Candidate orientation for the Medical Council of Canada Qualifying Examination Part II

1. Welcome to the
Candidate Orientation
for the
Medical Council of Canada
Qualifying Examination Part II.

2. 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

3. 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.
MCCQE Part II Candidate Orientation

4. What to bring
The list of items to bring to the exam is included in the
Candidate Information Sheet that will be sent to you by
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
MCCQE Part II Candidate Orientation

5. 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.
MCCQE Part II Candidate Orientation

6. 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.
MCCQE Part II Candidate Orientation

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

8. 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.
This includes the label backing sheet.
Each notebook contains a few extra
labels. If I lose one or two, I don’t
need to worry.
MCCQE Part II Candidate Orientation

9. Examples of what are considered ONE
answer for written questions
LABORATORY TESTING
• Amylase OR lipase (ordering either is considered the same as ordering both)
• CBC (includes platelets, Hb, WBC, MCV, HCT, Diff)
• Coagulation studies (includes PR, INR, PTT) This list will be printed
inside my candidate
• Electrolytes (includes Na+, K+, CL-, CHO3-,/Total CO2)
notebook — I will have
• Renal Function (includes creatinine, BUN)
access to it during the
• Urine Analysis (includes routine and microscopic analyses) examination.
• Urine culture and sensitivity (accepted as one answer)
• Cardiac Enzymes (includes CK-MB, Troponin T, LDH, CK)
• Lipid profile (includes total cholesterol, triglycerides, HDL, LDL)
• Serum calcium (means total and ionized)
• Lumbar puncture (includes CSF, gram stain, culture and sensitivity, glucose, protein)
DIAGNOSTIC IMAGING
• Abdominal Ultrasound • CT pelvis
• Pelvic Ultrasound • Upper GI series (includes esophagus, stomach, duodenum)
• CT abdomen
NOTE: Ensure your answers include all the tests and investigations you deem
necessary.
IMPORTANT: You are not limited to the
MCCQE Part II Candidate Orientation
tests and investigations on this list.

10. 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. Some of these stations may be
rest stations.
MCCQE Part II Candidate Orientation

11. 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). Some of these stations may be rest stations.
MCCQE Part II Candidate Orientation

12. Start station
My start station will be written on the
Candidate Information Sheet I will
receive in the mail and on 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.
MCCQE Part II Candidate Orientation

13. Timing of stations
Saturday (10-minute stations)
• You will have two minutes to read the
candidate 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 nine 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 two minutes to read the
instructions for the next station, and so on.
MCCQE Part II Candidate Orientation

14. Timing of stations
Sunday (five-minute stations)
• You will have 1 ½ minutes to read the
instructions posted by the door before the
buzzer sounds to prompt you to enter the
room.
• You will then have five 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.
MCCQE Part II Candidate Orientation

15. Candidate instructions
In any given station, you may
be asked to do one or more of
Before entering the
room, I will read my 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
MCCQE Part II Candidate Orientation

16. Candidate instructions
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.
MCCQE Part II Candidate Orientation

17. 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 five-minute stations)
MCCQE Part II Candidate Orientation

18. 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.
MCCQE Part II Candidate Orientation

19. 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.
MCCQE Part II Candidate Orientation

20. 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.
Download a
I may be evaluated on my interaction
with the nurse.
video clip of a
candidate in this
If a standardized health professional is
present in the room, the candidate type of station
instructions will clearly state so.
MCCQE Part II Candidate Orientation

21. 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.
MCCQE Part II Candidate Orientation

22. 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 Download a
perform them. video example
of an examiner
• By reporting findings if they intervening
are available.
MCCQE Part II Candidate Orientation

23. 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.
MCCQE Part II Candidate Orientation

24. Written stations
Sunday of the examination is comprised of 10 stations
of five minutes each, alternating between patient-
encounter stations and written stations.
• Before you exit the five-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.
MCCQE Part II Candidate Orientation

25. Write-in PEP
Sample form
MCCQE Part II Candidate Orientation

26. 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.
MCCQE Part II Candidate Orientation

27. Writing tasks
In the PEP, 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.
MCCQE Part II Candidate Orientation

28. 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.
MCCQE Part II Candidate Orientation

29. 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.
MCCQE Part II Candidate Orientation

30. 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.
MCCQE Part II Candidate Orientation

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

32. 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.
MCCQE Part II Candidate Orientation

33. 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.
MCCQE Part II Candidate Orientation

34. 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.
MCCQE Part II Candidate Orientation

35. Helpful tips
Candidate instructions
• 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.
MCCQE Part II Candidate Orientation

36. 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.
MCCQE Part II Candidate Orientation

37. Helpful tips
Post-encounter probe (PEP)
• When the number of
answers is specified in a
written question, do not
select / write more answers
than what has been asked.
• Write legibly.
MCCQE Part II Candidate Orientation

38. 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
MCCQE Part II Candidate Orientation

39. 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.
MCCQE Part II Candidate Orientation