100+ Free MCCQE Part I Practice Questions

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A 60-year-old man with known ischemic heart disease collapses, and there is no pulse. The monitor shows ventricular fibrillation. After starting high-quality chest compressions, what is the next priority intervention?

Administer intravenous amiodarone before any other step

Perform synchronized cardioversion

Deliver immediate defibrillation (unsynchronized shock)

Give oral aspirin

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Sample MCCQE Part I Practice Questions

Try these sample questions to test your MCCQE Part I exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 58-year-old man with no prior cardiac history attends for a routine check-up. He has no symptoms but is found to have a blood pressure of 162/98 mmHg on two separate office visits. He does not smoke, and his fasting glucose and lipids are normal. According to the 2020 Hypertension Canada guidelines, what is the most appropriate next step?

A.Confirm the diagnosis with out-of-office measurement (ambulatory or home BP monitoring) before starting therapy

B.Reassure him and repeat blood pressure measurement in one year

C.Start two antihypertensive agents immediately because his pressure is above 160/100

D.Order a CT angiogram to rule out renal artery stenosis

Explanation: Hypertension Canada recommends confirming elevated office blood pressure with out-of-office measurement (ambulatory blood pressure monitoring preferred, or home BP monitoring) to exclude white-coat hypertension before committing a patient to lifelong therapy, unless there is hypertensive emergency or very high pressures with target-organ damage. This reflects health promotion and accurate diagnosis.

2A healthy 52-year-old woman with no family history of colorectal cancer asks about screening. She has never been screened. According to the Canadian Task Force on Preventive Health Care, which screening approach is recommended for average-risk adults aged 50-74?

A.Annual colonoscopy starting at age 50

B.CT colonography every year

C.Fecal immunochemical test (FIT) every two years, or flexible sigmoidoscopy every 10 years

D.No screening is recommended unless symptoms develop

Explanation: The Canadian Task Force on Preventive Health Care recommends colorectal cancer screening for average-risk adults aged 50-74 using a fecal occult blood test (gFOBT or FIT) every two years, or flexible sigmoidoscopy every 10 years. Colonoscopy is used for follow-up of a positive test rather than as the primary average-risk screening tool in this framework.

3A 2-month-old infant is brought for a well-baby visit. The parents ask which vaccines are due. According to the routine Canadian immunization schedule, which combination is typically administered at the 2-month visit?

A.MMR and varicella vaccines

B.Influenza and tuberculosis (BCG) vaccines

C.Hepatitis A and meningococcal B only

D.DTaP-IPV-Hib, pneumococcal conjugate, and rotavirus vaccines

Explanation: At 2 months, the routine Canadian schedule includes DTaP-IPV-Hib (diphtheria, tetanus, acellular pertussis, inactivated polio, Haemophilus influenzae type b), pneumococcal conjugate, and rotavirus vaccines. This reflects health promotion and illness prevention in pediatric primary care.

4A 45-year-old man with a 25-pack-year smoking history and ongoing daily smoking attends for a periodic health exam. He is asymptomatic. Regarding lung cancer screening, which statement reflects current Canadian recommendations?

A.Annual chest X-ray is the recommended screening tool for all smokers

B.Low-dose CT screening is recommended for high-risk adults aged 55-74 with a significant smoking history

C.Sputum cytology every six months is the screening standard

D.No screening exists; only smoking cessation should be offered

Explanation: The Canadian Task Force recommends annual low-dose CT screening for adults at high risk, generally aged 55-74 with at least a 30-pack-year history who currently smoke or quit within 15 years. This 45-year-old does not yet meet the age/pack-year threshold, so smoking cessation counselling is the priority, but the recommended modality when eligible is low-dose CT.

5A 30-year-old pregnant woman at 11 weeks gestation attends her first prenatal visit. She reports no medical problems. Which supplement is most important to recommend for the prevention of neural tube defects?

