MCCQE Part 1 (2026): Format, Eligibility, Cost & Pass Score

1. What is the MCCQE Part 1?
2. What changed, and why old advice is now risky
3. The format: what exam day looks like
4. Who is eligible?
5. Applying as an IMG: the order matters
6. What it actually costs
7. Session dates and the deadline you cannot miss
8. How scoring works
9. How to pass: build your plan around your weak domains
10. Mistakes that cost IMGs a session
11. Key takeaways
12. Where this fits in your journey
13. Frequently asked questions

If you've been planning your move to Canada for a while, something may have confused you recently. You search for the MCCQE Part 1, and land on the Medical Council of Canada's website. There, the exam is just called the MCCQE. No "Part 1" anywhere.

You didn't make a mistake. The exam changed.

Most of what's written online about the MCCQE Part 1 is now out of date, and some of it badly so. For example, guides still describe a nine-hour exam with clinical decision-making cases that no longer exist. They also quote a pass score that has been replaced. Worse, some tell candidates in Lagos or Nairobi they can write from home. That last one could cost you an entire session.

This guide covers what the exam actually looks like now. It explains who qualifies, what it costs, and how to build a study plan that works. Everything here comes from the Medical Council of Canada (MCC) and is current as of July 2026.

What is the MCCQE Part 1?

The MCCQE, which most people still search for as the MCCQE Part 1, is Canada's national qualifying examination. It assesses the medical knowledge and clinical decision-making expected of someone completing medical school in Canada.

For international medical graduates, it matters for three reasons. First, passing it is required to apply to a Canadian residency programme. Second, some Practice-Ready Assessment programmes use it to screen applicants. Third, a pass is one of the criteria for the Licentiate of the Medical Council of Canada. This is a credential provincial regulators may require before granting a licence.

Put simply: almost every route into Canadian practice runs through this exam.

What changed, and why old advice is now risky

Four things shifted between 2025 and 2026. Each one changes how you should prepare.

The name. It is now simply the MCCQE. The old "Part I" label was dropped because there is no Part II anymore. So if a guide still refers to MCCQE Part 2, it is describing an exam that no longer runs.

The format. As of April 2025, the MCC removed the short-menu and short-answer write-in questions. Clinical decision-making is still assessed, but entirely through multiple-choice questions. As a result, candidates also get more time per question, and the appointment is shorter than it used to be.

The scoring scale. Scores are now reported from 300 to 600, with a pass score of 439. The previous scale ran from 100 to 400. Those numbers are not interchangeable, so a score from 2024 cannot be compared with one from 2025 onward.

Remote proctoring ended. This is the change most likely to catch IMGs off guard. Beginning with the August 2026 session, the MCC paused proctored delivery remotely. Every candidate now writes in person at a Prometric test centre. So if you were counting on writing from home, you need to build travel, and possibly a visa, into your timeline.

The format: what exam day looks like

The MCCQE is a one-day, computer-based exam delivered in Canada and more than 70 countries.

You will answer 230 multiple-choice questions, split into two sections of 115. Each section allows up to two hours and forty minutes, with an optional break in between. In total, that is roughly five and a half hours of testing.

Questions are built on the MCC Examination Objectives and organised under the CanMEDS roles. The blueprint spans two categories, each with four domains:

That second column is where many IMGs quietly lose marks. Communication and professional behaviours are not filler. In fact, they are weighted domains, and they reflect Canadian expectations around consent, capacity, disclosure and working within a team. So strong clinical knowledge alone will not carry you through them.

Who is eligible?

You can apply if you have graduated from, or are about to graduate from, one of the following:

• A medical school accredited by the Committee on Accreditation of Canadian Medical Schools
• A school listed in the World Directory of Medical Schools carrying a Canada Sponsor Note, marking it as acceptable in Canada
• A United States school of osteopathic medicine accredited by the American Osteopathic Association

Check the World Directory before you spend anything. If your school does not carry that sponsor note, you are not eligible. No amount of preparation changes that.

Attempts are limited. You get four in total. Attempts before 2018 do not count toward the limit. A fail counts as an attempt; a No Standing does not. After a third attempt, you must wait a full year before your fourth. Notably, the MCC will not shorten or waive that wait.

Four attempts sounds generous until you consider what each one costs. So treat your first sitting as though it is the only one you get.

