Candidate orientation

Welcome to the

Candidate Orientation
for the

Medical Council of Canada
Qualifying Examination Part II!

Introduction
Meet Dr. Campbell and Dr. Fournier. They will be
taking the Medical Council of Canada Qualifying
Examination (MCCQE) Part II today. Let’s follow them
as they go through the examination process.

MCCQE Part II Candidate Orientation

Purpose of the examination
The MCCQE Part II is a clinical skills assessment
comprised of a series of patient-based encounters.
The purpose of this examination is to make a fair and
accurate assessment of your clinical skills.


What to bring
The list of items to bring to the exam is included in the
Candidate Information Sheet that you will receive in
the mail prior to the examination.

Items to bring to the exam Items to leave at home
Reflex hammer Your lunch

Lab coat Pencil

Entrance card Electronic devices

Stethoscope


Coat check
A coat check will be provided at the site to store your
personal items during the examination and
sequestering period.
However, as storage space will be limited, we ask that
you please leave all large bags and handbags at
home.


Candidate registration
Dr. Fournier has arrived at the examination site. Once
he has registered, support staff will hand him an ID
badge, a pencil and a notebook before directing him to
the orientation room.


Candidate orientation
During the candidate orientation on examination
day, the facilitator will give a brief presentation and
answer your questions.


Candidate notebook
In her notebook, Dr. Campbell will find bar code labels,
blank pages, and a list of Common examples of what
is considered ONE answer for written questions (next
slide).

I can use my notebook throughout
the examination for reference and
note taking. The notebook will not
be graded.
I won’t tear out any pages because
I have to hand in my notebook
INTACT at the end of each
examination day.
Each notebook contains a few
extra labels. If I lose one or two, I
don’t need to worry.


Overview of the examination
Saturday

The Saturday session of the examination is comprised
of 10 patient-encounter stations. Each station is
10 minutes in length.


Overview of the examination
Sunday

The Sunday session of the examination is comprised
of 10 five-minute stations. Stations alternate between
patient-encounter stations (in blue) and written stations
(in red).


Start station

My start station will be written on the
Candidate Information Sheet I will
receive in the mail at the same time
as my ID badge.
On each day of the exam, I will start
at the same station number. I will
then go through the remaining
stations in numeric order.

I don’t have to remember all these
details. Exam staff will be there to
guide me and answer my questions
during the examination.


Timing of stations
Saturday (10-minute stations)

• You will have two minutes to read the
candidate’s instructions posted by the door
before the buzzer sounds to prompt you to
enter the room.
• You will then have 10 minutes in the room.
– A warning buzzer will sound at 9 minutes.
– A second buzzer will signal the end of the station. At
this point, you will have to leave the room.
• You will then get 2 minutes to read the
instructions for the next station, and so on.

Timing of stations
Sunday (five-minute stations)

• You will have 1 ½ minutes to read the
candidate’s instructions posted by the door
before the buzzer sounds to prompt you to
enter the room.
• You will then have 5 minutes in the room.
– A warning buzzer will sound at 4 ½ minutes.
– A second buzzer will signal the end of the station. At
this point, you will have to leave the room.
• You will then get 1 ½ minutes to read the
instructions for the next station, and so on.

Candidate instructions
In any given station, you may
be asked to do one or more of
Before entering the
room, I will read the the following tasks:
instructions carefully
in order to determine – Perform a physical
what my task is for examination
each station.
The instructions will
– Obtain a history
also be available in – Manage an acute patient
the room.
problem
– Respond to a patient’s
concerns
– Counsel the patient and/or a
colleague


Sample
Joseph Trans, 40 years old, presents himself to your office with a
2-hour history of abdominal pain.
IN THE NEXT 10 MINUTES:
• CONDUCT A FOCUSED AND RELEVANT PHYSICAL EXAMINATION.
As you proceed, EXPLAIN TO THE EXAMINER what you are doing
and DESCRIBE ANY FINDINGS.
GIVE 1 LABEL TO THE EXAMINER.
My task here is to conduct a physical examination.
Therefore, I won’t ask history questions to the patient.
I’ll treat the standardized patient as a real patient because
I will only get credit for tasks I complete satisfactorily.

More sample stations are available.

Bar code labels

As I walk into the room, I hand one or two bar
code labels to the examiner. The instructions
outside the door will remind me of how many
labels to give (one in the 10-minute stations
and two in the 5-minute stations)


Oral questions
In some stations, the examiner will ask me one to three brief questions
after the warning buzzer. In these stations, I will not be able to continue
interacting with the patient after the warning buzzer, even after I have
finished answering the examiner’s question(s).
The oral questions are related to the patient I just saw and are about
matters like diagnosis, management decisions, or ethical or legal issues.
The candidate instructions will clearly state if there are oral questions for
a station.


Medical equipment
If a station requires the use of medical equipment other
than a stethoscope and a reflex hammer, it will be
provided in the room.


Patient management stations
During the examination, you might be asked to
manage a patient problem.
In these stations, a standardized health
professional, such as a nurse, might be present in the
room.
I will direct the nurse to order any tests
or perform any procedures I believe are
appropriate for this patient.
I may be evaluated on my interaction
with the nurse.
If a standardized health professional is
present in the room, the candidate
instructions will clearly state so.


