Over 1,900 practice questions for the MCC Therapeutics Decision-Making exam. Clinical scenarios with AI-powered adaptive learning — built for IMGs pursuing family medicine licensure in Canada.
The Therapeutics Decision-Making (TDM) Examination is developed and administered by the Medical Council of Canada (MCC) on behalf of Practice Ready Assessment (PRA) programs across Canada. It assesses whether International Medical Graduates (IMGs) possess the therapeutic competence required to practise independently as a family physician in Canada.
“Therapeutics” here covers both pharmacological and non-pharmacological management of medical conditions. The exam tests your ability to select appropriate medications, adjust dosing for patient factors, identify drug interactions, monitor therapy, and integrate non-drug interventions — all at the level expected of a Canadian family physician working independently.
The TDM is a key step in the Practice Ready Assessment (PRA) pathway, which provides an alternative route to licensure for IMGs who may not have completed Canadian residency training. Eligibility is determined by individual provincial PRA programs, and you must apply through your PRA program — direct registration is not available.
Starting in January 2026, the MCC introduced a new exam format featuring multiple-choice questions (MCQ) and short-menu questions, replacing the previous short-answer format. This change enhances the candidate experience while maintaining the same rigorous assessment of therapeutic competence.
Updated for 2026 — new MCQ and short-menu format replacing short-answer questions.
2026 Update: The MCC implemented a new format starting January 2026 featuring MCQ and short-menu questions in two sections with an optional 20-minute break. A new pass score standard-setting exercise was conducted for the January 2026 sitting.
Key therapeutic areas tested. AiMedQs covers all domains with targeted question sets.
Drug selection, dosing, titration, monitoring parameters, adverse effects, drug interactions — the core of TDM assessment
Diabetes, hypertension, COPD, heart failure, thyroid disorders — long-term treatment planning and medication adjustments
Emergency presentations, acute medication decisions, urgent dose adjustments, anaphylaxis management, acute pain
Screening, immunizations, lifestyle counselling, risk factor modification, cancer screening guidelines
Depression, anxiety, bipolar disorder, insomnia, substance use — medication selection, titration, switching strategies
Pediatric dosing, geriatric considerations, pregnancy/breastfeeding safety, renal/hepatic dose adjustments
Ordering and interpreting diagnostic tests, lab monitoring for medication safety, therapeutic drug monitoring
Lifestyle modifications, physiotherapy referrals, cognitive behavioral therapy, patient education, shared decision-making
For current eligibility criteria, visit mcc.ca or contact your PRA program directly.
Dates subject to change. Check mcc.ca for the most current schedule.
1,900+ practice questions with AI-powered adaptive learning for the MCC TDM.
Practice with realistic clinical scenarios aligned to the TDM blueprint. Each scenario presents a family medicine patient requiring therapeutic decisions — reflecting real clinical scenarios.
All questions reflect Canadian prescribing practices, treatment guidelines, and formulary considerations. Built for the Canadian family medicine context the MCC tests.
Our AI identifies your weakest clinical domains and serves more questions in those areas. Efficient, targeted study that adapts to your performance.
Updated for the new 2026 TDM format with MCQ and short-menu questions. Practice the question types you will actually encounter on exam day.
Every question includes comprehensive therapeutic reasoning — why one drug is preferred, relevant interactions, dose adjustment rationale, and evidence-based guidelines.
Track your accuracy by clinical domain, monitor improvement trends, and identify exactly which therapeutic areas need more review before exam day.
A structured approach to TDM preparation. Adjust timelines based on your starting point and exam date.
Work through questions across all clinical domains. Build baseline competency in therapeutic decision-making. Use AiMedQs analytics to identify weak areas early.
Focus on your lowest-scoring domains using AI-recommended question sets. Review Canadian treatment guidelines and pharmacology fundamentals for weak areas.
Practice with mixed-topic sessions simulating exam conditions. Focus on complex multi-drug scenarios and time management. Build speed and confidence.
Review flagged questions and high-yield drug interactions. Focus on commonly tested therapeutic areas. Take full-length timed practice sessions.
Start free. Upgrade when you're ready.
The Therapeutics Decision-Making (TDM) Examination is developed and administered by the Medical Council of Canada (MCC) on behalf of Practice Ready Assessment (PRA) programs across Canada. It assesses whether International Medical Graduates (IMGs) have the therapeutic competence required to practise independently as a family physician in Canada.
Starting in 2026, the TDM exam features a new format with multiple-choice questions (MCQ) and short-menu questions divided into two sections, with an optional 20-minute break. There are approximately 100 questions based on 40 clinical patient scenarios. The exam is 3.5 hours, computer-based, and available in English and French.
The TDM exam content is developed by the Medical Council of Canada (MCC), and the examination is administered by the MCC on behalf of the Practice Ready Assessment (PRA) programs. It is delivered at Prometric test centres across Canada or via remote proctoring through ProProctor. Visit mcc.ca for official exam information.
Eligibility is determined by individual provincial Practice Ready Assessment (PRA) programs. You must apply for the TDM exam through your PRA program — you cannot register independently. Candidates typically are International Medical Graduates (IMGs) seeking to practise family medicine in Canada. Contact your PRA program directly for specific eligibility requirements.
The MCCQE Part I is a general medical licensing exam for all physicians in Canada, while the TDM is specifically designed for the PRA pathway. The TDM focuses heavily on therapeutics — pharmacological and non-pharmacological management of conditions at the family physician level. It is a separate requirement from MCCQE1, though some clinical knowledge overlaps.
The TDM tests your ability to make therapeutic decisions across all areas of family medicine: pharmacological management (drug selection, dosing, interactions, monitoring), chronic disease management, acute care, preventive medicine, mental health, special populations (pediatric, geriatric, pregnancy), diagnostic reasoning, and non-pharmacological management.
AiMedQs provides over 1,900 TDM practice questions covering all clinical domains tested on the exam. Our AI-powered platform adapts to your weak areas, uses spaced repetition for retention, and tracks your performance by therapeutic category. Questions include detailed clinical explanations with evidence-based reasoning in a Canadian family medicine context.
The TDM exam is typically offered three times per year. For 2026, the scheduled dates are January 14, June 2, and September 23. Registration opens several months before each sitting through your PRA program. Check mcc.ca for the most current dates and registration windows.
The TDM exam fee is approximately $2,640-$2,900 CAD plus GST, depending on when you register. Some PRA programs may reimburse exam fees for sponsored candidates who successfully complete their Clinical Field Assessment. Contact your PRA program for details on fee coverage.
Candidates have a maximum of 4 TDM examination attempts total, which includes a maximum of 2 pass results. Candidates who receive a fail result are ineligible to apply for the next examination session — there is a mandatory waiting period between attempts.
Over 1,900 practice questions. Canadian clinical context. AI-powered adaptive learning. Start preparing today.
Try 30 Questions FreeAiMedQs is an exam preparation tool and does not guarantee exam results. Content is for educational purposes only. AiMedQs is not affiliated with or endorsed by the Medical Council of Canada (MCC) or any Practice Ready Assessment (PRA) program. For official exam information, visit mcc.ca.