Applying as an IMG: the order matters

Everything runs through a physiciansapply.ca account. The sequence is where people lose time, so here it is plainly.

Start a source verification request for your medical degree first. The MCC verifies your diploma directly with the school that issued it. This is the step most likely to stall, especially if your university is slow to respond.

One useful detail many candidates miss: you can submit your exam application right after you pay for source verification. You do not have to wait for verification to finish first.

Next, prepare certified copies of your identity documents, upload everything through your account, and pay the application fee. Allow up to four weeks for processing. After that, you can only schedule your exam once your documents are approved and your degree shows as reviewed and accepted.

If you need test accommodations, apply considerably earlier. Those applications take up to nine weeks.

Once your application is accepted, you have a 12-month eligibility window in which to sit the exam. Appointments open about five months before a session begins, on a first-come, first-served basis. If you cannot sit within the window, you may extend it once by 12 months for a fee. However, this only applies when you are within 60 days of it expiring.

For a document-by-document breakdown, see our guide on documents needed before writing the MCCQE.

What it actually costs

All fees are in Canadian dollars and current as of July 2026. The MCC reviews them annually, so confirm before you pay.

A first-time IMG applicant should budget around $2,067 simply to reach the exam: account setup, one source verification, and the exam fee. Add the NAC Examination if you are heading for the residency match, and you are past $5,000 before travel.

Two warnings worth taking seriously. First, the MCCQE fee is non-refundable, and withdrawing costs $750 even when a refund is possible. Second, if you miss your appointment or cancel within 120 hours of it, your fees are simply gone. Rescheduling through Prometric costs $35 plus tax up to 31 days out, and $75 plus tax inside 30 days.

One thing softens the blow. Tuition tax credits are available for both the MCCQE and the NAC Examination if you keep your receipt.

Session dates and the deadline you cannot miss

2026 sessions: January 20 to February 17 · April 22 to May 30 · August 19 to October 21

2027 sessions: January 19 to February 11 · April 27 to June 1 · August 10 to September 7 · October 5 to 26

The August to October 2026 window is unusually long because the MCC combined two sessions after pausing remote delivery. As a result, results for it are released in three batches. Still, the MCC has confirmed that every candidate in that window will receive results in time for the 2027 CaRMS R-1 Main Residency Match.

Results normally arrive four weeks after the last day of the January, August and October sessions, and five weeks after the April session.

Now the date to write down. If you are applying to the 2027 CaRMS R-1 Main Residency Match, your MCCQE application and documents must be submitted by October 16, 2026. That deadline exists so your identity validity period is confirmed before file review opens on November 26, 2026. Miss it, and you are waiting another year.

If you are also sitting the NAC Examination, you can take the two in whichever order suits you.

How scoring works

Your total score falls somewhere between 300 and 600. The current MCCQE pass score is 439.

The exam measures you against a fixed standard, not against other candidates. So if everyone sitting on your day performs brilliantly, the bar does not move for you. A panel of 23 physicians set the current pass score in July 2025. It holds until the next review.

Correct answers earn a point, incorrect answers earn zero, and there is no penalty for guessing. So answer every question. Your final score also accounts for how difficult your particular questions were, so a raw total does not tell the whole story.

You will receive two documents. The Statement of Results gives your result, your total score, and the score required to pass. The Supplemental Information Report is the one worth studying closely. It breaks your performance down by domain and shows how you compared with other candidates.

That report is genuinely useful if you have to resit, because it tells you exactly where you fell short. It also points to something important about preparation.

How to pass: build your plan around your weak domains

Most IMGs who struggle with this exam are not short on knowledge. Instead, they are short on direction. They work through thousands of questions without ever discovering which of the eight domains is quietly costing them the pass.

Here is an approach that works.

Start with a diagnostic, not a syllabus. Before planning anything, sit a mixed set of questions spanning all eight domains. You need a baseline. Otherwise, guessing at your weak areas wastes weeks.

Study by domain, not by textbook chapter. The exam is blueprinted around dimensions of care and physician activities. If your revision is organised by specialty while the exam is organised by domain, you will carry blind spots you never see coming. So map your notes to the MCC Examination Objectives early.

Do questions actively. Reading explanations feels productive and mostly is not. Instead, for every wrong answer, write one sentence in your own words explaining why the correct answer is right. This single habit separates candidates who improve from candidates who plateau.

