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

New date scheduled for postponed TDM exam

Medical Council of Canada (MCC) has set October 21, 2020 as the new date for the postponed June 3, 2020 TDM exam.

This and future TDM exams will be offered online at Prometric test centres across Canada.

In addition to ensuring security and quality control, Prometric test centres adhere to guidelines set by local health authorities. The October 21, 2020 session will have physical distancing and personal protective measures in place to help keep candidates safe.

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

Next Exam Dates:

  • October 21, 2020 - Application Full
  • January 12, 2021 (applications will be available in October 2020)
  • June 2, 2021

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

Apply Now

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

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 $1,445 (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.