The Medical Council of Canada
Therapeutics Decision Making Exam

The Therapeutics Decision Making (TDM) exam assesses whether the therapeutic knowledge and skills of an internationally-trained physician is at a level required of a family physician practising independently and safely in Canada.

The TDM exam is a pan-Canadian initiative aimed at standardizing the selection process into Practice Ready Assessment (PRA) programs, and will become an eligibility requirement in Alberta on March 1, 2018 for candidates interested in practising Family Medicine.

Candidates must first meet the eligibility requirements below before applying to sit the TDM exam.

IMPORTANT: You are NOT eligible to apply for the TDM exam if you:

  • hold a valid letter of eligibility OR
  • have an open file with the CPSA

In light of the ongoing impacts of the COVID-19 pandemic, the Medical Council of Canada (MCC) and Practice-Ready Assessment (PRA) Programs across Canada have taken the difficult decision to postpone the Therapeutics Decision-Making (TDM) Examination originally scheduled for June 3, 2020. This exam administration will now take place in Fall 2020, with a date to be confirmed as soon as reasonably possible.

The MCC is working to move the current paper-pencil delivery of the TDM exam to a computer-based delivery. For more information, visit: NAC PRA

Next Exam Dates:

  • Wednesday, June 3, 2020 Postponed to Fall 2020 (due to COVID-19) - Application Full
  • January 13, 2021 (applications will be available in Fall 2020)
  • June 2, 2021

Due to a limited number of spots, we approve all applications on a first come, first served basis.

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Eligibility Requirements:

Before applying, you must have the following basic requirements:
  • Medical Degree

    Your medical degree must be from a school listed in the World Directory of Medical Schools

  • English Language Proficiency

    You must take the English Language Proficiency test if your medical education and patient care experience was not obtained in a country where English is the first and native language (regardless of whether English was the language of instruction)

  • Medical Council of Canada Qualifying Examination (MCCQE Part I)

    This exam is required if are an International Medical Graduate or Osteopath. The Medical Council of Canada Qualifying Examination Part I (MCCQE Part I) has replaced the Medical Council Canada Evaluating Exam (MCCEE), as per the Medical Council of Canada. See more.

    We will not accept the MCCEE for any future TDM examinations (January 2020 – ongoing).

  • Postgraduate Training Requirements

    Postgraduate training requirements (see note 2 & 3 below) for Family/General Practice as identified here.


  1. Approval to take the TDM examination DOES NOT determine eligibility for independent licensure in Alberta. If you wish to practice Family Medicine independently, you must meet all registration requirements at the time you apply for independent licensure. Obtaining the TDM DOES NOT guarantee your qualifications & training will be accepted.

  2. Fellowship training, community service, public service, national service, Medical Officer posts and practice experience DO NOT satisfy the postgraduate training requirements.

  3. If your postgraduate training was completed in the USA, UK, Ireland, or Australia, you are encouraged to apply to the College of Family Physicians of Canada (CFPC) for certification without examination via the Recognized Training and Certification Outside Canada alternate pathway to Family Medicine certification before applying for the TDM examination. You may be exempt from writing the TDM if you receive an Official Statement Letter from the CFPC finding you eligible for certification. If you obtain this letter and meet all other registration requirements, please complete the Review of Qualifications Form through physiciansapply and email a copy of that letter to

Candidate Guidelines:

The Candidate Guidelines include detailed information about TDM exam including exam tips, sample questions and more.

Study Resources:

We strongly recommend reviewing the tip and resources we've collected to help you better prepare for your exam. Download and review the TDM Exam Study Resources.


The cost of the TDM Exam is $1,445 (plus tax). Payment is required to save your seat for the exam and is due once the CPSA approves your exam application. The fee is non-refundable once you have written the exam.

The score recheck fee for the TDM Exam is $240 (plus tax). For more information on the TDM score recheck process, please review the Candidate Guidelines.

Next Steps:

After passing the TDM exam, the following must take place to complete your CPSA registration.