The current MCCQE format is MCQ-only.
The exam formerly known as the MCCQE Part I is now officially referred to as the Medical Council of Canada Qualifying Examination, or MCCQE. So when you see older websites, videos, or study groups using terms like “MCCQE1” or “MCCQE Part I,” they are usually referring to the same exam. MedCognito has already covered this name change in detail in its MCCQE name-change article.
For 2026 candidates, the key point is simple:
The MCCQE now consists of 230 multiple-choice questions divided into two sections of 115 questions each. There is no separate CDM section.
This format change matters because many candidates still prepare as if the exam has both MCQs and Clinical Decision-Making cases. That is outdated. The CDM component has been removed, but the exam still assesses clinical decision-making through MCQs.
Quick Summary of the Current MCCQE Format
| MCCQE Format Area | Current 2026 Format |
|---|---|
| Official exam name | MCCQE |
| Former name | MCCQE Part I |
| Question type | Multiple-choice questions only |
| Total questions | 230 MCQs |
| Sections | 2 sections |
| Questions per section | 115 MCQs |
| Time per section | 2 hours and 40 minutes |
| Optional break | 45 minutes between sections |
| Total appointment length | 6.5 hours |
| CDM component | Removed |
| Delivery | Prometric test centre or remote proctoring |
| Question options | 3 to 5 options per MCQ |
| Wrong-answer penalty | No penalty for incorrect answers |
The MCC states that the MCCQE is a one-day, computer-based examination delivered in Canada and in more than 70 countries, with candidates able to take it at an available Prometric test centre or through remote proctoring.
Is the MCCQE Still Called MCCQE Part I?
The old name was MCCQE Part I, and many candidates still use the term MCCQE1 in searches and study groups.
However, the current official name is MCCQE.
This can create confusion because older resources, question banks, blog posts, YouTube videos, and Facebook groups may still use the previous name. In most cases, they are talking about the same examination. But candidates should be careful: some older resources may also describe the old exam format, including CDM cases, which no longer reflects the current structure.
A good rule is this:
Use “MCCQE” for the current exam, but understand that “MCCQE Part I” and “MCCQE1” often appear in older or transitional materials.
How Many Questions Are on the MCCQE?
The current MCCQE has 230 multiple-choice questions. These are divided into two sections of 115 questions each.
Each section includes pilot questions, also called pre-test items. These are questions being tested for future use, but candidates do not know which questions are pilot items and which are scored. Because of that, you should treat every question seriously.
The structure is:
- Section 1: 115 MCQs
- Optional break: 45 minutes
- Section 2: 115 MCQs
This makes the current MCCQE more predictable than the older exam format because candidates now prepare for one main question type.
How Long Is the MCCQE?
The MCCQE exam appointment is 6.5 hours long. This includes check-in, security procedures, tutorial time, two MCQ sections, the optional break, and the optional end-of-exam survey.
Each MCQ section gives you 2 hours and 40 minutes to complete 115 questions. That means you have about 1 minute and 23 seconds per question on average.
This is important for preparation. You cannot study only for knowledge. You also need to practise pacing.
A good exam-day pacing target is:
- First pass: answer straightforward questions quickly
- Flag difficult questions
- Avoid spending too long on one item
- Return to flagged questions before submitting the section
- Make sure every question has an answer before time runs out
The MCC states that unanswered questions are marked incorrect once you leave a section, so every question should be answered before submission.
Is There Still a CDM Section on the MCCQE?
No. There is no separate CDM section on the current MCCQE.
The old Clinical Decision-Making component was removed as part of the new exam format that took effect in April 2025. The MCC explained that the new exam would consist of 230 MCQs and that MCQs would continue to assess critical knowledge and clinical decision-making.
This is one of the most important points for 2026 candidates:
CDM cases are gone, but clinical decision-making is not gone.
In the current format, clinical decision-making is tested through MCQ scenarios. You may still be asked about diagnosis, investigations, management, ethics, emergency care, prevention, and communication. The difference is that your answer is now selected from MCQ options rather than entered through a separate CDM format.
What Changed After the Format Update?
The biggest changes were:
- The CDM component was removed
- The exam became MCQ-only
- The appointment became shorter
- The exam was divided into two MCQ sections
- Candidates now have more time per question compared with the older structure
- Clinical decision-making is assessed through MCQs
The MCC described the change as part of a modernization effort focused on improving exam delivery and candidate experience while maintaining the exam’s integrity, validity, and reliability.
