Hi everyone,
I just took the MCCQE 1 today, and I wanted to share my experience. There's relatively little information online available on the MCCQE in contrast to the USMLEs, so I'd like to add a little for posterity.
I am an IMG with Canadian citizenship, not a Canadian medical student, so my perspective is a little different. I've also taken and passed the USMLE step 1, 2ck and 2cs, and failed step 3 once. I also took the MCCEE last fall. The MCCEE is relatively easy (sorry though if you failed it), so I won't comment much on that here.
In my opinion, MCCQE1 is most similar to the USMLE Step 2CK. The morning session is composed of 196 questions arranged in 7 blocks of 28 questions each. The testing is adaptive, meaning that if you score high in one block, the next block of questions will be slightly harder. If you score poorly, the next block will become slightly easier. If you feel like the exam is getting harder and harder, then that's a good sign. You'll probably get an exceptionally high score. If the exam is getting easier and easier, then, well I feel for you cuz I think thats what I got. I think a good strategy would be to take more time in the first few blocks to try to answer more questions correctly, since the earlier blocks factor more in determining the direction of your score.
The MCCQE has a lot of community health questions, pediatrics, obgyn, family medicine questions. The USMLEs tended to emphasize internal medicine and its subspecialties. It is absolutely essential to obtain a copy of
Public Health and Preventive Medicine in Canada, by Chandrakant P. Shah. It is a blue paperback available on Amazon, and in most Canadian medical libraries. This is the defacto bible for the community health questions on the MCCQE. Read this cover to cover multiple times as you're preparing for this test. Study the tables of Canadian statistics. Read about aboriginals and seniors in Canada. Occupational health, federal, provincial, municipal regulations. Everything in this book is fair game. I'm serious. 10-20% of the questions on this test will come directly from this book. Toronto Notes summarizes this book, but you still need to read the whole book for the details.
I recommend USMLEworld step2 for the multiple choice questions to review for the MCCQE. The Kaplan video lectures also help. Premier Review is probably a little too specific for the American market, but some of the points there do apply also. Beware those websites trying to sell you MCCQE questions. I think most of them are fake or available online already if you look hard enough for them.
The MCCQE is not a "deep" exam, like Step 1 or Step 2. It doesn't do cross-disciplinary questions like iin step 1 where a single question may draw knowledge from anatomy, biochemistry, patho, and a little of pedia. Rather, each question on the MCCQE comes purely from a single discipline, like pedia, ob, community health, internal med, surgery. This makes it much easier to study for.
Orthopedics and pediatric ortho are important. There's always a couple questions from derma and a couple from optha. There are relatively few illustrations, ecg, or x-rays. The ones that I did get were pretty easy to figure out. The ones in the USMLEs were much more challenging. I had no EKGs or MRI's or CT's on my test. One fetal heart tracing (late decels), a skin lesion, etc. If you've studied for the step 2, you should be prepared for the pictorials in mccqe. I think toronto notes also has some pictorials.
The mccqe test makers try to synthesize uniquely canadian questions whenever possible. This is kind of irritating since IMGs cannot easily obtain canadian clinical experience. But the canadian medical students definitely have an advantage on this test. Just by having been through all their rotations and seen how medicine is practiced here makes it much easier for them to take this test. A lot of them finished an hour before the test was up. About half my test room was empty already by 4:00pm. sigh.
The mccqe had weird psychological questions about what you would do if you were assisting another attending surgeon if he suddenly became frustrated and did something angry or odd. I really didn't know which answer option was the best. The situation would really depend on the personality of the surgeon, the hospital staff, among other things. I wasn't sure what was the common sense answer or what a "Canadian" response would be. If anyone knows how to study for these kinds of questions, please let me know. I think I should have read "Doing Right" more thoroughly or chatted with canadian med students more often. i don't know, man.
The majority of the question stems are short, like two or three sentences at most. This is in sharp contrast to usmle step 1/2 question stems which can fill one to two screens. Unfortunately, short stems do not make the question easier. A lot of time, either you know it or you don't, and there isn't enough given to make an educated guess. In this way, the mccqe seems to reward rote memorization for some questions. If you memorized the toronto notes sections on psychiatry, pediatrics, obgyn, family medicine, orthopedic surgery, and the Shah book on community health (which really isn't that hard to do in a couple months); I believe you could pass the MCCQE based simply on that strength of that rote memorization.
The afternoon of the MCCQE is the CDM or clinical decision making part. Do yourself a favor, surf over to
www.mcc.ca, and click on the mccqe1/resources/demo. Then click on both the mcq and cdm demo sections multiple times. You will get several questions in an accurate demo presentation of the test.
The CDM portion is not easy, however it is weighted at only 25% of the exam, although it takes four hours to complete (this is where the canadian medical graduates tended to finish in 2.5 to 3 hours. argh.) I believe the strategy for this part is to try to think like a Canadian doctor, not an American one. Only order tests that are necessary for diagnosis. Do not order excessively. Do not order exotic, expensive tests. (e.g. there are few opportunities on the MCCQE to order an MRI, whereas I remember ordering and evaluating them frequently on the USMLEs).
Supposedly, if you have too many unnecessary entries on the CDM, you may get a score of zero for that question, but if you have too few entries, you may still get partial points. So be stingy and be smart. Read the question carefully and try to read between the lines. The case scenarios are relatively short, but the answer options are many. Most of the options can be intelligently eliminated and you can just guess which of the remaining options are most likely to score you partial credit. I think aiming for full credit is difficult for IMGs because we don't generally have canadian clinical experience and these questions are borne out of the canadian experience of medicine. I think the canadian test makers are really proud of this section of the exam because it is so distinctive from the USMLEs and nearly every other computerized medical board exam on the planet.
btw, an odd insight: some of the questions seemed to me as if they were written first in French and then translated into English. Something about the sentence construction and the wording just made it seem slightly awkward in English. Given the imposing presence of french-speaking doctors on the medical council of Canada, this is not unexpected. But I sort of felt from the questions like that they had a different view of medicine than what we get from studying English medical books. I'm not sure how medical education is accomplished in the french speaking world, but I imagine that they probably look down with disdain at the American-centric medical tomes written in english and have their own far superior french texts for internal medicine and surgery which were probably written two centuries before the english versions ever came into existence. I never imagined that I would have to resort to studying french medical books for the canadian medical licensing exam, but it seems like it might offer a slight advantage.
The time management portion of the mccqe is significantly different from usmle. Basically you get 3.5 hours in the morning for the 196 questions. You can split it anyway you like. Its best to follow the recommendations and allot about 1 minute per question and 30minutes per section. Bathroom breaks are counted within the 3.5 hours. There is no "break screen" like on the usmles, you kinda just raise your hand and leave your computer with all your questions and answers available for everyone to see. A proctor goes to the bathroom with you. Its kind of weird. The USMLE system is much more formal and professional.
I liked the mccqe computer exam system better though. All 28 questions are presented on one screen and you just scroll down. It felt more like a paper exam, and more efficient to write. It also has a "time management" button on the side that tells you if you're doing the questions too slowly or at the right speed or too quickly. Pretty cute.
ok, thats a heckuva lot more info about the exam than I ever got. Hope it helps somebody out there.
good luck!