A.Folic acid (folate) supplementation

B.Vitamin C 1000 mg daily

C.Vitamin E 400 IU daily

D.High-dose vitamin A

Explanation: Folic acid supplementation, ideally started before conception and continued through the first trimester, reduces the risk of neural tube defects. This is a cornerstone of preconception and early prenatal health promotion in Canada.

6A 68-year-old woman with a body mass index of 22 and no history of fragility fracture asks about osteoporosis. To assess her absolute fracture risk and guide management decisions, which assessment tool is most appropriate in the Canadian context?

A.Random serum calcium level alone

B.Plain radiograph of the femur

C.The FRAX or CAROC 10-year fracture risk assessment combined with bone mineral density

D.Serum vitamin D level alone

Explanation: Canadian osteoporosis guidelines use a 10-year absolute fracture risk tool (FRAX or CAROC), incorporating bone mineral density and clinical risk factors, to classify patients as low, moderate, or high risk and guide whether pharmacotherapy is indicated. This integrates assessment and prevention.

7A 24-year-old sexually active woman requests advice on cervical cancer screening. She has never had an abnormal Pap test. In most Canadian provinces, what is the recommended starting age and approach for cervical screening in average-risk women?

A.Begin Pap testing at age 16 regardless of sexual activity

B.Screening is not recommended unless the woman is symptomatic

C.Annual Pap testing for all women starting at first intercourse

D.Begin cervical screening around age 21-25 with cytology (or HPV testing where implemented), at intervals of about 3 years

Explanation: Canadian programs generally begin cervical screening between ages 21 and 25, depending on the province, using cytology every 3 years (some provinces have transitioned to primary HPV testing at longer intervals). Screening before age 21 is not recommended because abnormalities usually regress.

8A 6-year-old child is brought to the office for a routine visit. The physician counsels the family on injury prevention. Which single intervention has the greatest evidence for reducing childhood injury death in this age group?

A.Daily multivitamins

B.Correct use of age-appropriate vehicle restraints (booster seats and seatbelts)

C.Avoiding all screen time

D.Routine abdominal ultrasound

Explanation: Motor vehicle collisions are a leading cause of childhood injury death, and correct use of age-appropriate restraints (booster seats, then seatbelts) substantially reduces injury and mortality. Anticipatory guidance on injury prevention is a key health promotion activity in pediatric care.

9A 55-year-old man with type 2 diabetes, hypertension, and an LDL cholesterol of 3.6 mmol/L is being assessed for cardiovascular risk reduction. According to Canadian Cardiovascular Society lipid guidelines, what is the most appropriate management?

A.Initiate a statin, as diabetes places him in a statin-indicated condition for primary prevention

B.No lipid-lowering therapy because his LDL is below 4.0 mmol/L

C.Start a fibrate as first-line therapy

D.Recommend only dietary changes and reassess in five years

Explanation: Diabetes in a patient of this age is a statin-indicated condition under Canadian Cardiovascular Society guidelines, warranting statin therapy for primary prevention regardless of being below an arbitrary LDL cutoff. Statins are first-line for atherosclerotic risk reduction.

10A 35-year-old man presents with sudden, severe, tearing chest pain radiating to the back. He has a history of poorly controlled hypertension. His blood pressure is 190/110 mmHg in the right arm and 150/90 mmHg in the left arm. Which diagnosis must be urgently excluded?

A.Acute pericarditis

B.Gastroesophageal reflux disease

C.Aortic dissection

D.Costochondritis

Explanation: Sudden tearing chest pain radiating to the back, hypertension, and a significant inter-arm blood pressure differential are classic features of acute aortic dissection, a surgical emergency. Prompt imaging (CT angiography or transesophageal echocardiography) and blood pressure control are required.

About the MCCQE Part I Exam

The MCCQE Part I is a one-day, computer-based exam of 230 multiple-choice questions assessing the medical knowledge and clinical decision-making of a candidate completing a Canadian medical degree. It is delivered through Prometric in Canada and over 70 countries and is required for the Licentiate of the Medical Council of Canada (LMCC).

