加拿大医务委员会-CA-MCC (The Medical Council of Canada) -4

以下内容来源:StackPath

考试当天 飞出国

设备

考试当天你必须携带这些东西:

  • 没有任何大学或医院标致的纯白色实验服
  • 听诊器
  • 反射锤

这些设备必须装在实验服口袋中,因为考试现场禁止携带任何袋子。

**注意:**所有个人物品都必须登记,例如,钥匙、纸张、笔、钱包、手机、掌上电脑以及外套,考试之前存放起来。尽管工作人员会竭尽全力保证你的个人物品安全,但是,MCC并不负责这些个人物品的安全,所以,请尽可能少带些个人物品。考场会提供铅笔和橡皮,因为考试时你会需要铅笔和橡皮。

现场登记与情况介绍

如果现场登记迟到超过15分钟,将很可能无法参加考试。

考试当天现场登记之后是考试情况介绍,你会得知有关此次考试的一些细节,此外,你还会有机会提问题。每个考试考点都是配有专门工作人员,确保你在整个考试过程中都可以获得必要的指导。

一旦应试者选择开始考试,即使没有完成考试,也算作进行了考试。

考试安全

应试者之间禁止交流;
OSCE考试一旦开始,考点就会马上处于与外界隔离的状态(考点工作人员除外);
禁止携带一切电子设备,包括智能手表;
考试期间禁止使用一切通讯设备,包括手机在内。

违反这些规定可能会导致被拒绝参加该考试,还可能会导致此次考试成绩无效,甚至会导致以后都不能再参加该考试。

应试者身份

现场登记时,你会收到一些条形码标签,上面印有应试者身份编号。每到下一个检查点,必须把标签交给监考医师,他们会把标签贴在评分工具上。此外,还必须带感光识别证,标明自己的身份编号和开始位置编号。

应试者记事本

考试时MCC会提供一个小笔记本,用来记笔记。MCC只提供一个笔记本,不会提供额外纸张。在笔记本上记得笔记不参与评分。笔记本封面上会贴着个人身份标签。离开考场时必须完整返还这个小册子,纸张或其他部分不能有任何损坏或丢失。

投诉与利益冲突

如果应试者认为考试期间出现的一些管理、环境或者个人健康问题很可能会严重影响自己的考试成绩,那么,他/她必须:

  • 在考场及时将这些障碍告知主监考官;
  • 事件发生后,在考试中心填写一份事件报告;
  • 考试结束之后一周内,登陆个人账户递交有关该事件的详细描述。

考试过程中应试者必须出示障碍/问题通知才可以打断考试。截止时间过后,包括考试成绩已经公布,考试当天出现的所有障碍将停止调查。

如果考试之前你担心存在可能的利益冲突,最好考试之前联系MCC。考试期间,当你发现与监考官或标准化病人存在冲突时,必须:

  • 离开考场并马上通知工作人员,工作人员得到通知后,会为你做相应调整;
  • 考试结束之后一周内,登陆个人账户递交有关该事件的详细描述。

出现下列情况时,MCC会认为应试者与监考官或标准化病人之间存在利益冲突:

  • 与应试者存在血缘关系或者婚姻关系;
  • 目前或一直以来与应试者存在重大业务往来或者社会关系,或者是应试者的专业同事;
  • 应试者与监考官或者标准化病人存在已得到证实的利益冲突,例如,在其他环境下存在严重投诉。

注意: 一般应试者与监考官或标准化病人之间互相认识就会被视为存在利益冲突。

终止考试

所有打算终止考试的应试者在考试当天都会被要求填写一份标准弃权表格。

考试持续时间

考试当天在考场会有一个相关情况介绍,还会张贴一些指示,这些都可以帮助你只专注自己的考试表现,不需浪费精力找考场。此外,附近还会有工作人员提供指导,有任何疑问都可以咨询附近工作人员。

该考试总时间大约6.5个小时到7小时,包括现场登记、情况介绍以及其他可能隔离时间。在整个考试中,OSCE大约3个小时。

11分钟的检查点

在OSCE,你必须:

  • 获得病例和/或执行身体检查;
  • 解决病人与考试结果、诊断或者医疗问题相关的困扰;
  • 在大众医疗诊所或急诊室中处理病人疾病。

提前完成接诊病人环节之后,你必须安静等待。如果你突然发现自己还有一些事情尚未完成,在时间截止之前你可以随时再次接诊病人。口试一旦开始,你就不可以再接触病人,即使离该检查点结束还有一些时间。结束铃声一响,你必须离开该检查点,到下一检查点,不可以提前离开检查点。

你不需要进行任何外生殖器检查或肠检,这是出于对标准化病人的尊重,而且,考试时间也不允许。当你认为某个检查点可以进行这样的检查时,必须通知监考医师。如果临床诊断或者口试环节需要一些调查结果,监考医师会为你提供这些材料。

