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Prepare for exams

Getting ready for your online exam

(Last updated August 24, 2020)

To prepare to take your Royal College certification examination online, there are key steps that you must follow in order to ensure a seamless experience. The information on this page will walk you through this process, from ensuring you have an appropriate computer setup to creating your proctoring profile and logging in on exam day. It is important that you review all of this material prior to writing the exam online.

Note: On Aug. 4, 2020 and Aug. 19, 2020 new information will be added to this page which will allow you to complete the pre-examination activities. We recommend that you bookmark this page, so you can easily return to it for reference.

It is important that you review all of this material that will be posted to this webpage prior to challenging the examination online.

Overview of the exam process

Step 1: Review process
  • Review Important Information section posted on July 23, 2020
  • Conduct system check
  • Watch the videos
Step 2: Complete exam demo
  • Exam demo available
  • Familiarize yourself with the Practique interface, including how to flag items, answer questions and submit the exam demo
Step 3: Complete signoff
  • Consent and acknowledgement signoff
  • Available Aug. 19, 2020
  • Deadline is Aug. 24, 2020
Step 4: Create profile
  • Create your profile to prepare to write your exam
  • After Aug. 19, 2020 you will receive an email to create your profile in the exam system required for ID verification on exam day
Step 5: Take exam
  • Log in and take the exam

Important information

What is Practique?

Practique is the examination system the Royal College is using to deliver the 2020 exams.

What is Examity?

Examity is the remote proctoring system the Royal College is using to invigilate your 2020 exam.

Special note for French-speaking candidates

Due to the accelerated timeline to implement online exams, proctoring services for the 2020 exam will be offered in English only. The preparatory material (except for the proctoring videos) will be available in French and English. Additionally, francophone Royal College staff members will be available on exam days to provide limited assistance to any French-speaking candidates who need help with the ID verification process and room scan instructions. French-speaking candidates who may need assistance creating their profiles and conducting exam day activities are strongly encouraged to consider going to their registered test centre on exam day where full support will be offered in French.

Step 1: Review the process

Is your computer ready?

Please ensure that your device meets the specifications by completing a system readiness check.

Note: you must complete your system readiness check on the computer you will be using for the exam in the location you will be writing it.

Please consult the “How to guides” if you require support with your computer system’s configuration in order to meet the minimum requirements and how to disable pop-ups in your browser.

Watch a demo video on how to access the online exam system

Watch this brief 3-minute video on how to access the online exam system

Watch a demo video on the steps required to create your profile

Watch this brief 2-minute video on how to create your profile

Watch an exam day video

Watch this in-depth 8-minute video on how to connect to a proctor and start your exam.

Note: this is a generic video and while it closely reflects the Royal College process, there may be some minor differences.

In the 8-minute video, the proctor will proceed through a list of checks before and after the examination. The directives for Royal College candidates will be different than the ones shown in the video. The remote link between candidate and examiner will be via Zoom. If there is an issue with Zoom, the proctor may use GoToMeeting as a backup.

Step 2: Complete exam demo

  • Visit the Practique exam demonstration site to familiarize yourself with the interface and functionality. You can access this site as many times as you would like to practise.
  • The candidate ID number and password for all eight examinations is 1001.
  • Click on the blue bar to see the full list of exam demos.
  • You will be required to use the PIN below to access your examination:
    • Diagnostic Radiology PIN: 318429
    • General Surgery PIN: 136713
    • Internal Medicine PIN: 296708
    • Obstetrics and Gynecology PIN: 969945
    • Orthopedic Surgery PIN: 173271
    • Psychiatry PIN: 527655
    • Surgical Foundation PIN: 065707
    • Urology PIN: 866748

  • * If updates are made to the exam demo site, updated PINs will be posted here.
  • * Please note the platform works best using Google Chrome. It is recommended that after completing an exam demo, you log out of the demonstration site completely (both the exam as well as the exam selection screen). It is also recommended that you clear your browser data after completing the demo to facilitate returning at a later time. Once you return to the initial log in screen, and use 1001 as your candidate ID and password, you can access the demonstration site again and repeat any of the exam demos.
  • Review new FAQs

Step 3: Complete signoff (*available August 19, 2020 and due by August 24, 2020)

  • Complete a mandatory consent form prior to taking the online exam to acknowledge that you have reviewed all of the pertinent information. This consent form is due on August 24, 2020. If you do not complete this final consent, acknowledging you have reviewed all of the material on this site, you will be not be permitted to take the online exam.
  • Note: Prior to completing this form, ensure you have your Royal College ID available.
  • Review new FAQs

Step 4: Create profile (*available after August 19, 2020)

After August 19, 2020, you will receive an email to create your profile in the Royal College process. This process will be documented in a video available July 31. This process will require you to:

  • Upload a photo of government-issued ID
  • Add a phone number you can be reached at
  • Answer some questions that will be used to verify your identity by the proctor on the day of your examination(s)

Once you have successfully completed this step, you are scheduled and officially ready to take the online exam.

