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The Medical Council of Canada Qualifying Examination Part II: Pre-Exam Candidate Orientation

Pre-Exam Candidate Orientation

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Page 1: Pre-Exam Candidate Orientation

The Medical Council of CanadaQualifying Examination Part II:

Pre-Exam Candidate Orientation

Page 2: Pre-Exam Candidate Orientation

MCCQE Part II Candidate Orientation

Introduction

Meet Dr. Campbell and Dr. Fournier. They will be taking the Medical Council of Canada Qualifying Examination (MCCQE) Part II today. Let’s follow them as they go through the examination process.

Page 3: Pre-Exam Candidate Orientation

MCCQE Part II Candidate Orientation

Purpose of the examination

The MCCQE Part II is a two-day clinical skills assessment comprised of a series of patient-based encounters.

The purpose of this examination is to make a fair and accurate assessment of your clinical skills.

Page 4: Pre-Exam Candidate Orientation

Items to bring to the exam Items to leave at home

Entrance card Your lunch

Lab coat Pencils/paper

Reflex hammer Electronic devices

Stethoscope Large bags or purses

What to bring

The list of items to bring to the exam is included in the Candidate Information Sheet that will be sent to you by mail prior to the examination.

MCCQE Part II Candidate Orientation

Page 5: Pre-Exam Candidate Orientation

Coat check

A coat check will be provided at the site to store your personal items during the examination and sequestering period.

However, as storage space will be limited, we ask that you please leave all large bags and handbags at home.

MCCQE Part II Candidate Orientation

Page 6: Pre-Exam Candidate Orientation

Candidate registration

Dr. Fournier has arrived at the examination site. Once he has registered, exam staff will hand him an ID badge, a pencil and a notebook before directing him to the orientation room.

MCCQE Part II Candidate Orientation

Page 7: Pre-Exam Candidate Orientation

Candidate orientation

During the candidate orientation on examination day, the facilitator will give a brief presentation and answer your questions.

MCCQE Part II Candidate Orientation

Page 8: Pre-Exam Candidate Orientation

Candidate notebook

In her notebook, Dr. Campbell will find bar code labels, blank pages, and a list of Common examples of what is considered ONE answer for written questions (next slide).

MCCQE Part II Candidate Orientation

I can use my notebook throughout the examination for reference and

note taking. The notebook will not be graded.

I won’t tear out any pages because I have to hand in my notebook INTACT at the end of each examination day.

This includes the label backing sheet.

Each notebook contains a few extra labels. If I lose one or two, I don’t

need to worry.

Page 9: Pre-Exam Candidate Orientation

MCCQE Part II Candidate Orientation

Examples of what are considered ONE answer for written questions

MCCQE Part II Candidate Orientation

LABORATORY TESTING

• Amylase OR lipase (ordering either is considered the same as ordering both)• CBC (includes platelets, Hb, WBC, MCV, HCT, Diff)• Coagulation studies (includes PR, INR, PTT)• Electrolytes (includes Na+, K+, CL-, CHO3

-,/Total CO2)

• Renal Function (includes creatinine, BUN)

• Urine Analysis (includes routine and microscopic analyses)

• Urine culture and sensitivity (accepted as one answer)

• Cardiac Enzymes (includes CK-MB, Troponin T, LDH, CK)

• Lipid profile (includes total cholesterol, triglycerides, HDL, LDL)

• Serum calcium (means total and ionized)

• Lumbar puncture (includes CSF, gram stain, culture and sensitivity, glucose, protein)

DIAGNOSTIC IMAGING

• Abdominal Ultrasound

• Pelvic Ultrasound

• CT abdomen

This list will be printed inside my candidate notebook — I will have access to it during the examination.

IMPORTANT: You are not limited to the tests and investigations on this list.

• CT pelvis• Upper GI series (includes esophagus, stomach, duodenum)

NOTE: Ensure your answers include all the tests and investigations you deem necessary.

