MCCQE Part 2 Guide: Format, Preparation & What to Expect (2026)

You passed the MCCQE Part 1. You matched to a residency program. Now there's one more exam standing between you and full medical licensure in Canada: the MCCQE Part 2.

While Part 1 tests what you know, Part 2 tests what you can do — and it's a fundamentally different kind of assessment.

What Is the MCCQE Part 2?

The MCCQE Part 2 is a clinical skills examination that assesses your ability to manage patient encounters effectively. It uses an Objective Structured Clinical Examination (OSCE) format — standardised patient stations evaluating history-taking, physical examination, communication, and clinical reasoning.

Key Facts

Detail	Information
Format	OSCE with standardised patients and written components
Stations	Multiple clinical stations (exact number varies)
Duration	Half-day examination
Eligibility	Must hold LMCC or be in approved postgraduate training
Timing	Taken during or after residency training
Cost	~$3,500 CAD
Purpose	Required for independent medical practice in Canada

MCCQE Part 2 vs Part 1 vs NAC OSCE

These three exams are often confused. Here's how they differ:

Feature	MCCQE Part 1	NAC OSCE	MCCQE Part 2
What it tests	Medical knowledge	Clinical skills (IMG eligibility)	Clinical skills (licensure)
Format	230 MCQs	12 OSCE stations	OSCE + written
Who takes it	All candidates	IMGs only	All candidates
When	Before residency	Before CaRMS	During/after residency
Purpose	Medical knowledge assessment	CaRMS eligibility for IMGs	Full licensure requirement
Clinical experience expected	Pre-residency knowledge	Pre-residency skills	Residency-level competence

Key difference: The MCCQE Part 2 assesses you at a higher clinical level than the NAC OSCE. Examiners expect residency-level decision-making, not medical student-level skills.

What the MCCQE Part 2 Tests

Clinical Competencies

Domain	What's Assessed
Patient assessment	Focused history and physical exam
Communication	Patient-centred communication, informed consent, breaking bad news
Diagnosis	Clinical reasoning, differential diagnosis, investigation ordering
Management	Treatment plans, prescribing, referrals, follow-up
Professionalism	Ethics, boundaries, cultural sensitivity
Collaboration	Consultation requests, interprofessional communication

Station Types

Clinical encounters — Full patient interactions with standardised patients
Written stations — Short-answer or structured responses to clinical scenarios
Mixed stations — Patient interaction followed by written questions

How to Prepare

1. Leverage Your Residency Training

Unlike Part 1 or the NAC OSCE, the best preparation for Part 2 is clinical experience. Every patient encounter during residency builds the skills this exam tests.

During residency, actively practise:

Structured history-taking (don't let bad habits develop)
Physical examination techniques (not just reviewing findings)
Communicating plans clearly to patients
Written consultation notes and referral letters

2. Study the Exam Format

Familiarise yourself with:

Time limits per station
How written stations are structured
Scoring rubrics (what examiners look for)
MCC objectives — the same objectives that govern Part 1

3. Practice Mock OSCEs

Partner with fellow residents. Rotate through common clinical scenarios:

Acute presentations (chest pain, shortness of breath, abdominal pain)
Chronic disease management (diabetes follow-up, COPD management)
Challenging communication (breaking bad news, medication non-adherence)
Ethical dilemmas (capacity, end-of-life decisions)

4. Review Canadian Guidelines

Part 2, like Part 1, tests Canadian-specific clinical practice. Ensure your management plans reflect Canadian guidelines (CCS, SOGC, CPS) and ethics frameworks (CMPA, CanMEDS).

5. Time Your Practice

Each station has strict time limits. Practise completing encounters within those limits — rushing through management at the end loses marks just as surely as running out of time.

Common Mistakes

Treating it like Part 1 — You can't MCQ your way through Part 2. Clinical performance and communication are evaluated, not just knowledge
Neglecting the written component — Written stations require clear, structured answers. Practice writing concise clinical notes
Forgetting communication marks — Even with perfect clinical reasoning, poor communication with the standardised patient loses significant marks
Not practising under time pressure — Every candidate who runs out of time at a station loses marks they could have earned

Frequently Asked Questions

When should I take the MCCQE Part 2?

Most candidates take Part 2 during their second or third year of residency, when they have enough clinical experience to perform confidently. Some programs encourage taking it earlier. Check with your residency program for recommended timing.

Can I practice medicine in Canada without passing Part 2?

Not independently. The MCCQE Part 2 is required for the LMCC (Licentiate of the Medical Council of Canada), which is a prerequisite for unsupervised practice in most provinces. You can practise under supervision during residency without Part 2.

Is the MCCQE Part 2 harder than Part 1?

Most candidates find Part 2 less academically demanding but more practically challenging. If you're in active clinical training, the content feels natural. The difficulty comes from performing under timed observation — exam anxiety affects clinical performance differently than written test performance.

How many attempts are allowed for Part 2?

There is no limit on attempts. You can retake Part 2 at the next available session. However, repeated failures may trigger additional requirements from provincial licensing bodies.