New application model and eligibility criteria for the TDM Examination

The Medical Council of Canada (MCC) is pleased to announce important changes to the Therapeutics Decision-Making (TDM) Examination application model and eligibility criteria, planned for fall 2026. The TDM Examination assesses the competence of candidates at the level required of a family physician practising independently and safely in Canada. It is primarily intended for internationally trained physicians pursuing the Practice-Ready Assessment (PRA) pathway, and is part of the selection process to enter most PRA programs. Currently, the TDM Examination is administered by the MCC on behalf of the PRA programs, each program managing the exam application process for its applicants.

Beginning in September 2026, candidates will apply for the TDM Examination directly through the MCC and no longer through the PRA programs. Approval from a PRA program will not be required to take the exam. As candidate volumes are expected to increase in the coming years, a centralized application process will help improve overall efficiency and experience for both candidates and PRA programs.

New eligibility criteria and updated policies

With the launch of the new application model, new eligibility criteria for the TDM Examination will be introduced. To apply for the exam, candidates will need to have their medical degree submitted for source verification in their physiciansapply.ca account. After their application has been approved, they will schedule their exam appointment with our vendor Prometric. The TDM Examination will continue to be delivered globally through Prometric at test centres across Canada and worldwide, and via remote proctoring.

To enhance the exam’s process and better support candidates in their career progression, the following updated policies will be implemented, effective September 2026:

• A total of four exam attempts will be allowed, whether it is a pass or fail result
• The limit on the number of attempts with a pass result and the three-year result validity period will be removed

After three consecutive fail attempts, a waiting period will also be required between the third and fourth attempt.

The current application model and policies will be in place until the June 2, 2026 TDM Examination.

Candidates planning to take the TDM Examination for admission to a PRA program should first review the program’s requirements to determine their eligibility, as well as the licensing criteria set by the provincial medical regulatory authority (MRA). Our eBook Physician Licensing in Canada provides a summarized list of requirements from the MRAs and PRA programs.