In order to create their online profile, candidates will be emailed their Candidate ID and password, by specialty, on the following dates:

PsychiatryAugust 20, 2020
Obstetrics and GynecologyAugust 24, 2020
Orthopedic SurgeryAugust 24, 2020
Diagnostic RadiologyAugust 28, 2020
General SurgeryAugust 31, 2020
UrologySeptember 7, 2020
Internal MedicineSeptember 11, 2020
Surgical FoundationsSeptember 18, 2020

Note: If you change your mind and decide to take the exam at your registered test centre after completing the online consent form and creating a profile, this is not a problem. Simply go to your registered test centre and you will be able to take a paper-based exam.

Step 5: Take exam

On exam day

  • Log into Practique (through the same link used to create your profile) on exam day.
  • Select Start Exam
  • A proctor will guide you through the ID verification followed by an assessment of your room. You must be able to move your webcam to show a 360- degree view of your environment.

The proctor can assist you with minor technical issues to ensure you can start the exam. However, you should have thoroughly verified your system meets the minimum system requirements.

When can you log in?

On exam day, you can log in 15 minutes before your scheduled exam start time and the window will remain open for 30 minutes after the start time.

For example, if you have an exam that starts at 9 a.m., you can log in at 8:50 a.m. You will be connected to a proctor, who will perform the mandatory ID checks and room scan. This should not take more than 10 minutes. If you start your exam at 9:10 a.m., you will have until 12:10 p.m. to complete the exam, which is a full three hours. Similarly, if you log in at 9:10 a.m. and start your exam at 9:29 a.m. after completing the ID verification and room scan, you will have until 12:29 to complete the exam.

Warning: After 30 minutes from the official start time, candidates will not be able to start the exam. All times are according to the proctor’s clock.

Questions about the spring 2020 exams?

If you have other questions about the spring 2020 exams, please visit our frequently asked questions.

To submit a question, please email the Royal College at and include “Online exams” in the subject line.

We recognize exams are a stressful experience and that we are in unprecedented times. The Royal College is committed to communicating with you in a respectful, professional and civil manner. Similarly, we ask the same courtesy is provided to our employees. Thank you!

Online Exam Checklist


  • I have reviewed all of the reference material regarding the proctoring and exam process.
  • I have secured an appropriate location in which to take the exam where I will be alone and uninterrupted for the duration of my exam time.
  • I have successfully tested my computer system in the location where I plan on taking the exam.
  • I have created my profile with Practique and submitted ID, challenge questions, and phone number.
  • I have completed a system check one week prior to my exam.
  • I have disabled pop-ups in my browser.

Exam day

An hour before your exam is scheduled to begin:

  • I have checked that my computer and internet connection are working. (We suggest re-doing a system check to verify internet speed.)

Fifteen minutes before the start time of the exam:

  • I am alone in the room and do not anticipate any distractions.
  • My workspace is clear of all material not required for my exam.
  • If applicable, my laptop computer is connected to a power source.
  • Any items that I do not want to be visible to the proctor must be removed from the environment (e.g. family pictures, …)
  • I have a snack and drink with me, if I wish.
  • I have all of the stationary materials I need:
    • Single blank 8.5 x 11 paper to take notes
    • Pen or pencil (with sharpener and eraser, if required)

How exams are developed

Each specialty and subspecialty has an examination board comprising content experts from across Canada. Editors, translators, linguistic reviewers, item creators, item reviewers and other content experts are involved in the exam development process.