Page 10: Pre-Exam Candidate Orientation

MCCQE Part II Candidate Orientation

Overview of the examination

The Saturday session of the examination is comprised of ten 10-minute stations:

• eight patient-encounter stations (in blue);

• two rest stations (in yellow).

Saturday

0102

03

04

0506

07

08

09

10

Page 11: Pre-Exam Candidate Orientation

MCCQE Part II Candidate Orientation

Overview of the examination

The Sunday session of the examination is comprised of ten 5-minute stations:

• Four patient-encounter stations (in blue);

• Four written stations (in red);

• two rest stations (in yellow).

Sunday

0102

03

04

0506

07

08

09

10

Page 12: Pre-Exam Candidate Orientation

Start station

MCCQE Part II Candidate Orientation

Exam staff will be there to guide me and answer my questions during the

examination.

My start station will be written on the Candidate Information Sheet I will receive in the mail and on my ID

badge.

On each day of the exam, I will start at the same station number. I will

then go through the remaining stations in numeric order.

0102

03

04

0506

07

08

09

10

Page 13: Pre-Exam Candidate Orientation

Timing of stations

• You will have two minutes to read the candidate instructions posted by the door before the buzzer sounds to prompt you to enter the room.

• You will then have ten minutes in the room.

– A warning buzzer will sound at nine minutes.

– A second buzzer will signal the end of the station. At this point, you will have to leave the room.

• You will then get two minutes to read the instructions for the next station, and so on.

MCCQE Part II Candidate Orientation

Saturday (10-minute stations)

Page 14: Pre-Exam Candidate Orientation

Timing of stations

• You will have 1 ½ minutes to read the instructions posted by the door before the buzzer sounds to prompt you to enter the room.

• You will then have five minutes in the room.

– A warning buzzer will sound at 4 ½ minutes.

– A second buzzer will signal the end of the station. At this point, you will have to leave the room.

• You will then get 1 ½ minutes to read the instructions for the next station, and so on.

MCCQE Part II Candidate Orientation

Sunday (five-minute stations)

Page 15: Pre-Exam Candidate Orientation

Candidate instructions

In any given station, you may be asked to do one or more of the following tasks:

– Perform a physical examination

– Obtain a history

– Manage an acute patient problem

– Respond to a patient’s concerns

– Counsel the patient and/or a colleague

MCCQE Part II Candidate Orientation

Before entering the room, I will read my instructions carefully in order to determine what my task is for

each station.

The instructions will also be available in

the room.

Page 16: Pre-Exam Candidate Orientation

Candidate instructions

Joseph Trans, 40 years old, presents himself to your office with a 2-hour history of abdominal pain.

IN THE NEXT 10 MINUTES:

• CONDUCT A FOCUSED AND RELEVANT PHYSICAL EXAMINATION.

As you proceed, EXPLAIN TO THE EXAMINER what you are doing and DESCRIBE ANY FINDINGS.

GIVE 1 LABEL TO THE EXAMINER.

MCCQE Part II Candidate Orientation

Sample

My task here is to conduct a physical examination. Therefore, I won’t ask history questions to the patient.

I’ll treat the standardized patient as a real patient because I will only get credit for tasks I complete satisfactorily.

More sample stations are available.

Page 17: Pre-Exam Candidate Orientation

Bar code labels

MCCQE Part II Candidate Orientation

As I walk into the room, I hand one or two bar code labels to the examiner. The instructions outside the door will remind me of how many labels to give (one in the 10-minute stations

and two in the 5-minute stations)

Page 18: Pre-Exam Candidate Orientation

Oral questions

MCCQE Part II Candidate Orientation

In some stations, the examiner will ask me one to three brief questions after the warning buzzer. In these stations, I will not be able to continue interacting with the patient after the warning buzzer, even after I have finished answering the examiner’s question(s). (If there are no oral questions for a station, I will have the full ten minutes to interact with the patient.)

The oral questions are related to the patient I just saw and are about matters like diagnosis, management decisions, or ethical or legal issues.

The candidate instructions will clearly state if there are oral questions for a station.

