How long is a NAC Examination station?

Each station is 11 minutes long, with 2 minutes between stations.

How many stations are there?

Twelve, of which two are pilot stations that do not count toward your score. Ten are scored.

What is the pass score?

The total score is reported on a 500 to 700 scale and the pass score is 577. A total at or above the pass score is a pass.

How many competencies does the exam assess?

Seven: history taking, physical examination, communication skills, diagnosis, management, investigations, and data interpretation.

The NAC Examination

Everything on this page comes from the Medical Council of Canada's own published material. Where the MCC does not answer a question, we say so instead of guessing. The note on reading time below is one of those places.

What it is

The National Assessment Collaboration Examination assesses whether an international medical graduate is ready to enter a Canadian residency program. It is an objective structured clinical examination.

Structure

12 stations, of which 2 are pilot stations that do not count toward your final score. Ten are scored.
Each station is 11 minutes long, with 2 minutes between stations.
There are also two or three wait stations with no clinical scenario, no task, and no score.
Each station has at least one standardized participant and a physician examiner. A brief written statement introduces the clinical problem and sets out your tasks: take a history, conduct and describe a physical examination, and so on.

One thing the MCC's published material does not settle: whether you read the station's written statement during the two minutes between stations or inside the eleven. Prep resources commonly describe reading it at the door, but that is not an MCC statement, so we do not present it as one.

The seven competencies

Each station is scored against up to seven competencies:

History taking
Physical examination
Communication skills
Diagnosis
Management
Investigations
Data interpretation

These roll up into three broader domains for the purpose of subscores: assessment and diagnosis, management, and communication skills.

Scoring

From May 2023 onward, the total score is reported on a scale from 500 to 700, with a mean of 600 and a standard deviation of 25. The pass score is 577, and a total at or above it is a pass.

Your statement of results also shows subscores for the three domains. The MCC is explicit that these are reported on a different scale from the total, are not comparable across examination forms or sessions, are less reliable than the total, and should not be used to compare candidates' performances. Its own guidance is to use the total score rather than the subscores.

Pass rates

In 2024, 81.7% of the 1,741 candidates passed. That was 82.0% of first-time test takers and 79.8% of repeat test takers.

That single figure is easy to misread, so here is the number that matters more: the three test forms used in 2024 passed at 81.2%, 87.8%, and 75.6%, a twelve-point spread inside one year. The examination is criterion-referenced, which means your performance is compared against the standard, not against the other candidates in your session. Everyone who reaches the pass score passes, however well or badly anyone else does. An overall pass rate tells you about the cohort; it does not tell you your odds.

How this differs from what we offer

Our station catalogue is built to the shape described above: a brief, a standardized patient, a described physical examination, and an examiner's questions. Our feedback is organized by the same competencies. We do not produce a score on the MCC's scale and we do not predict a pass or fail outcome. The MCC's own position on subscore reliability is reason enough not to attempt it.

Longer guides

Format and timing, scoring, preparing as an international medical graduate, and practising with NACMATE each have a guide of their own on the guides page.