Exam Development
Topic Information
Objectives of Training or competencies The exam is based on the Objectives of Training or competencies of the specialty or subspecialty. To access this document, visit the Information by discipline.
Create exam blueprint A blueprint of the exam is created based on the Objectives of Training or competencies. The blueprint for your specialty or subspecialty may be found in the Exam Format document.
Create exam items Items are created by content experts.
Items reviewed by examination board Items are reviewed and edited by the Examination Board for accuracy and clarity.
Items are edited and translated Items are edited and translated for readability and appropriate language.
Items are reviewed by linguistic reviewer Items are reviewed by a linguistic reviewer who is also a content expert and part of the examination board.
Exam is reviewed as a whole The exam is reviewed as a whole by members of the examination board.
Exam administration The exam is administered to candidates.
Psychometric analysis During this process, questions that were overly difficult, non-discriminating, or for which new evidence emerged between the time of question writing and exam administration are reviewed. As a result of this review process, some questions may be deleted from the final exam score for all candidates.
Data verification A thorough process of data verification and quality assurance of exam results is conducted during and after the exams.

Exam Format

The Exam Format document will detail the exam components, process and timing, reference materials and practice questions, if applicable.

Information by Discipline

To access this document, visit the Information by discipline. Choose your specialty or subspecialty from the dropdown menu. Click on the “Exam Format” document.

Written exams

Written exams could refer to a Multiple Choice Question (MCQ) exam and/or a Short Answer Question (SAQ) exam. For information about the format of your specialty or subspecialty examination, review the Exam Format document.

De-coupled Exams

As the training programs across Canada move towards a CBD format, exams with multiple components will be de-coupled – the written and the oral/applied exam will be treated as separate exams (eligibility and registration will be distinct for each component) and success at the written exam will be required before the candidate has eligibility to sit any subsequent exam component.

If a candidate is successful at the written component, they will not be required to sit that component again, and in the case of a fail or inability to sit the oral/applied component, they will only be required to register for the oral/applied component in any subsequent years. In other words, the successful result at the written component will carry forward to subsequent years and it will not be required to be completed again.

The de-coupled exam format applies to the following specialties:

  • Internal Medicine (beginning with the 2020 exam)
  • Psychiatry
  • Pediatrics
  • Exams in CBD training programs (beginning in 2022)

Multiple-choice question exam information

The Royal College's examinations are used to determine if a candidate has reached an acceptable level of competence based on the objectives of training of their specialty. Multiple-choice questions are used to assess candidate's knowledge and ability to apply this knowledge over a wide range of content areas.

What should you expect? A description of RCPSC Multiple-Choice Questions

Royal College multiple-choice questions consist of a stem and four options. Of these options, there is only one correct answer and three distractors. An answer sheet will be provided for you to record the best response for each question.

Typically, the questions conform to a format similar to that of Example 1 below:

Example 1

Which of the following pulmonary function tests is increased in patients with advanced pulmonary fibrosis and emphysema?

  1. Vital capacity
  2. Maximum breathing capacity
  3. Tidal volume
  4. Residual volume

(Correct answer is 4.)

Each page of the multiple-choice question booklet consists of both English and French versions of the same questions.

Helpful Hints

  • Since all multiple-choice questions are marked by an optical scanner, use only the pencil provided to completely blacken the answer sheet oval with your chosen responses to ensure that the scanner can properly identify your answers. If you choose to change an answer, erase completely.
  • Any question with more than one marked answer will be considered incorrect.
  • Manage your time wisely. Note the number of questions and the time allotted for the examination. You may want to skip over questions that you may find difficult for further consideration after you finish the rest of the questions.
  • If you don't know the answer to a question, guess. There is no penalty for incorrect answers.
  • Do not be late for the examination.
  • Pay attention to the examination instructions that the invigilator will provide prior to the exam administration.

Short answer question exam information

The Royal College’s examinations are used to determine if a candidate has reached an acceptable level of competence based on the objectives of training of their specialty.

What are Short-Answer Questions (SAQs)?

Many Royal College specialty examinations have an SAQ component. SAQs are questions that can be answered in a few short words or phrases. Typically, these questions contain words such as ‘list’ or ‘name’ suggesting that a series of short responses are required.

Each SAQ will usually consist of the question, a space where the candidate can provide his or her answer as well as the mark allocation for the question.

Different Kinds of SAQs

Short-answer questions can vary in terms of complexity. For example, the following question requires recall of factual knowledge at a low level of complexity:

Example 1:

List THREE medical specialties with Royal College certification exams. Total Marks
a) 2
b) 2
c) 2

More complex questions are usually based on case scenarios (sometimes called clinical vignettes). These questions can elicit application of knowledge or clinical reasoning. As well, a series of questions may be based on these scenarios building on case information.

Example 2:

51 year old man is diagnosed with Barrett’s esophagus. Total Marks
a) What is the BEST treatment option that should be pursued? 2
b) List 4 steps in the pathogenesis of Barrett’s esophagus. 4
c) List one ongoing clinical issue that needs to be addressed pertaining to the long-term health of this patient of enrolling him in a surveillance program. 2

How are SAQs marked?