Physician examiners
• Examiners observe and assess your performance with
pre-set score sheets.
• A second observer may be present to observe
protocols and to ensure exam quality.
• In physical examination stations:
• Tell the examiner what you are doing and briefly describe your
findings.
• You must demonstrate your clinical skills. You will only get credit
for tasks completed satisfactorily.


Examiner interventions
Examiners may intervene:
• By asking you to reread the instructions.
• To protect the standardized patient.
• To stop you from doing genital or rectal
examinations.
– If such examinations are
needed, clearly inform the
examiner that you would
perform them.
• By reporting findings if they
are available.


Standardized patients (SPs)
SPs are trained to simulate patients’ signs and
symptoms in a reliable and consistent manner.
Treat them as you would treat actual patients and
accept their simulated findings as being real. You may
be scored on the way you interact with them.


Written stations
Sunday of the examination is comprised of 10 stations
of 5 minutes each, alternating between patient-
encounter stations and written stations.
• Before you exit the 5-minute encounter station, the
examiner will hand you the post-encounter probe
(PEP) sheet.
• There are two types of PEPs:
– Write-in
– Extended match
• Wait until the start buzzer before
beginning to write.


Write-in PEP
Sample form


Write-in PEP

I must write legibly if I want to get credit
for my answers.
When lines are numbered in the PEP
sheet, only the first answer will count.
If the lines are NOT numbered, the
number of answers is not limited.


Writing tasks

In the PEP, I may be asked to complete
patient-associated tasks such as writing
admission orders, a prescription, or a
SOAP note. For these questions, I am
expected to fill out the provided mark sheet or
prescription form as completely as I would in a
hospital/clinic or when filling in a prescription
pad.
For prescription-writing questions only, a
copy of the Compendium of Pharmaceuticals
and Specialties (CPS) will be available in the
room.


Extended match (PEP)

I will read the questions carefully
before answering them. If I fill in
more answers than specified in
the question, my score for that
question will be zero.


Rest stations
• Rest stations may be included in the examination for
each session.
• During these stations, there are no patients, no
questions and no evaluations.
• Please sit quietly. You can take this time to rest
before your next station.
I might sit through a few rest
stations during the
examination.


Sequestering
For security reasons, candidates may be required to
remain on site before or after the examination session
on each examination day.
• Access to personal belonging or telephones will not
be allowed during this time.

Any breach of the rules or lack
of co-operation on my part
could invalidate my examination
results and prevent access to
my future examinations.


Sign out
Before leaving after each exam day, follow the site
staff’s instructions:
• Hand in your notebook (leave all pages
intact, including the back sheet from your bar code
labels and any unused labels).
• Hand in your ID badge.
• Sign out on the sheet.


Confidentiality reminder
During the application process, we agreed to use examination
materials solely for the purpose of completing the examination
and not to disseminate or reveal to others the examination
materials or content.

That means we CANNOT divulge
station content, patient portrayals
and findings, oral questions, PEP
questions, etc., at ANY TIME even
after the examination is over.


What do I do if…
I have to go to the bathroom?

You can use the washrooms:
• Before you start the examination
• While in sequestering
If you have an urgent need at other times,
please inform site staff.


What do I do if…
I lose my notebook and/or my bar code labels?
I feel ill?
I don’t know where to go?

Consult the site staff as soon as possible.

They are there to help you and are aware of
the protocols to follow.

It is imperative that you remain calm and
co-operative.


Helpful tips

• Read your instructions carefully.
• Complete the specified task(s).
Joseph Trans, 40 years old, presents himself to your office
with a 2-hour history of abdominal pain.
IN THE NEXT 5 MINUTES:
•CONDUCT A FOCUSED AND RELEVANT PHYSICAL EXAMINATION.
As you proceed, EXPLAIN TO THE EXAMINER what you are
doing and DESCRIBE ANY FINDINGS.
At the next station, you will be asked to answer questions
about this patient.
GIVE 2 LABELS TO THE EXAMINER.


Helpful tips
Inside the station

• Demonstrate your clinical skills. You will not get credit
for simply SAYING you would do something (with the
exception of genital and rectal examinations).
• You will only receive credit for tasks
completed satisfactorily.
• Treat the SPs as you would treat
real patients.


Helpful tips
Post encounter probe (PEP)

• When the number of
answers is specified in a
written question, only
select / write the specified
number of answers.

• Write legibly.


Useful links

Medical Council of Canada
mcc.ca

Objectives for the Qualifying Examination
mcc.ca/en/exams/objectives

Qualifying Examination Part II
mcc.ca/en/exams/qe2

MCCQE Part II interaction rating scales
mcc.ca/pdf/Rating-Scale_E.pdf


Questions?
And remember, site staff will be available
throughout the day to answer your
Please take the time to
questions and guide you to your stations.
review the information in
this presentation and on
the mcc.ca website. If
you have any questions
on examination
day, you can ask the
facilitator during your
Candidate Orientation.


Candidate orientation

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