尽管通常应试者会被希望直接与标准化病人接触,包括直接提问问题、进行身体检查和解释药方,但是,体检检查点需要采取不同的方式。进行身体检查时,你必须简要说明自己正在做的事情,并报告自己的检查结果,因为这是获得满分的一个重要环节。例如,你只有说明自己在检查病人,监考医师才可以为病人检查环节打分。检查过程中的所有发现(包括面色苍白)都必须报告给监考官,证明自己发现了这一点。如果你在检查过程中没有任何确切的发现,你可以报告一切正常。监考医师不能做任何假设,例如,应试者在寻找面色苍白、炎症、皮疹。同样地,监考医师必须根据你报告的检查发现(无论正确还是错误)进行打分。

检查点之间的流动

应试者有一定的时间转向下一个检查点并阅读张贴的考试说明。在这段时间内,监考医师为测试下一位应试者准备仪器。应试者必须从纸上撕下一个条形码身份标签,准备交给监考医师。考试铃声一响,你就可以进入考场进行规定的任务。

应试者说明

请仔细阅读每个检查点的考试说明。例如,在体检检查点,你必须接诊病人,并且当你实施个人认为合适的检查操作时,必须同时向病人和监考医师报告自己正在做的事情以及所有检查发现。在体检检查点,你只可以向病人提问与检查本身直接相关的问题,例如,“你抬胳膊时感觉疼吗?”,其他任何细节性问题病人都不允许作答。提问问题不参与评分,但是会使用一些在该检查点的有限时间。相反地,你也不可以在病史检查点进行任何体检操作。

在组合病史/体检检查点或者管理检查点,即所做的任务对处理病人疾病必不可少,那么,你可以自行决定这两个(或更多)任务中的哪些因素必须优先考虑。

每个检查点都会同时在考场门口和考场内张贴考试说明,包括病人名字和年龄、所患疾病、考试背景(大众医疗诊所或急诊室)以及该检查点的性质(病史检查点还是体检检查点)。考场可能会提供重要提示、检查结果和/或家庭病例,在等待进入检查点时,你可以做一些笔记。

下面是临床检查点的应试者说明的一个例子:

Jonathan Jones,男,65岁,一直腹痛。

  • 接下来的8分钟:

进行一次定向相关身体检查

  • 进行身体检查过程中

向监考官解释自己正在做的事情并描述自己的检查发现

  • 8分钟提示铃响后,监考官会提问一些有关该病人的问题

  • 交给监考官一个标签

这些说明中的一个关键词是定向。你进行的身体检查必须和评估的腹痛相关。在病史获得方面没有任何要求,也不会参与评分,身体检查的方式和执行的具体操作除外。

有关考试材料或考试内容的保密性

考试流程包括同意不向其他任何人传播或透漏考试材料和考试内容,因此你不可以在任何时间以任何方式讨论或透漏考试内容,包括病人描述、检查发现、口试问题、病例等等,即使是考试结束之后也不可以。

违反保密协议的例子包括但不局限于,把病人的反应与同事进行对比,与将来影视则交流考试内容,以及在网上发布信息。

MCC积极监控违反保密协议的行为,并且对透漏考试内容的应试者采取相应的纪律和法律手段。凡是同意遵守保密协议却违反该协议向外传播考试内容的行为都将被视为极度不专业行为。

违反保密协议向外传播考试内容的应试者不但被取消考试成绩,其行为还会上报管理机构以及其他医疗组织,更严重的是,以后都不能再参加所有MCC考试。

以下内容来源:StackPath

Exam Day

Equipment

You must bring with you to the examination:

  • Plain white lab coat without a university or hospital crest
  • Stethoscope
  • Reflex hammer

The equipment must be carried in lab coat pockets, as no bags will be allowed.

NOTE: All personal belongings will be collected at registration (e.g., keys, papers, pens and pencils, wallets, cell phones, PDAs, as well as coats) and stored until after the examination. While every effort will be made to store your belongings safely, the Medical Council of Canada (MCC) is not responsible for these belongings and you are encouraged to bring as few personal belongings as possible.

You will be provided pencils (with erasers) at the site. You will be required to use the pencils (with erasers) provided at the site.

Registration and orientation

If you are more than 15 minutes late for registration, you may be denied entry to the examination.

Immediately following registration on examination day, you will attend an orientation to the examination. The orientation provides you with the logistical details of the examination and an opportunity to ask questions. Each examination site is staffed to ensure that you are guided through the examination.

Once a candidate chooses to begin the examination, it will count as an attempt even if he/she cannot finish.

Examination security

No talking between candidates is permitted:
Once the OSCE has begun, up until sequestering
Between stations (except with site staff)
All electronic devices are not permitted (including smartwatches)
Access to communication devices, including telephones or cell phones, during the exam and sequestering is not permitted
Breaking the rules may result in dismissal from the examination, may invalidate your results and you may be barred from taking future MCC examinations.

Candidate identification

Candidate identification numbers are printed on bar code labels that are distributed to you at registration. You are asked to give a label to the physician examiners as you proceed from station to station. The physician examiners, in turn, attach the label to your scoring instruments. In addition, you are required to wear a photographic identification badge, which also indicates your ID number and start location number.