Each short-answer question is created with a list of anticipated ‘model’ responses. This list is used to guide the markers as to the value of the responses when scoring the question. Partial marks may be allocated for some responses.

Example 3 below contains a question with a model response list.

Example 3:

Question: You see a 45-year-old man in your office for headaches. The headaches started one year ago and have been increasing in frequency. They now occur four to six times per month. With each headache he misses three to four days of work. You suspect he suffers from migraine. Total Marks
a) List FOUR clinical features of migraine. 2
List TWO prophylactic medications for migraine. 2
Model responses for Example 3:
a) One-half mark for each (maximum two marks)
  • throbbing
  • associated with nausea/vomiting
  • associated with photo/phonophobia
  • hemicranial pain
  • preceding aura
  • inability to continue with daily activities
  • relieved by sleep
b) One mark for each (maximum two marks)
  • amitriptyline
  • propranolol
  • flunarizine
  • valproic acid

The use of a model response list helps guide the markers to assess the responses with little or no interpretation. With this in mind, candidates should provide the answers that are most obvious and correct.

Helpful Hints

  • Make sure your handwriting is legible. Examiners can only give credit for what they can read.
  • Avoid rambling answers. Answers to SAQs are to be concise and direct. An essay answer is neither required nor recommended.
  • Carefully re-read the question and the answer. Ensure that the response you provide is the best answer to the question
  • Note the number of questions and the time allotted for the examination. Manage your time wisely. You may want to skip over questions that you may find difficult for future consideration after you finish the rest of the questions.
  • Do not be late for the examination.
  • Pay attention to the examination instructions that the invigilator will provide prior to the exam administration.

Applied (Oral/OSCE/practical) exams

Applied exams take place in Ottawa at the Royal College or La Cité. Applied exams are sometimes referred to as “live exams” and may include an oral, OSCE, and/or practical examination.

For information about the format of your specialty or subspecialty examination, review the Exam Format document.

Applied exam information What happens at a typical applied examination?
  • At registration, you will be asked to present a piece of government-issued photo ID and all electronic devices (cell phones, digital/smart watches) will be collected. Wallets, keys and other loose belongings will also be collected. All other personal belongings, such as purses, bags, suitcases, can be placed in cabinets provided at the reception on the exam floor. Please note that study materials are not permitted in the waiting room after you have registered.
  • After registration, you will be shown to the waiting room. Royal College staff will give you a 5-10 minute warning before orientation is scheduled. Washrooms will be available at this time.
  • A candidate orientation information session will take place with the chair or director of the examination board and the Royal College exam lead.
  • After the information session, you will be escorted to the exam floor by Royal College staff and will be placed in front of your first examination room.
  • All personal belongings will be returned to you upon completion of the exam or at the end of the sequestering period, if applicable.

When is sequestering required?

Sequestering may be required following the examination in order to ensure that candidates do not communicate the content of the examination to others preparing to take the examination.

Please note that all personal belongings including electronic devices will not be accessible until the sequestering period is finished. Respect the sign in times on the appointment letter to ensure the sequestering period is as short as possible for all candidates.

Pass rates

Fully Canadian trained, first-attempt Candidates
Spring and Fall Sessions 2017-2019

The following table summarizes the average pass rates for residents in Canada, in percentages, for all Royal College specialties and subspecialties certification examinations over the last three years.

Note: *This data reports only the pass rate for those candidates with MD from Canadian universities AND FITERS completed in Canadian programs AND those taking the examination for the first time. This is referred to as the CMDPG category. In previous years, the CRAFT candidate group was used as reference. If this report is compared to previous years, the average number of CMDPG candidates may be considerably less than previous CRAFT candidate groups.

*Only specialties and subspecialties that had an average of five or more CMDPG candidates registered at the certification examinations for the last three years have been posted.
Due to the limited number of candidates for some specialties, average pass rate statistics cannot be reported in order to maintain confidentiality.

