The document provides information and instructions for candidates taking the National Assessment Collaboration exam. It discusses the structure and content of the exam, which assesses entry-level competence in medicine and lasts about 3 hours. Candidates are not permitted to discuss exam content due to confidentiality agreements. The summary also outlines what candidates can bring, the check-in process, and expectations during the exam, which involves interactions with standardized patients at different clinical stations.

1. CANDIDATE ORIENTATION
© NAC / MCC Orientation 2015

2. NAC Exam ][
 The National Assessment Collaboration (NAC) exam
assesses the competence of candidates; specifically the
knowledge, skills and attitudes essential for entrance into
postgraduate training in Canada.
 The NAC exam may include problems in:
□ Medicine □ Surgery
□ Pediatrics □ Obstetrics and Gynecology
□ Psychiatry □ Preventive Medicine and Community Health

3. Confidentiality
Upon registration for this exam, you signed a document
attesting you would NOT disseminate or reveal to others
the exam materials and content. This means that you
CANNOT discuss or disclose exam content at any time, in
any way, even after the exam is over. Examples of
breaches in confidentiality include, but are not limited to,
comparing patient responses with your colleagues, sharing
content with future exam candidates and posting
information online.
Breaking confidentiality and disseminating exam content
can lead to candidates being denied a standing on the
exam and being reported to regulatory authorities and to
other medical organizations, and being barred from taking
MCC exams in the future.
][

4. Duration ][
 The exam duration is about 3 hours.
 Plan to be at the exam site for a minimum of
6.5 to 7 hours.
 No external contact will be permitted during the
exam and sequestering period.
 No conversations about the exam will be
permitted.
 Candidates will not be dismissed until the time
specified on the information sheet.

5. Items to bring ][
 Reflex hammer
 Stethoscope
 White lab coat without a university or hospital logo
Items that are NOT permitted:
 Cell phones, pagers, media players, laptops
 Electronic devices for internet access, transmission,
reference or recording purposes (includes smartwatches)
 Electronic stethoscopes
 Pens, pencils, pen lights
 Paper, books, notebooks
 Bags, briefcases, wallets, keys

6. Coat check ][
 A coat check will be provided at the site to store your
personal items during the exam and sequestering period.
 However, as storage space will be limited, we ask that
you please leave all large bags, handbags and
unnecessary personal belongings at home.
 NOTE: While every effort will be made to store your
belongings safely, the Medical Council of Canada (MCC)
cannot be held responsible for theft or damage.

7. Candidate notebook ][
 Do not open until the examination begins.
 Inside, you will find a sheet of bar code ID labels
and 16 blank pages for your use during the
examination.
 You will be given 1 notebook and no additional
pages can be added.
 Never rip out any pages; your
notebook must be returned intact
at the end of the examination.

8. Introduction to the OSCE][
 What is an OSCE?
Objective Structured Clinical Examination
 A form of performance-based testing used to measure
candidates’ clinical competence.
 During an OSCE, candidates are observed and
evaluated as they go through a series of stations in
which they interview, examine and treat standardized
patients (SPs) who present various types of medical
problems.
 The NAC OSCE clinical stations are 11 minutes in
length.

9. Candidate instructions ][
 At each clinical station, there is a written
statement (Candidate instructions) that:
 Introduces a clinical problem.
 Directs the candidate to appropriately interact with
a standardized patient (SP).
 Specifies the task, such as obtaining a focused
history, conducting a focused physical examination,
and/or addressing the patient’s concerns.
 Indicates whether there are examiner oral
questions at the 8-minute signal.

