1. Why two different OSCEs?

Until 2018 the MCCQE Part II was open to all candidates who had passed Part I. After the 2018 restructure, the MCC created the NAC OSCE specifically as a diagnostic test for IMGs entering the Canadian system, while MCCQE Part II became a certifying OSCE for residents already in Canadian programs. Since 2022, Part II is restricted to residents who have completed at least 12 months of an accredited Canadian residency.

2. NAC OSCE — Structure and purpose

2.1 Eligibility

Open to graduates of a medical school listed in the World Directory of Medical Schools, who have passed MCC source verification and applied via physiciansapply.ca. There is no requirement to have passed MCCQE Part I beforehand.

2.2 Format

The NAC OSCE consists of 12 stations of 11 minutes each (2-minute reading + 9-minute encounter). Stations cover history-taking, physical examination, counselling, data interpretation, and mixed clinical encounters. There are 1-2 rest stations interspersed.

2.3 Scoring

Each station has a checklist (10-30 items) scored by a physician examiner + a Global Rating Scale (GRS) from 1 to 5. A standard-setting procedure converts raw scores to a scaled score. The passing standard is set annually; results are reported as Pass / Below Performance Expected / Inferior.

According to MCC NAC Examination Booklet 2024: "The NAC OSCE is designed to assess whether an international medical graduate has the level of clinical skills required to enter postgraduate training in Canada." Source: mcc.ca/examinations/nac (accessed 2026-05-27).

3. MCCQE Part II OSCE — Structure and purpose

3.1 Eligibility

Restricted since 2022 to residents enrolled in an accredited Canadian residency program who have completed ≥ 12 months of training and passed MCCQE Part I. Required for LMCC certification.

3.2 Format

The MCCQE Part II consists of 14 stations of 10 minutes each (2-minute reading + 8-minute encounter). The total exam takes approximately 4 hours. Like the NAC, stations include history, physical, counselling, and mixed encounters, but content is calibrated to a higher level of clinical responsibility (i.e., independent decision-making expected at end of residency PGY-1).

3.3 Scoring

Same model as NAC: checklist + GRS, scaled, modified Angoff standard-setting panel. Passing score is reported as a scaled value; first-time pass rate is ~95 % among Canadian residents (MCC report 2023).

4. Side-by-side comparison

5. The candidate pathway for IMGs

1. Step 1: Open physiciansapply.ca account + upload medical school diploma + final transcript + photo ID.
2. Step 2: MCC source verification (4-12 weeks).
3. Step 3: Register for NAC OSCE (Spring or Fall window).
4. Step 4: Sit MCCQE Part I (recommended before or alongside NAC).
5. Step 5: Submit CaRMS R-1 application for residency (Sept-Oct, match in March).
6. Step 6: Once matched, complete residency + MCCQE Part II OSCE in PGY-1/PGY-2.
7. Step 7: Obtain LMCC + provincial licence (CPSO Ontario, CMQ Quebec, etc.).

6. Key takeaways

• NAC OSCE = 12 stations, IMG diagnostic, required for CaRMS R-1 streams.
• MCCQE Part II = 14 stations, residents only since 2022, required for LMCC.
• Both use checklist + Global Rating Scale; modified Angoff standard-setting.
• Apply via physiciansapply.ca; budget 12-18 months for full IMG pathway.
• Time pressure is the #1 reason for failure — practice with a stopwatch.

Further reading

• MCC — NAC OSCE official page
• MCC — MCCQE Part II official page
• physiciansapply.ca
• CaRMS R-1 main residency match
• AIPSO — Association for International Physicians

7. Practical checklist — Day before your OSCE