For candidates, the practical meaning is clear: you should not build your 2026 study plan around outdated CDM preparation. You should prepare for MCQ-based clinical reasoning.
What Kind of MCQs Are on the MCCQE?
The MCCQE uses single-best-answer MCQs.
According to the MCC, each question may have three to five answer options. One option is the best answer, and the other options are distractors. You can select only one answer.
Some questions may include clinical images, diagrams, radiographs, ECGs, tables, or other visual information. If normal lab values are relevant to a question, the MCC states that they will be presented directly in the question.
This means candidates should practise more than simple recall. You need to be comfortable interpreting clinical stems, patient context, investigation results, and management priorities.
Typical MCCQE-style MCQs may test:
- Most likely diagnosis
- Most appropriate next step
- Initial investigation
- Best management option
- Emergency stabilization
- Preventive care
- Screening
- Ethics and professionalism
- Communication
- Public health responsibilities
- Patient safety
The exam is MCQ-only, but it is not a memory-only exam.
Can You Go Back to Questions During the MCCQE?
Yes, but only within the same section.
The MCC allows candidates to move freely between questions within a section. You can flag questions and return to them at any point before submitting that section.
However, once you submit a section, you cannot return to it. This matters because the optional break comes after the first section. Once you leave section one, that section is closed.
So your strategy should be:
- Do not submit a section until you are ready
- Check that every question has an answer
- Review flagged questions if time allows
- Do not expect to return to section one after the break
Is There a Penalty for Wrong Answers?
No. The MCC states that there is no penalty for incorrect answers.
This means you should answer every question, even when you are unsure. Leaving a question blank is not a good strategy because unanswered questions are marked incorrect after the section is submitted or time expires.
When you are unsure, eliminate clearly wrong options, choose the best remaining answer, flag the question, and move on.
What Is the Break Structure?
There is one optional 45-minute break between the two MCQ sections.
You can take less than 45 minutes if you want to start the second section early. However, unused break time does not become extra exam time. If you do not manually end the break, the timer for the second section starts automatically after the 45 minutes.
The MCC also explains that candidates must leave the exam room during the optional break for exam security reasons. During the break, candidates may access food, beverages, cell phones, and medication, but they must allow time for security check-in when returning.
You can also take unscheduled breaks, but these count against your exam time. The exam timer continues during unscheduled breaks.
Can You Take Notes During the MCCQE?
Yes. The note-taking tool depends on whether you take the exam at a test centre or through remote proctoring.
At a test centre, candidates have access to a dry erase board. Through remote proctoring, candidates have access to an electronic scratchpad. The MCC also notes that if a candidate is disconnected during a remotely proctored exam, scratchpad notes will be lost.
This is worth considering when choosing between remote proctoring and a test centre. If you rely heavily on notes, calculations, or written organization during questions, you should practise using the type of note-taking method that matches your exam modality.
How Is the MCCQE Scored?
The MCCQE is reported on a score scale from 300 to 600, with a pass score of 439. A candidate passes if the total score is equal to or greater than the pass score.
For MCQs, each correct answer receives one raw point and each incorrect answer receives zero. However, the MCC explains that raw scores alone are not enough because the difficulty of the questions must also be considered. The total score is calculated using both item performance and item difficulty.
The MCC also explains that the current 300–600 score scale applies from the April 2025 session onward. Scores from before 2025 cannot be directly compared with scores from 2025 and later because the exam format and score scale changed.
For a format article, the most important scoring takeaway is this:
Answer every question. There is no wrong-answer penalty, and every blank question is a lost opportunity.
What Does the MCCQE Test?
The MCCQE assesses the medical knowledge, skills, abilities, and clinical decision-making expected of a student completing a medical degree in Canada. The exam is based on the MCC Examination Objectives, organized under the CanMEDS roles.
The MCC blueprint assesses performance across two broad categories:
- Dimensions of care
- Physician activities
These categories include areas such as health promotion, illness prevention, assessment, diagnosis, acute care, management, chronic care, communication, psychosocial aspects, and professional behaviours.
This is why the MCCQE does not only test whether you know disease facts. It tests whether you can apply medical knowledge safely and appropriately in the Canadian clinical context.
