For medical graduates looking to practice in Canada, the Therapeutics Decision-Making (TDM) Examination is a crucial step. This national standardized exam goes beyond testing theoretical knowledge—it evaluates how well you can apply that knowledge in real-world clinical scenarios.
Specifically, the TDM exam assesses your ability to make safe and effective treatment decisions using both pharmacological and nonpharmacological approaches. If you’re aiming to meet the standards required of a family physician in Canada, understanding the TDM exam structure, eligibility, and preparation strategies is key to success.
What is the TDM Examination?
The Therapeutics Decision-Making (TDM) Examination evaluates whether candidates have the clinical competence needed to practice independently and safely as a family physician in Canada. Developed and administered by the Medical Council of Canada (MCC), the exam is used by Practice-Ready Assessment (PRA) programs to help select qualified candidates for entry into these programs.
TDM Exam Format
The TDM Examination is a computer-based test lasting 3.5 hours, available multiple times a year in Canada and worldwide. Candidates can take the exam at a Prometric test center or through remote proctoring. The exam is offered in English and French.
It consists of 40 clinical cases with approximately 100 short-answer write-in questions, and candidates are given up to 3 hours to complete it.
Learn more about the TDM Exam Dates 2025.
What Does the TDM Examination Test?
The TDM Examination evaluates a candidate’s ability to apply knowledge in the pharmacological and non-pharmacological management of medical conditions. It features patient-based scenarios that reflect common or critical clinical situations family physicians in Canada must handle.
The exam assesses performance across two key areas:
- Dimensions of Care – covering health promotion and illness prevention, acute illness, chronic illness, and safety/adverse effects.
- Therapeutic Interventions – ensuring candidates can make safe and effective treatment decisions.
A structured exam blueprint determines the content distribution, ensuring a balanced assessment of these competencies.
Who is Eligible for the TDM Exam?
Your Provincial Practice-Ready Assessment (PRA) program determines your eligibility to take the exams. To confirm your eligibility, you must contact your PRA program directly.
You must apply for the TDM Examination through your PRA program. Once your application is approved, you will receive a notification via your physiciansapply.ca account before the scheduling period begins.
Exam scheduling is done online through Prometric on a first-come, first-served basis. Ensure you book your spot as soon as scheduling opens to secure your preferred exam date and location.
How Many Times Can You Take the TDM Exam?
You can take the TDM Examination a maximum of four (4) times, which comes with a maximum of 2 pass results. If you fail, you cannot take the exam in a consecutive session. This means that if you take the examination in January 2025 and you fail, you are ineligible for the next session which is June 2025 unless the next, September 2025.
The TDM Examination is administered multiple times a year and the results are released to the Practice Ready Assessment programs nearly 8 weeks after the exam date.
You will receive a notification in your physiciansapply.ca account confirming your assigned exam center.
How to Choose a Good TDM Prep Course
Preparing for the TDM Examination requires more than just reviewing medical knowledge—it demands strong decision-making and problem-solving skills. A well-structured prep course can significantly enhance your chances of success. Here’s what to consider when choosing the right one:
1. Course Coverage
A good prep course should comprehensively cover all aspects of the exam, including:
- Pharmacological and non-pharmacological management of medical conditions.
- Case-based practice with patient scenarios similar to the exam format.
- Decision-making skills to help you choose appropriate treatments and interventions.
2. Quality of Instruction
Look for courses taught by experienced medical professionals familiar with the TDM exam blueprint. The best courses offer:
- Expert-led lectures that break down complex topics.
- Interactive case discussions to improve clinical reasoning.
- Personalized feedback to identify and correct weaknesses.
3. Timeline and Flexibility
Choose a course that fits your schedule and study pace. Consider:
- Self-paced vs. live classes – Self-paced courses offer flexibility, while live classes provide structured learning.
- Duration of the course – Ensure it gives you enough time to prepare thoroughly before your exam date.
- Accessibility – Some courses offer online access, allowing you to study from anywhere.
4. Budget and Value for Money
Prep courses vary in cost, so choose one that fits your budget without compromising quality. Look for:
- Free or low-cost trial options to test the course before committing.
- Access to additional study materials, such as practice questions, case banks, and mock exams.
- Refund policies in case you need to withdraw.
5. Reviews and Success Rate
Check student reviews and testimonials to gauge the effectiveness of a course. A prep course with a high pass rate and positive feedback is a good indicator of success.
By considering these factors, you can find a TDM prep course that best suits your learning needs, schedule, and budget—helping you feel confident and well-prepared on exam day.
Frequently Asked Questions
What is the TDM exam in Canada?
The TDM Examination is a national standardized exam that evaluates a candidate’s ability to apply knowledge in the pharmacological and nonpharmacological management of medical conditions. It assesses whether candidates meet the competence level required of a family physician in Canada.
What is the full meaning of TDM?
TDM stands for Therapeutics Decision-Making.
Is the TMD Exam a pass-fail?
Yes, the TDM Exam is a pass-or-fail exam with no scores being reported to the PRA program. If your score is equal to or greater than the pass score, it is a pass. However, if your score is less than the pass score, it is a fail.
Does the TDM result expire?
The TDM pass result is valid for 3 years. You will need to retake the exam if your result has expired or approaching expiry.
