1. CANDIDATE ORIENTATION
© NAC / MCC Orientation 2014

2. [
NAC Examination
]
 The National Assessment Collaboration (NAC)
Examination assesses the competence of candidates;
specifically the knowledge, skills and attitudes essential
for entrance into postgraduate training in Canada.
 The NAC examination may include problems in:
□ Medicine
□ Pediatrics
□ Psychiatry
□ Surgery
□ Obstetrics and Gynecology
□ Preventive Medicine and Community Health

3. [ Confidentiality ]
Upon registration for this exam, you signed a document
attesting you would NOT disseminate or reveal to others
any content of the examination. This means you CANNOT
discuss or disclose exam content with others at any time, in
any way, even after the exam is over. Examples of this
include comparing patient responses with your colleagues,
sharing exam content with future exam candidates, and
posting case information or exam questions online.
Any breach in confidentiality of exam materials may lead to
disciplinary and legal measures, including invalidating your
results and preventing you from participating in future
examinations.

4. [ Duration ]

The examination duration is about three hours

Plan to be at the examination site for a minimum
of six and a half to seven hours

No external contact will be permitted during the
examination and sequestering period

No conversations about the examination will be
permitted

Candidates will not be dismissed until the time
specified on the information sheet

5. [Items to bring ]
 Reflex hammer
 Stethoscope
 White lab coat without a university or hospital crest
Items that are NOT permitted:





Cell phones, pagers, media players, laptops
Electronic devices for internet access, reference or
recording purposes
Pens, pencils, pen lights
Paper, books, notebooks
Bags, briefcases, wallets, keys

6. [ Candidate notebook ]

Do not open your notebook until the examination
begins

Inside, you will find a sheet of bar code ID labels
and some blank pages for your use during the
examination

Never rip out any pages; your notebook must be
returned intact at the end of the
examination

7. [
Introduction to the OSCE

What is an OSCE?
(Objective Structured Clinical Examination)



]
A form of performance-based testing used to measure
candidates’ clinical competence
During an OSCE, candidates are observed and
evaluated as they go through a series of stations in
which they interview, examine and treat standardized
patients (SPs) who present various types of medical
problems
The NAC OSCE consists of 12 clinical stations of
11 minutes each

8. [ Candidate instructions ]

At each clinical station, there is a written
statement (Candidate instructions) that:

Introduces a clinical problem

Directs the candidate to appropriately interact with
a standardized patient (SP)

Specifies the task, such as obtaining a focused
history, conducting a focused physical examination,
and/or addressing the patient’s concerns

Indicates whether there are examiner oral
questions at the eight-minute signal

9. [
Important reminders
]

Your badge has a station number that indicates
your start station

Candidate instructions are posted outside each
station

READ everything carefully

Pay attention to the statement which explains
your task

A copy of the instructions will be available inside
the room for your reference

10. [
Physician examiners, SPs and labels
 Hand one bar code label to the examiner as you
walk into the room (instructions on the door)
 Examiners observe and assess your performance
with preset rating sheets
 Standardized patients (SPs)
are trained to simulate
patients’ signs and
symptoms in a reliable and
consistent manner
 Treat them as you
would real patients
]

11. [ Physical examinations ]
 You will be expected to use the hand sanitizer that
will be available in every physical examination
station. You may be prompted by the examiner.
 Be sure to drape the standardized
patients (SPs) appropriately
 Carry out any maneuvers necessary for
assessing the presenting problem

Examiners only give credit for tasks
completed satisfactorily

12. [ Physical examinations ]
 Examiners may intervene by:

Asking you to reread the instructions
 The
intent is to remind you to refocus on the task and to
save you time

Stopping genital, rectal, vaginal, breast or other
invasive examinations
 If
such examinations are appropriate, all you need to do
is clearly inform the examiner

Help the examiner score by:


Telling the examiner what you are doing (e.g., inspection)
Describing any findings

Include findings that are normal

13. [
Signals
]
 The eight-minute warning signal will indicate:
 EITHER that your time with the patient is over and the
physician examiner will begin to ask you questions,
 OR if there are no examiner questions (as indicated on the
candidate instructions), that you still have three minutes
remaining with the patient
 A signal also indicates the beginning and the end of
each station
 After each final signal, you will have two minutes to
move to the next station and read your instructions

14. [
Examiner oral
questions at eight
minutes
]
 Physician examiner oral questions may follow the
warning signal. They:
 are related to the patient you just saw
 ask about matters like diagnosis, management
decisions, and/or your response to an ethical issue
 Candidate instructions on station doors will indicate
whether there are oral questions at the eight-minute
signal
 If there are no oral questions, you will have the
full 11 minutes with the patient

15. [ Signing out ]
 Before leaving, you must follow the sign-out procedure.
 When it is your turn, hand in your:



candidate notebook (all pages intact)
ID badge
unused bar code labels including the backing sheet
 Sign out on the sheet
Congratulations! At this point,
the examination is over!

16. [ Sequestering ]
 Candidates may be required to remain on site
before or after the examination for security
reasons
 The length of time depends on the time zone
 There is no access to personal belongings or telephones
during this time
 No conversations about the examination will be permitted
Remember: Any breach of examination
content or lack of cooperation could invalidate
and/or prevent access to future Medical
Council of Canada examinations.

17. [Final review of important points ]
 Read your instructions carefully
 Complete the specified task
 Demonstrate your clinical skills
 You receive credit for tasks completed satisfactorily
 Treat the SPs as real patients
 DO NOT leave without signing out
 DO NOT divulge or disseminate any examination
content, even after the examination is over

18. [
Focus on the examination
]
Your group leader and the support staff are
there to answer your questions and guide you
from station to station
Try to relax and stay focused on the
examination
The purpose of the examination is to provide a
fair and accurate assessment of your clinical
skills

19. [ And finally,breaks
bathroom
]
Before the examination begins
After the examination is over
Urgent need: notify staff

20. [ RESULTS ]
 Results will be made available to you in your
physiciansapply.ca account, six to eight
weeks after the exam date
 Through your online account, you will be
able to:
 View your results documents
 Share them with other organizations