How the NAC OSCE is scored

This guide explains how the examination turns its stations into a result, using the Medical Council of Canada's own descriptions. NACMATE does not predict a score or a result, and nothing here is advice on how to score well on a particular case.

What is assessed

The examination assesses seven competencies: history taking, physical examination, communication skills, diagnosis, management, investigations, and data interpretation. (Source: NAC Examination, Medical Council of Canada)

For subscores, the seven competencies roll up into three domains: assessment and diagnosis; management; and communication skills. (Source: NAC Examination results, Medical Council of Canada)

How a station is marked

Stations are scored with a key-features approach, which gives score points only to the critical or key steps a physician must take to manage the patient's case effectively. (Source: NAC Examination Annual Technical Report 2024 (PDF), Medical Council of Canada)

Where a station has oral questions, those answers are scored in the same key-features format as the patient interaction. (Source: NAC Examination Annual Technical Report 2024 (PDF), Medical Council of Canada)

Physician examiners also rate candidates' proficiency in several competencies on a five-point rating scale. (Source: NAC Examination Annual Technical Report 2024 (PDF), Medical Council of Canada)

The score scale

Since May 2023, the total score is reported on a scale from 500 to 700. The May 2023 examination had a mean of 600 and a standard deviation of 25. The pass score is 577. (Source: Score interpretation, Medical Council of Canada)

A total score at or above the pass score is a pass, and a total score below it is a fail. (Source: NAC Examination results, Medical Council of Canada)

The examination is criterion-referenced: your performance is compared against the established standard, not against the performance of other candidates. (Source: NAC Examination results, Medical Council of Canada)

Reading your results

Subscores are reported on a different scale from the total score and are not comparable across examination forms or sessions. The MCC says they are not as reliable as total scores, should not be used to compare candidates, and advises using total scores instead. (Source: Score interpretation, Medical Council of Canada)

What this means for practice

Practice helps most when it shows you which steps of a case you reached, which you left out, and how you came across while doing it. In a NACMATE report, a language model judges your session against the station's fixed marking criteria and names the ones it reached and the ones it did not, organized by competency, and our code checks every quote it cites against your transcript. The report does not turn any of this into a number on the examination's scale.

Sources

More guides are on the guides page, and the exam overview has the examination's structure on one page.