Hundreds of people a month still search for “MCCQE Part 2”. The exam does not exist: the Medical Council of Canada stopped delivering it on June 10, 2021, and on April 1, 2026 it dropped “Part I” from the surviving exam’s name for the same reason. But the question behind the search is a real one — what replaced Part 2, and which exams does an international medical graduate actually need in 2026 to match, to enter practice-ready assessment, or to be licensed? This post answers it route by route.
What MCCQE Part 2 exam was, and why it ended
The MCCQE Part 2 exam was a clinical skills OSCE, sat after a year of postgraduate training, that tested history-taking, physical examination, communication and management in standardised-patient stations. Together with Part I it earned the LMCC. In June 2021 the MCC announced that “the impact of the pandemic, and the unprecedented challenges associated with delivering a MCCQE Part 2 examination” had led its Council to end the exam permanently and to rewrite the LMCC criteria: graduation from an acceptable medical school, a pass on Part I, twelve months of acceptable postgraduate training and verified credentials. The MCC was careful to add that “the LMCC is not a licence to practise medicine” — licensing stayed with the provincial and territorial regulators, and it is their requirements that filled the space Part II left.
The second rewrite came on January 26, 2026, when the MCC removed the twelve-month training requirement altogether. The LMCC now needs only a pass on the MCCQE part 2 exam and successful source verification of the medical degree. In five years the pathway went from two exams plus a year of residency to one exam. What did not go away is the need to demonstrate clinical skills — that requirement simply moved.
Where the clinical-skills assessment went after MCCQE part 2 removal
For the two groups Part II used to matter most to, the answer is different.
International graduates applying to residency. The NAC Examination — a one-day OSCE of ten scored and two pilot stations, eleven minutes each — is now the clinical-skills gate. Every province requires it for IMG applicants in the CaRMS R-1 match except Quebec, where the Collège des médecins no longer requires it but the universities still do. It is taken before residency rather than after, it is sat in Canada (nine centres in 2026), and it costs $3,320. In effect, for IMGs, the NAC is the Part II — earlier, more expensive, and with a three-attempt lifetime limit. Our NAC OSCE preparation page covers the format and how to practise.
Physicians entering Practice-Ready Assessment. PRA programs — the accelerated route for experienced family physicians in nine provinces — replaced the exam with two things: the Therapeutics Decision-Making (TDM) Examination, which most family-medicine PRA programs require for selection, and a supervised clinical field assessment of twelve weeks or so inside the program itself. The TDM is not a Part II either: it is a written therapeutics exam of 55 cases, delivered at Prometric, with sessions in January, June and September. See our TDM guide.
Canadian graduates. For CMGs the change was simpler. Residency certification — CCFP from the College of Family Physicians or FRCPC/FRCSC from the Royal College — became the clinical standard regulators rely on, alongside the LMCC. No CMG sits a national OSCE after the MCCQE any more.
Which exams you need in 2026, by route
| Route | Required | Not required |
|---|---|---|
| CaRMS residency, IMG (all provinces except Quebec) | MCCQE (result in file by the provincial deadline, usually late October) + NAC Examination | MCCQE Part II, TDM |
| CaRMS residency, IMG, Quebec | MCCQE; NAC required by the universities | MCCQE Part II |
| Practice-Ready Assessment (family medicine) | MCCQE; NAC in most provinces; TDM in most programs; in-program clinical field assessment | MCCQE Part II |
| Independent licence after Canadian residency | LMCC (MCCQE pass + verified degree) + CCFP or Royal College certification | MCCQE Part II |
| Canadian medical graduate | MCCQE, usually in final year or PGY-1 | NAC, Part II |
Requirements are as published by the MCC, CaRMS (R-1 summary of MCC examination requirements) and the PRA programs in September 2026. Programs change their criteria between cycles; 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 nothing to do. A pass on Part I never expired and now satisfies the exam requirement for the LMCC on its own — apply for the LMCC through physiciansapply.ca ($50 if you applied for the exam before January 26, 2026, otherwise free). What a program may ask about is the recency of your clinical practice, which is a different question; how long the MCCQE is valid for explains where those checks come from.
“MCCQE1 and MCCQE are different exams.” They are the same exam. The rename on April 1, 2026 changed nothing about the format — 230 multiple-choice questions, a 300–600 scale, a pass score of 439 — or the eligibility rules. Resources still calling it MCCQE1 are not out of date; resources still describing clinical decision-making cases are, because those were removed in April 2025.
“The NAC is optional if I have strong MCCQE scores.” Outside Quebec it is required for every IMG stream in the match, regardless of your MCCQE score, and it can be taken a maximum of three times, never in consecutive sessions. It is the exam most IMGs under-prepare for because there is no question bank for an OSCE — which is exactly why practising timed stations with a partner matters.
Planning the sequence
For most IMGs the order is MCCQE first, then NAC, with the TDM only if PRA is the goal. The MCCQE has four sessions a year and a twelve-month eligibility window; the NAC has two sessions a year with application windows months in advance (roughly November–December for May, March for September). A candidate who passes the MCCQE in the April 2027 session, sits the NAC in September 2027 and has both results by late November is on time for the 2028 match. Our 2027 MCCQE dates and NAC 2027 outlook lay out the calendar.
mccQbank prepares for both halves of the old Part I/Part II pair: a question bank of 2,400+ bilingual MCQs for the MCCQE, and OSCE-R, 112 timed NAC-style stations across 16 systems for the clinical-skills exam that replaced Part II. Start with 30 free questions or see plans and bundles.
Sources: MCC — “The MCC ceases delivery of the MCCQE Part II” (June 10, 2021); “Important update to LMCC eligibility and issuance starting January 26, 2026”; MCCQE name update (April 1, 2026); NAC Examination eligibility and scheduling pages; TDM Examination pages; fee schedule; CaRMS R-1 Summary of MCC Examination Requirements. Checked September 2026.
