The Medical Council of Canada
Therapeutics Decision Making Exam

Next Exam Dates:

  • January 12, 2021 (applications will be available November 3, 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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New TDM exam process

On March 1, 2018, CPSA required all international medical graduates (IMGs) in Family Medicine who weren’t eligible for our General Register to pass the Therapeutics Decision Making (TDM) exam before submitting a Review of Qualifications for independent practice in Alberta.

As of October 1, 2020, IMGs who wish to practice independently in Family Medicine in Alberta must be eligible for our Provisional Register requirements and submit a Review of Qualifications before applying and taking the TDM exam.

If you are a Family Medicine physician and you want to join our temporary Provisional Register, you will need to pass the TDM exam and get AHS sponsorship within 1 year of receiving your CPSA eligibility letter. Once you have both, your Registration Administrator will send you a letter outlining which documentation we need before you register for our Provisional Register.

Why the change?

  • This change helps us avoid delays in recruiting physicians to Alberta.
  • Applicants understand their CPSA-eligibility before writing the TDM exam.
  • The updated process better aligns with PRA programs across Canada.

What is the TDM exam?

The Therapeutics Decision Making (TDM) exam is for International medical graduates (IMGs) in Family Medicine through the Medical Council of Canada (MCC). Through the TDM exam, your clinical skills and knowledge are reviewed to ensure you can practice at the level we expect of physicians in Canada. It standardizes the selection process for practice readiness assessment (PRA) programs across Canada.

The TDM exam is not required for physicians who are eligible for our Provisional Register and who have Recognized Training and Certification Outside Canada through the College of Family Physicians of Canada (CFPC).

For more information on the exam, visit MCC’s TDM Exam Information.

Keep reading to learn more about TDM exam, the application process, fees, study resources, next steps and more.

How to Apply

First, make sure you are eligible to practice independently in Alberta. Review our Family Medicine eligibility requirements and apply for independent practice. You will receive your CPSA eligibility letter telling you your eligibility and next steps.

The TDM exam is held twice a year.  If you are planning to apply, we recommend keeping an eye on this webpage for updates—this is where we post the date the application is opening. Once the application is open, you apply through this webpage at the “Apply” link below using the same email used to apply for independent licensure. You will be asked to provide:

  • MINC Number
  • Medical Degree
  • English language proficiency
  • MCC credentials (MCCQEI)
  • Postgraduate training
  • Previous PRA and TDM exam attempts
  • Test Accommodations

After you submit your application, we review it and determine your eligibility to write the TDM exam. You will get an email stating your eligibility.  If eligible, you will be instructed to pay the TDM exam fee(s) online. Once this payment is received and processed, your spot to write the exam is secure. You will receive emails throughout this process informing you of the next steps.

Exam Details

If you are eligible to write the online TDM exam, the MCC will send you a message through your account a few weeks before the exam date. This message will include:

  • your Authorization to Test (ATT) number
  • instructions on how to schedule your exam
  • when the scheduling period will begin

In addition to ensuring security and quality control, Prometric test centres adhere to local health authority guidelines. Sessions will have physical distancing and personal protective measures in place to help keep candidates safe.

For more information about the TDM exam scheduling, please visit MCC’s TDM Examination webpage.

Ways to write the exam

The MCC is offering two ways to write January’s 2021 TDM exam. You can choose to either:

  • write the exam remotely through remote proctoring or
  • write the exam at a Prometric test centre within Canada

Remote proctoring offers TDM applicants the opportunity to test anywhere globally, as long as the computer configuration requirements are met. See link for more details on remote proctoring.

You are able to identify which method you prefer on your TDM application form.

Information & Resources

We strongly recommend reviewing MCC's Candidate information sheet and preparation resources to help you better prepare for your exam.

You can also learn more about the TDM exam, withdrawal policies, what to expect on the day of your exam, scoring and results, and test accommodations by visiting MCC's TDM webpage.


The cost of the TDM Exam is $1,995 (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 the exam

If you passed the TDM exam

Congratulations on passing your exam! Once you pass the TDM exam, you will receive a result letter. This letter will be sent to you via email and also added to your CPSA file and account.

If you haven’t already got Alberta Health Services (AHS) sponsorship, you need to get it by going to and applying for physician postings eligible for AHS sponsorship. If you’re hired through AHS, they will sponsor you. Refer to your eligibility letter for more details.

When our Registration team receives both your TDM exam pass result letter and AHS sponsorship form, you will receive more information on which documentation is required to continue with registration on our Provisional Register.

If you didn’t pass the TDM exam

You can take the test again at least seven months after your first attempt. You can’t take back-to-back tests. If you do not pass, your registration file will close after one year. Once your file has closed, you can then re-apply for independent licensure at any time. You must meet our current registration requirements at that time.

For more information on the TDM exam validity periods, visit TDM Examination Scoring and Results.