CMDPG Candidates only

Three-year average



Standard Deviation


Adolescent Medicine

- - -

Anatomical Pathology

97.4 2.3 26


95.0 0.9 113

Cardiac Surgery

94.4 9.6 6

Cardiology (adult)

94.2 3.4 46
Cardiology (pediatric) - - -

Child and Adolescent Psychiatry

93.3 11.5 26

Clinical Immunology and Allergy

100.0 0.0 13

Clinical Pharmacology and Toxicology

- - -

Colorectal Surgery

94.4 9.6 8

Critical Care Medicine (adult)

96.9 2.7 34
Critical Care Medicine (pediatric) 85.6 10.6 7


98.1 1.7 33

Developmental Pediatrics

- - -

Diagnostic Radiology

96.9 0.5 85

Emergency Medicine

99.0 0.9 69

Endocrinology and Metabolism

95.5 5.4 33

Forensic Pathology

- - -

Forensic Psychiatry

90.0 17.3 10


100.0 0.0 32

General Internal Medecine

93.1 2.5 98

General Pathology

- - -

General Surgery

96.1 2.4 88

General Surgical Oncology

100.0 0.0 6

Geriatric Medicine

96.8 2.8 21

Geriatric Psychiatry

100.0 0.0 13

Gynecologic Oncology

96.3 6.4 7

Gynecologic Reproductive Endocrinology and Infertility

91.5 7.5 9

Hematological Pathology

- - -


93.8 2.4 31

Infectious Diseases

92.5 10.4 29

Internal Medicine

97.5 1.6 554

Interventional Radiology

- - -

Maternal-Fetal Medicine

- - -

Medical Biochemistry

- - -

Medical Genetics

- - -

Medical Microbiology

96.3 6.4 12

Medical Oncology

95.4 4.0 42

Neonatal-Perinatal Medicine

83.8 7.7 7


95.8 4.6 25


98.4 2.8 44


- - -


- - -


98.1 3.2 14

Nuclear Medicine

92.5 6.6 8

Obstetrics and Gynecology

98.5 1.3 89

Occupational Medicine

- - -


100.0 0.0 38

Orthopedic Surgery

96.9 1.5 56

Otolaryngology - Head and Neck Surgery

95.3 5.5 29

Pain Medicine

83.8 14.7 8

Palliative Medicine

- - -

Pediatric Emergency Medicine

98.1 3.2 15

Pediatric Surgery

- - -

Pediatric Hematology/Oncology

- - -

Pediatric Radiology

78.8 17.1 7


93.9 4.8 134

Physical Medicine and Rehabilitation

96.3 3.4 20

Plastic Surgery

98.6 2.4 23


98.2 0.9 133

Public Health and Preventive Medicine

87.7 0.3 19

Radiation Oncology

97.9 3.6 15

Respirology (adult)

93.8 2.8 33
Respirology (pediatric) - - -


97.7 2.1 28

Surgical Foundations

94.2 3.0 319

Thoracic Surgery

- - -


94.3 4.3 30

Vascular Surgery

94.2 5.0 10

Studying for the exam

The Objectives of Training document contains useful information regarding the content for your specialty or subspecialty examination. Also, the Exam Format document will often list reference materials and practice questions that are specific to your specialty or subspecialty.

To access these documents, visit the Information by Discipline. Choose your specialty or subspecialty from the dropdown menu. Click on the “Objectives of Training” or “Exam Format” document displayed at the bottom.

Exam Tips

Tips for writing the Exam
Exam Type Information
MCQ Tips for the Multiple Choice Question (MCQ) exam:
  • Ensure each mark completely fills the circle. See an example of a poorly-filled out scantron sheet.
  • Completely erase a mark you wish to change.
  • Make no stray marks on the answer sheet.
  • Mark only one answer for each question. Multiple marks will be counted as wrong.
  • Ensure you identification number is correctly recorded.
  • Only answers on the answer sheet will be scored.
  • It is to your advantage to answer every question, even if you are not satisfied that you know the correct answer.
SAQ Tips for the Short-Answer Question (SAQ) exam:
  • Use a ball-point or fountain pen only.
  • Write or print as legibly as possible.
  • Be as brief and as direct as possible, making use of the space provided after each question.
  • If a specific number of answers is requested (e.g. list FOUR), do not list more than requested as they will not be marked (e.g. if four are requested, only the first four will be marked).
  • Please make sure that you have completed all pages of the exam booklets.
  • Please affix your candidate number sticker in the space provided on the COVER PAGE of each booklet.

Recommended study tools

Take a look at this guide that has recommended study tools to help you prepare for your Royal College exam.

Contact us:; Telephone: toll-free 1-800-668-3740 ext. 278 or 419 or 613-730-6278; Fax: 613-730-8261

We recognize exams are a stressful experience and that we are in unprecedented times. The Royal College is committed to communicating with you in a respectful, professional and civil manner. Similarly, we ask the same courtesy is provided to our employees. Thank you!