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

Upcoming Exam Dates:

  • Tuesday, January 21, 2020 (Edmonton, AB)
  • June 2020 (Edmonton, AB)

Further information will be available on our website in the fall of 2019 as to when our January 2020 TDM Application Form will be open.

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

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

Application Form:

The TDM Application Form for the June 25, 2019 exam is closed. All available spots for this exam have been filled.

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 2019 TDM Exam is $1,445 (plus applicable taxes). 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 2019 TDM Exam is $240 (plus applicable taxes). For more information on the TDM score recheck process, please review the Candidate Guidelines.

Withdrawal policy:

You will receive a partial refund* only if you withdraw your application up to 30 days prior to the TDM Exam.
All fees will be forfeited if you did not withdraw before the withdrawal deadline date or if you are absent on the day of the exam.

The TDM Exam withdrawal fee for the 2019 calendar year is $400.
*Partial refund:
$1,445 (plus applicable taxes) minus withdrawal fee of $400.

Next Steps:

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


The TDM is offered by participating jurisdictions of the National Assessment Collaboration Practice Ready Assessment (NAC-PRA). Included are British Columbia, Alberta, Saskatchewan and Manitoba. Please contact these jurisdictions for more information.