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Eligibility and application

Learn about the eligibility requirements and applying for the TDM Examination as an international medical graduate for entry to a PRA program.

The Medical Council of Canada (MCC) is now responsible for administering applications for the Therapeutics Decision-Making (TDM) Examination. Eligible candidates can apply for the exam through the MCC during the designated application period, without an invitation or approval from the Practice-Ready Assessment (PRA) programs. Before applying for the TDM Examination for admission to a PRA program, it is important to review the program’s requirements to determine your eligibility.

For more information about the changes that came into effect in September 2026, see New application model and eligibility criteria for the TDM Examination.

 January 13, 2027 TDM Examination

Applications for the January 2027 TDM Examination are currently accepted. The application period will close on October 26, 2026, at 4.00 p.m., Eastern Time. To apply, you will need to complete and submit an online form available in the section How to apply for the TDM Examination on this page. Your application cannot be submitted through your physiciansapply.ca account.

If you have not already done so, we recommend submitting your medical degree for source verification and ensuring your identity validity period is not expired in your physiciansapply.ca account as early as possible. If you do not have a physiciansapply.ca account, you will need to create one.

FAQs – Applying for the TDM Examination

You need to complete and submit the TDM Examination application online form available on this page, in the section How to apply for the TDM Examination. Please note that you cannot submit your application through your physiciansapply.ca account. The application form will be accessible until application closes on October 26 at 4:00 p.m., Eastern Time.

If you no longer want to take the TDM Examination after you have applied, you can request to withdraw your application. In certain circumstances, you may be eligible for a refund; however, a withdrawal fee would be charged. You cannot defer your application to a future session.

If you have not already done so, you can submit a source verification request for your medical degree and a copy of your acceptable identity document(s) in your physiciansapply.ca account as early as possible. 

No. The required documentation must be approved and the status of your medical degree must be “reviewed and accepted” in your physiciansapply.ca account for your exam application to be complete.

To apply for the TDM Examination, you must have submitted your medical degree for source verification in your physiciansapply.ca account; there is no language testing or postgraduate training requirements. Eligibility for a PRA program, however, is determined separately by each program, and applicants must meet all program-specific criteria.

Before applying for the TDM Examination, it is therefore important to review the requirements of the PRA program you are interested in to confirm your eligibility.

Passing the MCCQE and/or the NAC Examination is not required to apply for the TDM Examination. However, before applying for the exam, it is important to review the requirements of the PRA program you are interested in to confirm your eligibility, as each provincial program determines applicants’ eligibility based on its own criteria. You may consult our eBook Physician Licensing in Canada that includes a comparison table to review the different requirements across all family medicine PRA programs.

Most PRA programs in family medicine require passing the TDM Examination as part of their eligibility criteria. However, it is important to review the requirements of the PRA program of your interest to determine your eligibility to the program and confirm if passing the TDM Examination is part of their criteria.
You may also consult our eBook Physician Licensing in Canada that provides a summarized list of requirements from the medical regulatory authorities and PRA programs to apply for the practice-ready assessment pathway. The eBook includes a comparison table that allows you to review the different requirements across all family medicine PRA programs.

Since candidates will apply for the TDM Examination directly with the MCC, approval from a PRA program will not be required. PRA eligibility is assessed separately by each provincial program.

Passing the TDM Examination alone does not confer eligibility for a PRA program; applicants must meet all program-specific criteria. Before applying to the TDM Examination, it is important to review the requirements of the PRA program you are interested in to confirm your eligibility.

Free new preparation resources are available to help candidates prepare for the TDM Examination, such as the eight free sample cases that reflect the style of the exam and the list of core TDM exam topics . You can also read our TDM Examination multiple-choice and short-menu questions page for tips on how to answer MCQs and SMQs.

Eligibility requirements

To take the Therapeutics Decision-Making (TDM) Examination, you must be a graduate from:

  • A medical school outside Canada that is listed in the World Directory of Medical Schools and identified by a Canada Sponsor Note indicating it is an acceptable medical school in Canada; or
  • A U.S. School of Osteopathic Medicine; or
  • A U.S. School of Allopathic Medicine

Limited exam attempts

As of September 2026, you can take the TDM Examination a maximum of 4 times, regardless of if you pass or fail the exam. Once you choose to start the exam, it will count as an attempt.

Exam attempts prior to September 2026 count towards the total limit. A No Standing does not count as an attempt; a fail result or a Denied Standing are considered attempts.

After three consecutive fail attempts, you will be required to wait 1 year from the time you receive the result before reapplying for your fourth attempt. This 1-year waiting period has been implemented to enable candidates to take the time to prepare for their fourth and final attempt, and it cannot be shortened or waived.

Candidates who receive a fail result are ineligible to apply to the consecutive examination session. For example:

Exam challenged

January 2026
June 2026

Ineligible session

June 2026
September 2026

Next eligible session

September 2026
January 2027

How to apply for the TDM Examination

If you meet the eligibility requirements, you can apply for the TDM Examination using the application form available below. You must complete and submit this form online, as you will not be able to apply through your physiciansapply.ca account. You will receive communications about the progress of your application in your account. If you do not already have an account, you will have to create one.

You need to apply between the application opening and closing dates of the specific session you would like to take the exam.

Before applying for the TDM Examination for admission to a PRA program, it is important to review the program’s requirements to determine your eligibility.

Learn about the PRA programs   

 Steps to apply for the TDM Examination:

  1. If you have not already done so, create a source verification request (SVR) for your medical degree through your physiciansapply.ca account.
  2. If required, prepare copies of your acceptable identity document(s) that will need to be submitted. Your primary identity document(s) must be certified according to our certification requirements. You may review the guidelines on preparing your documents to ensure your documents are ready for upload.
  3. Complete and submit the TDM Examination application form online. You will receive a message in your physiciansapply.ca account confirming receipt of your application within approximately 5 business days.
  1. Monitor your physiciansapply.ca account for a follow-up message with instructions on payment of the TDM Examination application fee.
  2. Proceed with the payment once the application fee has been added to your account. If you request to withdraw your application after the fee has been paid, you may be eligible for a refund; however, a withdrawal fee would be charged.
Please allow up to 5 business days for the processing of your exam application. Once your documents are approved and the status of your medical degree is reviewed and accepted in your physiciansapply.ca account, you will receive a message that your application is complete. A further message will be sent prior to the opening of the scheduling period.

Accessibility and test accommodations

If you have a documented functional limitation and associated accommodation need, you may be able to receive test accommodations to take the TDM Examination (e.g., additional testing time, break time, access to assistive equipment, medication, breast pump, food). To request a test accommodation, you must identify it in your TDM application form. You also have to send your completed Request for test accommodations form and supporting documentation to candidateaffairs@mcc.ca immediately after submitting your exam application.

If you apply for the January 2027 TDM Examination and require a test accommodation, we strongly encourage you to submit all the required test accommodation documentation as early as possible, to allow sufficient time for your request to be processed.

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