What the MCQ-Only Format Means for IMGs
For international medical graduates, the MCQ-only format can feel like good news. There is now one main question format to prepare for, and you do not need to practise a separate CDM response style.
But IMGs should not mistake “MCQ-only” for “easy.”
The exam still tests Canadian-style clinical reasoning. You may know the diagnosis and still miss the question if you choose the wrong next step. You may know the treatment and still miss the question if the stem is testing patient safety, consent, confidentiality, capacity, prevention, or communication.
Common IMG challenges include:
- Over-investigating when the exam wants the most appropriate first test
- Choosing specialist referral too early
- Missing Canadian screening or prevention priorities
- Underestimating ethics and communication questions
- Treating stable and unstable patients the same way
- Focusing on rare diagnoses before common or dangerous ones
- Memorizing facts without practising decision-making
The best preparation is not just doing more MCQs. It is learning how to review MCQs properly.
How to Prepare for the Current MCCQE Format
To prepare for the current MCCQE, your study plan should match the exam structure.
That means you should focus on:
- MCQ-based clinical reasoning
You need to practise how to identify what the question is really asking: diagnosis, investigation, management, ethics, prevention, or emergency care. - Timed question blocks
Since each section has 115 questions in 2 hours and 40 minutes, pacing should be part of your preparation from the beginning. - Blueprint-based content review
The exam is based on MCC objectives and blueprint categories, so your study should not be random. - Careful review of wrong answers
Do not only ask, “What was the right answer?” Ask, “Why did I choose the wrong option?” - Exam-day simulation
Practise longer blocks so you can build stamina for two large MCQ sections. - Canadian clinical expectations
This is especially important for IMGs. The MCCQE often rewards safe, practical, patient-centred decisions.
MedCognito’s MCCQE preparation is built around structured lessons, MCQ practice, mock exams, feedback, and support for internationally trained candidates preparing for Canadian medical licensing exams.
Common Mistakes Candidates Make With the New Format
The current format creates a few traps.
The first mistake is assuming CDM removal means clinical decision-making is no longer tested. That is wrong. The MCC specifically states that critical knowledge and clinical decision-making continue to be assessed through MCQs.
The second mistake is using outdated resources without checking whether they reflect the current exam. Some older materials still describe the old MCQ + CDM structure.
The third mistake is practising only untimed questions. The exam gives you about 1 minute and 23 seconds per question, so timing must be part of your preparation.
The fourth mistake is leaving questions blank. Since there is no penalty for wrong answers, every question should be answered.
The fifth mistake is reviewing questions passively. You should review the reasoning behind both the correct answer and the distractors.
Final Thoughts: The MCCQE Is MCQ-Only, But Still Reasoning-Heavy
The 2026 MCCQE format is clearer than the old structure.
There are 230 MCQs, divided into two sections of 115 questions, with 2 hours and 40 minutes per section and one optional 45-minute break. The full exam appointment is 6.5 hours.
There is no separate CDM component. But clinical decision-making remains central to the exam.
So your preparation should not focus only on memorizing facts. It should train you to read clinical stems carefully, recognize what the question is testing, manage time, avoid distractors, and choose the safest, most appropriate answer in a Canadian clinical context.
That is how to prepare for the current MCCQE.
FAQs
What is the current MCCQE format?
The current MCCQE is an MCQ-only exam with 230 multiple-choice questions divided into two sections of 115 questions each.
Is MCCQE still called MCCQE Part I?
The current official name is MCCQE. The exam was formerly known as MCCQE Part I, and many older resources still use that name.
How long is the MCCQE?
The full exam appointment is 6.5 hours. Each MCQ section is 2 hours and 40 minutes, with an optional 45-minute break between sections.
How many questions are on the MCCQE?
There are 230 MCQs in total. Each of the two sections contains 115 questions.
Is CDM still part of the MCCQE?
No. The separate CDM component has been removed. Clinical decision-making is now tested through MCQs.
Can I go back to previous questions?
You can move freely within the same section and return to flagged questions before submitting that section. Once you submit a section, you cannot return to it.
Is there a penalty for wrong answers?
No. The MCC states that there is no penalty for incorrect answers, so you should answer every question.
What is the MCCQE pass score?
The pass score is 439 on a score scale from 300 to 600.