Page 19: Pre-Exam Candidate Orientation

Medical equipment

If a station requires the use of medical equipment other than a stethoscope and a reflex hammer, it will be provided in the room.

MCCQE Part II Candidate Orientation

Page 20: Pre-Exam Candidate Orientation

Patient management stations

During the examination, you might be asked to manage a patient problem.

In these stations, a standardized health professional, such as a nurse, might be present in the room.

MCCQE Part II Candidate Orientation

I will direct the nurse to order any tests or perform any procedures I believe

are appropriate for this patient.

I may be evaluated on my interaction with the nurse.

If a standardized health professional is present in the room, the candidate

instructions will clearly state so.

Download a video clip of a

candidate in this type of station

Page 21: Pre-Exam Candidate Orientation

Physician examiners

• Examiners observe and assess your performance with pre-set score sheets.

• A second observer may be present to observe protocols and to ensure exam quality.

• In physical examination stations:

MCCQE Part II Candidate Orientation

• Tell the examiner what you are doing and briefly describe your findings.

• You must demonstrate your clinical skills. You will only get credit for tasks completed to the examiner’s satisfaction.

Page 22: Pre-Exam Candidate Orientation

Examiner interventions

Examiners may intervene:

• By asking you to reread the instructions.

• To protect the standardized patient.

• To stop you from doing genital or rectal examinations.

MCCQE Part II Candidate Orientation

– If such examinations are needed, clearly inform the examiner that you would perform them.

• By reporting findings if they are available. If no findings are reported to you, please trust the findings from your examination of the standardized patient.

Download a video example of an examiner

intervening

Page 23: Pre-Exam Candidate Orientation

Standardized patients (SPs)

SPs are trained to simulate patients’ signs and symptoms in a reliable and consistent manner.

Treat them as you would treat actual patients and accept their simulated findings as being real. You may be scored on the way you interact with them.

MCCQE Part II Candidate Orientation

Page 24: Pre-Exam Candidate Orientation

Written stations

Sunday of the examination is comprised of 10 stations of five minutes each, alternating between patient-encounter stations and written stations.• Before you exit the five-minute encounter station,

the examiner will hand you the post-encounter probe (PEP) sheet.

• There are two types of PEPs:

MCCQE Part II Candidate Orientation

– Write-in

– Multiple choice

• Wait until the start buzzer before beginning to write.

Page 25: Pre-Exam Candidate Orientation

Write-in PEP

MCCQE Part II Candidate Orientation

Sample form

Page 26: Pre-Exam Candidate Orientation

Write-in PEP

MCCQE Part II Candidate Orientation

I must write legibly if I want to get credit for my answers.

When lines are numbered in the PEP sheet, only the first answer on each line

will count.

If the lines are NOT numbered, the number of answers is not limited.

Page 27: Pre-Exam Candidate Orientation

Writing tasks

MCCQE Part II Candidate Orientation

In the PEP, I may be asked to complete patient-associated tasks such as writing admission orders, a prescription, or a SOAP note. For these questions, I am expected to fill out the provided mark sheet or prescription form as completely as I would in a hospital/clinic or when filling in a prescription pad.

For prescription-writing questions only, a copy of the Compendium of Pharmaceuticals and Specialties (CPS) will be available in the room.

Page 28: Pre-Exam Candidate Orientation

Multiple choice (PEP)

MCCQE Part II Candidate Orientation

I will read the questions carefully before answering them. If I fill in more answers than specified in the question, my score for that question will be zero.

Page 29: Pre-Exam Candidate Orientation

Rest stations

• Rest stations may be included in the examination for each session.

• During these stations, there are no patients, no questions and no evaluations.

• Please sit quietly. You can take this time to rest before your next station.

MCCQE Part II Candidate Orientation

I might sit through a few rest stations during the

examination.

Page 30: Pre-Exam Candidate Orientation

Sequestering

For security reasons, candidates may be required to remain on site for up to three hours before or after the examination session on each examination day.

• Access to personal belonging or telephones will not be allowed during this time.

MCCQE Part II Candidate Orientation

Any breach of the rules or lack of co-operation on my part

could invalidate my examination results and

prevent access to my future examinations.

