The NAC Examination (National Assessment Collaboration) is a half-day OSCE, an objective structured clinical examination, that the Medical Council of Canada uses to assess whether you are ready to enter a Canadian residency program. International medical graduates (IMGs) applying to residency through CaRMS must take it. You rotate through 12 stations of 11 minutes, and it is held twice a year, in spring and fall, at a limited number of centres in Canada.
At a glance
- Stations
- 12 stations, 11 minutes eachYour total score is the average of your 10 scored stations. The other 2 are unscored pilot stations.
- Length
- About five hours at the centreThe exam itself takes about 3.5 hours, with 2 minutes between stations
- Sessions
- Twice a year, spring and fall2026: May 2, and September 19 and 20. No 2027 date published as of October 9, 2026. Every date: Deadline Radar
- Where
- Centres in Canada onlySeptember 2026: Edmonton, Calgary, Winnipeg, Hamilton, London, Ottawa, Toronto, Windsor, Saskatoon. You rank up to 3; the MCC assigns one.
- Fee
- $3,320 CAD
- Pass score
- 577 on a scale of 500 to 700Results about 8 weeks after the session
- Attempts
- 3 at most, pass or failNever in two consecutive sessions
- Language
- English or French
Also explained: The MCCQE · The TDM exam
Who needs the NAC?
IMGs applying to residency. The MCC states that IMGs must take the NAC Examination to apply to Canadian residency through CaRMS. For the R-1 match you need results for both the NAC and the MCCQE, in whichever order you prefer.
Some practice-ready routes. A few family medicine Practice-Ready Assessment programs ask for it too, and each sets that rule itself. Practice Ready Ontario, for example, lists the NAC (March 2013 or later) or an MCCQE Part II pass from before 2021. The PRA comparison shows the exams each program lists.
In detail
Can you apply, and how?
You can apply if you graduated from, or will finish your degree within 15 months of the exam at, a medical school outside Canada listed in the World Directory of Medical Schools with a Canada Sponsor Note, a US school of osteopathic medicine, or a US allopathic school (graduates from July 1, 2025 only). You apply through your physiciansapply.ca account once the source verification request for your degree has been submitted and paid. When you apply you rank up to 3 exam centres, and the MCC assigns you one.
What each station measures
Each station has at least one standardized participant and a physician examiner, who assesses you on up to 7 competencies: history taking, physical examination, communication skills, diagnosis, investigations, data interpretation, and management. Clinical content spans medicine, surgery, pediatrics, obstetrics and gynecology, psychiatry, and preventive medicine and public health. There are also unscored waiting stations with no task: the MCC's overview page says two to three, and its exam-day page says two to four.
Scoring, results and attempts
Every station carries the same weight, and your total score is the average of your 10 scored stations, reported on a scale of 500 to 700. The pass score is 577. Results come out about 8 weeks after the last day of the session. You can sit the NAC 3 times at most, whether you passed or failed before, and never in two consecutive sessions. Only your most recent result is valid, and it does not expire.
Capable clinicians fail the NAC by treating stations as knowledge checks instead of timed encounters with a standardized participant and an examiner; prepare by rehearsing the encounter itself: the opening, time checkpoints, communication under observation, and the management close.
From the Path to Practice Series
Common questions about the NAC for IMGs
More NAC questions, each with its official source: IMG FAQ Center.
Do IMGs need the NAC exam to apply for residency in Canada?
Yes. The MCC states that IMGs must take the NAC Examination to apply to Canadian residency through CaRMS, and the R-1 match needs results for both the NAC and the MCCQE. You can take them in either order.
Can I take the NAC exam outside Canada?
No. The NAC is held twice a year at a limited number of exam centres across Canada. You rank up to 3 centres when you apply and the MCC assigns one.
How much does the NAC exam cost?
The application fee is $3,320 CAD.
How many times can I take the NAC exam?
Three times at most, whether you passed or failed before, and not in two consecutive sessions. Only your most recent result is valid, and it does not expire.
What is the pass score for the NAC exam?
The total score is reported on a scale of 500 to 700, and the pass score is 577. Results come out about 8 weeks after the session.
When is the next NAC exam?
The 2026 sessions were May 2 and September 19 and 20. As of October 9, 2026 the MCC had not published a 2027 date; it says the exam is typically held in May and September. The Deadline Radar adds the date once the MCC posts it.
Sources (7), checked October 9, 2026
Every fact about the exam on this page comes from the Medical Council of Canada's own pages, and the Practice Ready Ontario example from Touchstone Institute, read on October 9, 2026. Each fact also carries its source in the page code. The preparation advice is mine.
- Medical Council of Canada, NAC Examination. Supports: what the exam assesses, that IMGs must take it for CaRMS, 12 stations of 11 minutes, 2 pilot stations, up to 7 competencies, clinical content, twice a year, English or French, waiting stations (two to three).
- Medical Council of Canada, NAC Examination eligibility and application. Supports: eligible schools, applying through physiciansapply.ca after the source verification request, ranking up to 3 centres, centres in Canada only, 3 attempts, no consecutive sessions, the MCCQE and NAC both needed for the R-1 match.
- Medical Council of Canada, NAC Examination scheduling. Supports: the 2026 dates, the September 2026 centres, no 2027 date published.
- Medical Council of Canada, NAC Examination exam day. Supports: about five hours at the centre, about 3.5 hours of exam, two to four waiting stations.
- Medical Council of Canada, NAC Examination results. Supports: the competencies, equal station weight, the average of 10 stations, the 500 to 700 scale, the pass score of 577, results in about 8 weeks, the most recent result being the valid one.
- Medical Council of Canada, Fees. Supports: the $3,320 NAC fee.
- Touchstone Institute, Practice Ready Ontario. Supports: Practice Ready Ontario's NAC or MCCQE Part II requirement.
Independent explainer, not affiliated with or endorsed by the Medical Council of Canada; formats, fees and dates change, so confirm on mcc.ca before booking, and read the disclaimer.