Assessment

230 single-best-answer MCQs in two sections of 115 items (some are unscored pilot questions). The Clinical Decision-Making component was discontinued in April 2025.

Time Limit

One day, about 6.5 hours total: two sections of 2 hours 40 minutes each, with an optional 45-minute break.

Passing Score

439 on a 300-600 scale (mean 450, SD 30), criterion-referenced (Modified Angoff / Borderline Group), set in July 2025.

Exam Fee

Approximately CAD $1,375-$1,400 application fee plus a Prometric seat fee; confirm current amounts in your physiciansapply.ca account. (Medical Council of Canada (MCC))

MCCQE Part I Exam Content Outline

20%

Health Promotion and Illness Prevention

Screening, immunization, counselling, and prevention guided by Canadian preventive-care recommendations.

30%

Acute Care

Emergencies and acute presentations across medicine, surgery, paediatrics, obstetrics, and psychiatry.

30%

Chronic Care

Longitudinal management of chronic disease, multimorbidity, and secondary prevention.

20%

Psychosocial Aspects

Mental health, substance use, and the social and behavioural dimensions of care.

30%

Assessment / Diagnosis

History, physical examination, and interpretation of investigations to reach a diagnosis.

20%

Management

Safe, effective, patient-centred treatment planning and pharmacotherapy.

30%

Communication

Patient and interprofessional communication, consent, and breaking bad news.

20%

Professional Behaviours

Ethics, professionalism, confidentiality, and Canadian medico-legal obligations.

How to Pass the MCCQE Part I Exam

What You Need to Know

Passing score: 439 on a 300-600 scale (mean 450, SD 30), criterion-referenced (Modified Angoff / Borderline Group), set in July 2025.
Assessment: 230 single-best-answer MCQs in two sections of 115 items (some are unscored pilot questions). The Clinical Decision-Making component was discontinued in April 2025.
Time limit: One day, about 6.5 hours total: two sections of 2 hours 40 minutes each, with an optional 45-minute break.
Exam fee: Approximately CAD $1,375-$1,400 application fee plus a Prometric seat fee; confirm current amounts in your physiciansapply.ca account.

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

MCCQE Part I Study Tips from Top Performers

1Map your study to the MCC blueprint: Dimensions of Care (health promotion, acute, chronic, psychosocial) crossed with Physician Activities (assessment, management, communication, professional behaviours), and use the MCC Examination Objectives as your master list.

2Prioritize Canadian guidelines and standards (Hypertension Canada, Diabetes Canada, Canadian Task Force on Preventive Health Care, CMA Code of Ethics, CMPA medico-legal guidance) because the exam reflects Canadian practice and ethics.

3Build endurance with timed MCQ blocks and practise applied clinical reasoning, since the post-2025 exam is MCQ-only with vignette-style single-best-answer questions.

Frequently Asked Questions

How many questions are on the MCCQE Part I and how long is it?

The exam has 230 multiple-choice questions split into two sections of 115. It is a one-day, computer-based test of about 6.5 hours, with two 2-hour-40-minute sections and an optional 45-minute break.

What is the passing score for the MCCQE Part I?

The pass score is 439 on a 300-600 reporting scale (mean 450, standard deviation 30), set through a standard-setting exercise in July 2025. It is criterion-referenced, so you are compared to a fixed standard, not to other candidates.

Did the MCCQE Part I change in 2025?

Yes. As of April 2025 the Clinical Decision-Making (CDM) component was removed, leaving an MCQ-only exam, and the reporting scale changed from 100-400 (pass 226) to 300-600 (pass 439).

Who administers the exam and where can I take it?

The Medical Council of Canada administers the exam through Prometric, at test centres or by remote proctoring, in Canada and over 70 countries during several sessions each year.