Page 31: Pre-Exam Candidate Orientation

Sign out

Before leaving after each exam day, follow the site staff’s instructions:

• Hand in your notebook (leave all pages intact, including the backing sheet from your bar code labels and any unused labels);

• Hand in your ID badge;

• Sign out on the sheet.

MCCQE Part II Candidate Orientation

Page 32: Pre-Exam Candidate Orientation

Confidentiality reminder

MCCQE Part II Candidate Orientation

During the application process, we agreed to use examination materials solely for the purpose of completing the examination and not to disseminate or reveal to others the examination

materials or content.

That means you CANNOT discuss or disclose exam content (including patient portrayals and findings, oral questions, etc.) at ANY TIME, in ANY WAY even after the examination is over.

Examples of this include comparing patient responses with your colleagues, sharing content with future exam candidates, and

posting case information 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.

Page 33: Pre-Exam Candidate Orientation

What do I do if…

You can use the washrooms:

• Before you start the examination

• While in sequestering

If you have an urgent need at other times, please inform site staff.

MCCQE Part II Candidate Orientation

I have to go to the bathroom?

Page 34: Pre-Exam Candidate Orientation

What do I do if…

Consult the site staff as soon as possible.

They are there to help you and are aware of the protocols to follow.

It is imperative that you remain calm and co-operative.

MCCQE Part II Candidate Orientation

I lose my notebook and/or my bar code labels?I feel ill? I don’t know where to go?

Page 35: Pre-Exam Candidate Orientation

Helpful tips

• Read your instructions carefully.

• Complete the specified task(s).

MCCQE Part II Candidate Orientation

Candidate instructions

Joseph Trans, 40 years old, presents himself to your office with a 2-hour history of abdominal pain.

IN THE NEXT 5 MINUTES:

• CONDUCT A FOCUSED AND RELEVANT PHYSICAL EXAMINATION.

As you proceed, EXPLAIN TO THE EXAMINER what you are doing and DESCRIBE ANY FINDINGS.

At the next station, you will be asked to answer questions about this patient.

GIVE 2 LABELS TO THE EXAMINER.

Page 36: Pre-Exam Candidate Orientation

Helpful tips

MCCQE Part II Candidate Orientation

Inside the station

• Demonstrate your clinical skills. You will not get credit for simply SAYING you would do something (with the exception of genital and rectal examinations).

• You will only receive credit for tasks completed satisfactorily.

• Treat the SPs as you would treat real patients.

Page 37: Pre-Exam Candidate Orientation

Helpful tips

• When the number of answers is specified in a written question, do not select / write more answers than what has been asked.

• Write legibly.

MCCQE Part II Candidate Orientation

Post-encounter probe (PEP)

Page 38: Pre-Exam Candidate Orientation

Useful links

MCCQE Part II Candidate Orientation

Medical Council of Canadamcc.ca

Objectives for the Qualifying Examinationhttp://mcc.ca/examinations/objectives-overview/

Qualifying Examination Part IIhttp://mcc.ca/examinations/mccqe-part-ii/

MCCQE Part II interaction rating scaleshttp://mcc.ca/wp-content/uploads/Exams-interaction-rating-scale-items.pdf

Page 39: Pre-Exam Candidate Orientation

Questions?

MCCQE Part II Candidate Orientation

And remember, site staff will be available throughout the day to answer your

questions and guide you to your stations.Please take the time to

review the information in this presentation and on the mcc.ca website. If

you have any questions on

examination day, you can ask the facilitator

during your Candidate Orientation.

Page 40: Pre-Exam Candidate Orientation

Examination results

• Approximately eight or nine weeks after the examination, you will receive an email notification stating that you can verify your pass/fail result through your physiciansapply.ca account.

• A Statement of Results and a supplemental feedback report will be posted in your physiciansapply.ca account shortly thereafter.

• If you have passed the examination, the MCC will also send you a package by mail with your Licentiate documents.

MCCQE Part II Candidate Orientation