications open on November 18 and close on December 9, 2026 at 11:59 p.m. ET, with results in late June 2027. May 2027 centres are in Edmonton, Winnipeg, Hamilton, London, Ottawa (French offered), Toronto, Windsor, Saskatoon and Dublin, where a $1,500 extra fee applies. Our CaRMS planner for IMGs lists the MCC sessions whose results arrive before your CaRMS deadline.
Frequently asked questions
Is there still an MCCQE Part 2?
No. The MCC stopped delivering the MCCQE Part II in 2021 and has not offered it since. The one remaining qualifying exam is called the MCCQE (formerly the MCCQE Part I).
When was the MCCQE Part 2 discontinued?
The MCC confirmed on June 10, 2021, following a May 31 communication, that it was stepping away from delivering the exam. It said it would refund the Part II exam fee and award the LMCC to candidates who met the updated criteria.
Does an old MCCQE Part 2 pass still count?
Yes, in two provinces. Under the current CaRMS criteria (2026 match), Newfoundland and Labrador accepts the MCCQE Part II (or the LMCC) and Ontario accepts the MCCQE Part II in place of the NAC Examination. Every other province on the CaRMS IMG summary requires the NAC.
What is the MCCQE Part 2 fee or pass rate now?
Neither exists any more, because the exam is no longer offered. The fees that apply now are $3,320 for the NAC and $2,850 for the TDM on the MCC fee schedule.
For the clinical-skills exam that replaced Part II for IMGs, our NAC OSCE practice has 122 timed stations across 16 organ systems: see NAC OSCE prep.
Sources: MCC “The MCC ceases delivery of the MCCQE Part II” (June 10, 2021); MCC “Important update to LMCC eligibility and issuance starting January 26, 2026”; MCC name update (April 1, 2026); MCC NAC Examination overview, eligibility and scheduling pages; MCC TDM Examination and scheduling pages; MCC PRA page; MCC fee schedule; CaRMS R-1 Summary of MCC Examination Requirements (2026-match criteria). All checked 9 November 2026.
