Second Edition · 2026

The definitive NAC OSCE review for a new generation of Canadian physicians.

A complete station-based review with Canada-specific management and counselling — 92 high-yield cases across 8 core specialties, aligned with 2025–2026 guidelines. Built for IMGs and Canadian graduates preparing for the Medical Council of Canada OSCE.

92high-yield stations
8core specialties
561pages
NAC OSCE: A Comprehensive Review — 2nd Edition book cover
Why this manual

Built from the blueprint, not bolted onto it.

Every station mirrors the structure of the real exam, with communication and ethics integrated where they actually live — inside the clinical encounter.

01

Guideline-aligned

Every scenario integrates the latest recommendations from CFPC, CCS, CAEP and Choosing Wisely Canada — reviewed for the 2025–2026 cycle.

02

Exam-blueprint structure

A uniform template — Overview, Candidate Instructions, Clinical Approach, Differential, Management, Counselling — so every station rehearses the same cognitive load as the real thing.

03

Communication embedded

Calgary-Cambridge, SPIKES, capacity assessment and shared decision-making are woven into the cases — not relegated to an appendix nobody reads.

04

Written for IMGs

Bridges international clinical training to Canadian standards, with explicit attention to the cultural, ethical and system-level differences the exam actually tests.

Inside the book

Three foundational chapters, eight clinical sections.

Every station follows a structured step-by-step clinical approach — red flags, differentials, investigations, and management at a glance.

I

Introduction & Exam Blueprint

Purpose, audience, station structure, scoring, 2025–2026 updates and what examiners actually look for.

II

Clinical Frameworks

MCC objectives, Canadian guideline integration, and the Calgary-Cambridge, SPIKES and NURSE communication models woven throughout.

III

Internal Medicine & Neurology

The largest clinical block — chest pain, dyspnea, diabetes, stroke, seizures, cognitive decline and more, with differential-driven workups.

IV

Emergency, OB/GYN & Surgery

Acute presentations, obstetric emergencies, women's health, abdominal pain and the procedural reasoning the exam rewards.

V

Pediatrics & Psychiatry

Developmental red flags, common paediatric presentations, mood and psychotic disorders, capacity and safety assessments.

VI

Population Health, Ethics & Communication

Preventive counselling, cultural safety, consent, breaking bad news and the counselling encounters that separate candidates.

See the full table of contents
2026 Exam Schedule

Know your dates. Plan your preparation.

Both 2026 application windows are now closed. Registration for the 2027 cycle is expected to open in late 2026.

Registration closed
Session 1
May 2, 2026
  • Exam dateMay 2, 2026
  • Application closedDec 10, 2025
  • Accommodation closedJan 6, 2026
  • Results releasedEnd of June 2026
Registration closed
Session 2
Sept 19–20, 2026
  • Exam datesSept 19–20, 2026
  • Application closedMar 25, 2026
  • Accommodation deadlineApr 21, 2026
  • Results releasedLate Nov 2026
The exam, explained

What is the NAC OSCE?

A quick reference for anyone starting their preparation — what the exam is, what it tests, and how it's scored.

Purpose and eligibility

The NAC OSCE (National Assessment Collaboration Objective Structured Clinical Examination) is a standardised, pan-Canadian clinical skills exam administered by the Medical Council of Canada (MCC). It assesses whether international medical graduates (IMGs) have the clinical skills, knowledge, and attitudes required to enter a Canadian residency program. Approximately 1,700 candidates sit the NAC OSCE each year, making it one of the primary gateways in the Canadian IMG pathway.

Format

The NAC OSCE exam consists of 12 clinical stations, each exactly 11 minutes long, for a total duration of approximately three hours. At every station, a standardised patient (SP) and a physician examiner assess the candidate on up to seven competencies: history taking, communication skills, diagnosis, data interpretation, investigations, management, and physical examination. All candidates at a given session rotate through the same series of stations.

Disciplines and systems covered

Stations draw from seven medical disciplines — Medicine (2–4 stations), Surgery (2–4 stations), Psychiatry (1–2), Obstetrics & Gynecology (1–2), Pediatrics (1–2), Geriatric Medicine (1–2), and Urgent Care (1). Every exam form is guaranteed to include Respiratory, Cardiovascular, and Gastrointestinal cases at minimum. Management is benchmarked to Canadian guidelines — CFPC, CCS, CAEP, and Choosing Wisely Canada — not international standards.

Scoring and the pass standard

Your total NAC OSCE score is the average of 10 station scores, converted to a scale of 1300–1500. The current pass score is 1374. The standard is benchmarked to the expected performance of a recent Canadian medical graduate entering postgraduate training. Full blueprint breakdown →

Clarity, speed of scanning, and trustworthiness — that’s what separates a study manual from a textbook. This book was designed around all three.

Preview before you commit.

The first three chapters — Introduction, The NAC OSCE Exam, and Clinical Frameworks — are available to read in full, at no cost.

Read the Sample Buy on Amazon