10.  Your badge has a station number that indicates
your start station.
 Candidate instructions are posted outside each
station.
 READ everything carefully.
 Pay attention to the statement which explains
your task.
 A copy of the instructions will be available inside
the room for your reference.
[ Important reminders ]

11. [
 Standardized patients (SPs)
are trained to simulate
patients’ signs and
symptoms in a reliable and
consistent manner.
 Treat them as you
would real patients.
 Hand 1 bar code label to the examiner as you walk
into the room (instructions on the door).
 Examiners observe and assess your performance
with preset rating sheets.
Physician examiners, SPs and labels]

12. Physical examinations ]
 Carry out any maneuvers necessary for
assessing the presenting problem.
 Examiners only give credit for tasks
completed satisfactorily!
[
 You will be expected to use the hand sanitizer that
will be available in every physical examination
station. You may be prompted by the examiner.
 Be sure to drape the standardized
patients (SPs) appropriately.

13. Physical examinations
 Examiners may intervene to:
 ask you to reread the instructions.
 The intent is to remind you to refocus on the task and to
save you time.
 stop you from performing genital, rectal, vaginal, breast
or other invasive examinations.
 If such examinations are appropriate, all you need to do
is clearly inform the examiner.
 Help the examiner score by:
 telling the examiner what you are doing (e.g., inspection).
 describing any findings.
 Include findings that are normal.
][

14. ][Signals
 A signal indicates the beginning and the end of each
station.
 The 8-minute warning signal will indicate:
 EITHER that your time with the patient is over and the
physician examiner will begin to ask you questions.
 OR if there are no questions (as indicated on the candidate
instructions), that you still have 3 minutes remaining with the
patient.
 After each final signal, you will have 2 minutes to move
to the next station and read your instructions.

15.  Physician examiner oral questions may follow the
warning signal. They:
 are related to the patient you just saw.
 ask about matters like diagnosis, management
decisions, and/or your response to an ethical issue.
 Candidate instructions on station doors will indicate
whether there are oral questions at the 8-minute signal.
 If there are no oral questions, you will have the
full 11 minutes with the patient.
[ ]Examiner oral
questions at 8 minutes

16. [
 Before leaving, you must follow the sign-out procedure.
 When it is your turn, hand in your:
 candidate notebook (all pages intact)
 ID badge
 unused bar code labels including the backing sheet
Signing out ]
Congratulations! At this point,
the exam is over!
 Sign out on the sheet.

17.  Candidates may be required to remain on site before or
after the exam for security reasons.
The length of time depends on the time zone.
There is no access to personal belongings or telephones during this
time.
No conversations about the exam will be permitted.
 Exam conditions still apply during sequestering.
You must only speak the language of the exam (English or French)
during sequestering.
Sequestering[ ]
REMEMBER: Breaking confidentiality can lead to being
denied a standing on the exam and/or being barred from
taking MCC exams in the future.

18.  If you encounter issues during the exam that you
believe may significantly affect your results, you
MUST:
1. Immediately communicate your concern to a Senior
staff member or the Chief examiner.
2. Submit a message through your physiciansapply.ca
account detailing the incident immediately following
the exam.
MCC review of your concern is possible only if candidates
provide notification of the concern/problem in this manner.
Please visit MCC’s website for further information.
[ Reporting concerns ]

19. Read the instructions carefully.
Complete the specified task.
Demonstrate your clinical skills.
You receive credit for tasks completed satisfactorily.
Treat the SPs as real patients.
DO NOT leave without signing out.
DO NOT divulge or disseminate any exam content,
even after the exam is over.
[ ]Final review of important points

20. Your group leader and the support staff are
there to answer your questions and guide you
from station to station.
Try to relax and stay focused on the exam.
The purpose of the exam is to provide a fair
and accurate assessment of your clinical skills.
Focus on the exam ][

21. Bathroom breaks
Before the exam begins
After the exam is over
Urgent need: notify staff
][

22.  Results will be made available to you in your
physiciansapply.ca account, 6 to 8 weeks
after the exam date.
RESULTS
 Through your online account, you will be
able to:
 view your results documents.
 share them with other organizations.
][

23.  Before you start the exam:
 If you are unwell or have extenuating circumstances
which may negatively impact your performance today,
and wish to withdraw from the exam, please notify a
staff member as soon as possible.
 If you choose to start the exam, it will count as an
attempt, even if you cannot finish.
IMPORTANT ][