NAC OSCE

Overview

The National Assessment Collaboration (NAC) Examination is a clinical skills exam run by the Medical Council of Canada (MCC). It is an Objective Structured Clinical Examination (OSCE) that checks whether an international medical graduate (IMG) is ready to enter a Canadian residency programme. IMGs need it to apply for residency through CaRMS.

Who can apply

You must have graduated from, or expect to complete all medical degree requirements within 15 months of the exam date at, one of these:

• an international medical school listed in the World Directory of Medical Schools

• a US school of osteopathic medicine

• a US allopathic medical school (graduates from 1 July 2025 onward only)

The NAC Examination itself does not require a pass on the MCCQE, but CaRMS R-1 residency applications need both exams.

You can take the NAC Examination a maximum of three times, whether you passed or failed earlier attempts.

Exam pattern

Syllabus

Stations draw on six clinical areas: medicine, surgery, paediatrics, obstetrics and gynaecology, psychiatry, and preventive medicine and public health.

Seven competencies are assessed across the stations:

• history taking

• physical examination

• investigations

• data interpretation

• diagnosis

• management

• communication skills

Marking and results

• Your total score is reported on a scale of 500 to 700.

• The pass score is 577.

• Results are available about 8 weeks after the last day of the session.

• You receive a Statement of Results with your result and total score, and a Supplemental Information Report with subscores.

• A NAC result has no time limit; it stays valid no matter how long ago you took the exam.

Important dates

The exam is held twice a year, in spring and fall, at a limited number of centres across Canada.

For September 2026, centres were listed in Edmonton, Calgary, Winnipeg, Hamilton, London, Ottawa (French), Toronto, Windsor and Saskatoon.

Fees

Fees are in Canadian dollars, as listed by MCC in 2026:

• NAC Examination application: $3,320 (non-refundable)

• Scheduling request: $130

• Appeal: $1,200

• Source verification request: $232 per medical credential

How to apply

1. Prepare your identity documents and the required forms (a Student Attestation or a source verification request for your degree).

2. Log in to physiciansapply.ca.

3. Go to Examinations, choose "Apply for an exam" and select the NAC Examination.

4. Complete the application and pay the fee within the application window.

After the exam

International medical graduates use their NAC result, together with the MCCQE, when applying to Canadian residency programmes through CaRMS.

Preparation tips

• Practise across all six clinical areas, since any of them can appear at a station.

• Work on all seven competencies, including communication, not only diagnosis.

• Practise finishing a clinical encounter within 11 minutes.