Track accuracy by domain over time. This is where analytics matter more than sheer volume. For instance, knowing you are at 78 per cent overall tells you very little. But knowing you are at 84 per cent in assessment and diagnosis, and only 61 per cent in professional behaviours, tells you exactly where to focus next.

Give yourself three to six months. Most IMGs balancing clinical work need that long to cover the objectives properly. Compressing it into six weeks, on the other hand, is how strong candidates end up needing a second attempt.

Rehearse the endurance. Two sections of 115 questions is a long sit. So practise a few full-length blocks under timed conditions, so exam day is not the first time your concentration is tested at hour four.

The offline element matters for a large part of our community. If you are studying in a city where power or data is not guaranteed, an online-only question bank is not really available to you. That is why Sentia lets you build or import an MCCQE question bank and study it entirely offline. You can see your accuracy by topic as you go, so your revision targets your actual weak domains rather than your assumed ones.

Mistakes that cost IMGs a session

Studying from outdated material. If your resource mentions clinical decision-making cases or a pass score in the 200s, it predates the current exam.

Leaving source verification late. It is the slowest step and largely outside your control. So begin it the moment you decide on Canada.

Assuming you can write from home. Not anymore. Instead, factor in travel to a Prometric centre, and a visa if you need one.

Ignoring communication and professional behaviours. They are weighted domains, and they are where clinically strong candidates often lose marks.

Booking late in a session. Appointments are first come, first served. So if you have a CaRMS deadline, sit early enough to absorb a cancellation or delay.

Key takeaways

• The MCCQE Part 1 is now called simply the MCCQE, and there is no Part II
• 230 multiple-choice questions in two sections of 115, up to two hours forty minutes each
• Scores run from 300 to 600, and the MCCQE pass score is 439
• You get four attempts, with a mandatory one-year wait before the fourth
• Budget roughly $2,067 CAD to reach the exam, considerably more with the NAC Examination
• Remote proctoring ended with the August 2026 session, so all sittings are in person
• For the 2027 CaRMS match, apply by October 16, 2026

Where this fits in your journey

Passing the MCCQE is a milestone rather than a finish line. It opens the door to the residency match. It also counts toward the Licentiate of the Medical Council of Canada. This is the credential provincial regulators look for when you apply for a licence. To see how those pieces connect, our guide to the LMCC and provincial licensing covers what comes next.

The exam is demanding, and the recent changes have made preparation harder to navigate than it used to be. Still, it remains a knowledge exam with a published blueprint, a fixed pass standard, and a feedback report that tells you where you stand. So candidates who prepare against the blueprint, rather than against a stack of textbooks, pass it every session.

Study for the MCCQE offline with a free Sentia question bank and detailed analytics, so you always know which domain deserves your next two weeks.

Preparing for the MCCQE? Join the Sentia Telegram community for step-by-step guidance, shared question banks, and support from fellow medical students and International Medical Graduates walking the same path. → https://t.me/+ixuxt5zYIGNjMWIx

Frequently asked questions

Is the MCCQE Part 1 the same as the MCCQE?

Yes. The exam was renamed after MCCQE Part II was discontinued. Most candidates still search for "MCCQE Part 1", but the MCC now calls it simply the MCCQE.

What is the pass score for the MCCQE?

439, on a scale of 300 to 600. It was set through a standard-setting exercise in July 2025 and remains in place until the next review.

How many times can I take the MCCQE?

Four times. Attempts before 2018 do not count. After a third attempt, you must wait one year before the fourth, and that wait cannot be waived.

Can I take the MCCQE from my home country?

You can take it at a Prometric test centre in one of more than 70 countries, but not from home. Remote proctoring was paused beginning with the August 2026 session.

Do I need to pass the MCCQE before the NAC Examination?

No. If you are applying to CaRMS and submitting both results, you may sit them in whichever order you prefer.

How much does the MCCQE cost?

The application fee is $1,500 CAD. A first-time IMG applicant should also budget $335 for the physiciansapply.ca account and $232 for source verification of their medical degree.

How long should I study for the MCCQE?

Most IMGs balancing clinical work need three to six months. What matters more than the total is whether your revision targets your weakest blueprint domains.

When will I receive my results?

Four weeks after the last day of the January, August and October sessions, and five weeks after the April session. Results appear only in your physiciansapply.ca account.