If you’re preparing for the Therapeutics Decision-Making (TDM) Exam as part of the Practice-Ready Assessment (PRA) route in Canada, you’re likely wondering:
What is the passing score for the TDM exam?
And you’re probably hoping for a simple number — something concrete to aim for. But here’s the twist: the TDM exam doesn’t give you a numeric score. Instead, it’s a pass/fail-only assessment.
In this article, we’ll break down exactly how the TDM exam is scored, what “passing” really means, and what to do if you fail or your result expires.
What Is the Passing Score for the TDM Exam?
The TDM exam uses a pass/fail scoring system. No numeric score is reported. A candidate passes by meeting or exceeding a pre-established performance standard determined by physician assessors — not by outperforming others.
Why Is There No Score?
This isn’t an oversight — it’s intentional.
The Medical Council of Canada (MCC) uses a criterion-referenced scoring system for the TDM exam. That means:
- You’re measured against a standard, not other test-takers.
- A score that meets or exceeds the “acceptable competence” threshold = pass.
- Falling below it = fail.
Your exam is marked by trained Canadian physicians, and each response is evaluated independently twice. Any disagreement between the two physician markers is reviewed by a third subject matter expert — so it’s a triple-check process.
The MCC does this to ensure fairness, accuracy, and to discourage comparing candidates based on minor score differences. In fact, you and the PRA programs will only ever see your pass/fail result. No breakdown, no percentile, no performance band.
How the Pass Score Is Set
Every few years, the MCC brings together a panel of Canadian family physicians to conduct a standard-setting exercise. This group decides what “acceptable competence” looks like in real-world clinical decision-making.
That becomes the pass score benchmark — and every candidate is measured against it.
For example:
- In 2018, the standard was set by a panel of eight physicians from across Canada.
- The final pass mark was approved by the National Assessment Collaboration PRA Committee, ensuring it reflects real-world practice expectations.
What Happens After the Exam?
After you take the TDM exam:
- Your result will appear in your physiciansapply.ca account roughly 8 weeks after the exam date.
- The MCC will also notify the PRA programs that require your result.
- Results are never emailed or given over the phone.
You’ll only see “pass” or “fail.”
How Long Is a Pass Valid?
A pass result is valid for 3 years. If you don’t enter a PRA program within that time:
- You’ll need to retake the TDM exam.
- You’re allowed a maximum of two pass results.
Important: Only your most recent result is valid, even if you passed before and then failed on a retake.
What If You Fail the TDM Exam?
Let’s be honest — failing can be a setback, but it’s not the end of the road.
If you fail:
- You’ll have to wait for the next exam session to retake.
- There’s no publicly stated limit on failures, but PRA programs may factor in multiple attempts when assessing your readiness.
If you’ve failed before or your result is about to expire, it’s a smart move to get support before attempting again. This isn’t an exam you want to take lightly — especially when it directly affects your eligibility for PRA.
FAQ: TDM Exam and Scoring
Can I appeal my TDM exam result?
No. MCC’s decision is final. Because scoring involves quality assurance and triple-checking by physician markers, results are not subject to appeal.
Is the same pass mark used every year?
Not necessarily. The MCC may adjust the passing standard after periodic review, but these changes apply prospectively and are not made arbitrarily.
Do I need to know my exact score to improve?
No — but you do need to understand the TDM exam format, question types, and how to think like a Canadian physician. Clinical reasoning, not rote memorization, is the name of the game.
Want to Pass the TDM Exam With Confidence?
At MedCognito, we’ve helped hundreds of IMGs understand and pass the TDM exam by teaching the very thinking patterns physician assessors are looking for.
- Taught by Canadian-trained physicians
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- Strategic feedback on your decision-making
- Tailored support until exam day
Explore the MedCognito TDM Prep Course
Final Thoughts
So, what’s the passing score for the TDM exam?
There isn’t one — not in the way you’re used to. You either meet the standard of acceptable competence or you don’t. The TDM exam is about thinking like a safe, rational, and competent Canadian doctor.If you’re preparing, don’t chase a number. Chase understanding. Build judgment. Know what makes a decision therapeutically sound — and the pass will follow.
One Response
I was surprised to learn that the TDM doesn’t use numeric scores — that definitely changes how I approach prep. It’s good to know it’s about meeting a standard, not competing with others, which feels more fair for a clinical setting.