Candidate notebooks

The MCC provides a small notebook that you may use for writing notes while taking the examination. Only one notebook will be provided and no pages can be added. The notes in the notebook will not be scored. Your ID label is attached to the notebook cover. This booklet must be returned intact at the checkout (including unused labels), i.e., no pages or parts can be torn or ripped out.

Complaints and conflict of interest

A candidate who believes that administrative, environmental or personal health problems encountered during the course of an examination session may significantly affect his/her results must:

  • Immediately communicate such concerns to the Chief Examiner on site at the time of the examination session in question
  • Complete an incident report at the exam centre as soon as possible after the incident
  • Submit a message through your account detailing the incident within one week following the examination

Any intervention, if appropriate, is possible only if notice of the concern/problem is presented by the candidate in this manner. Concerns relating to exam day occurrences cannot be investigated after this deadline including once results have been released.

If you have concerns about a potential conflict of interest prior to the examination, you are strongly encouraged to contact the MCC before exam day. If, during the examination, you encounter an examiner or standardized patient where a conflict exists, you should:

  • Exit the station and inform the staff immediately (once staff are notified, they will make alternate arrangements for the administration of the specific station for you)
  • Submit a message through your account informing the MCC of the occurrence within one week of the examination

The MCC takes the view that a conflict of interest exists, without limitation, in situations where the examiner or standardized patient is (i) related by blood or marriage to the candidate; (ii) is or has been in a significant business or social relationship with the candidate, or is a professional colleague; or (iii) where a conflict of interest relating to the candidate and such examiner or standardized patient has been previously identified (e.g., there is an outstanding complaint in another context). Please note that knowing or being known to an examiner or standardized patient is not generally deemed a conflict of interest.

Discontinuation of examination

All candidates who choose to discontinue the examination will be asked to sign a standard waiver form on exam day.

Navigating the examination and duration

Remember that there is an orientation at the examination site on the day itself. Signs will be posted and a considerable effort is made to allow you to focus on your performance, not on finding the next room. Staff will always be nearby to provide directions. If in doubt, ask the nearest staff person for directions.

The examination includes registration of candidates, an orientation session and sometimes a sequestering period for a total time of approximately six and a half to seven hours. Of the total time, the OSCE is approximately three hours in length.

Eleven-minute stations

In OSCE stations, you may be required to:

  • Obtain a history and/or conduct a physical examination
  • Address patient concerns regarding results, a diagnosis or a medical problem
  • Manage a patient problem in a family practice clinic or in an Emergency Department setting

If you finish the patient encounter early, you must wait quietly. If you remember something more that you would like to do, you may re-engage the patient at any time until the warning bell/announcement or final 11-minute buzzer/announcement depending on the station. After the oral questions begin, you may not return to the patient encounter, even if there is time remaining before the end of the station. After the final bell sounds, you must leave the station and move to the next one. You may not leave early.

You are not expected to carry out genital or rectal examinations. This is out of respect for the standardized patients and the short time allotted to each station. In a station where you believe that such an examination is appropriate, you should inform the physician examiner. If there are relevant findings needed to complete the clinical encounter, or answer the oral questions, the physician examiner will provide these findings to you.

Although it is always expected that candidates will interact directly with the standardized patients (asking questions directly, conducting a physical examination, explaining a prescription), physical examination stations require a somewhat different strategy. While conducting a physical examination, you should state briefly what you are doing and report your findings. This is critical to receiving full credit. For instance, a physician examiner cannot give credit for observing the patient unless you state that you are observing the patient. If there are findings; for example, pallor, then report this to the examiner to indicate that you have noted it. If you observe that there are no positive findings, then you can just report “Normal”. A physician examiner is not allowed to assume, for example, that a candidate is looking for pallor, inflammation, skin rashes. Likewise, credit for findings (positive or negative) cannot be given unless you report what you found.

Moving from station to station

A set amount of time is allowed for moving to the next station and for reading the posted instructions. During this time, the physician examiner completes the rating instrument for the current candidate and prepares for the next candidate. Remove one bar code identification label from the sheet, so it is ready to give to the physician examiner. At the sound of the buzzer, you enter the room and proceed with the required task.

Candidate instructions

Read the instructions for each station carefully. For instance, in a physical examination station, you must greet the patient and report what you are doing and report your findings (to both the patient and the physician examiner) as you carry out those examination manoeuvers that you deem appropriate. It is not appropriate to ask questions to the patient during a physical examination station unless the questions relate directly to the examination itself; for example, “Does it hurt when you raise your arm?” Patients are discouraged from answering other questions in any detail. There is no credit given for asking questions and doing so will use some of the limited time available for that station. Conversely, it is not appropriate to carry out any physical examination manoeuvers in a history station.

In a combined history/physical examination station or a management station (i.e., doing whatever tasks are necessary to manage the patient’s problem at that moment), it is up to you to prioritize the elements of the two (or more) tasks.

The instructions for each station are posted next to the door and are available inside each room. The instructions provide the patient’s name and age, the presenting problem, the setting (family practice clinic or Emergency Department), and the nature of the station, be it a history and/or physical. Vital signs, test results and/or elements of the family history may be provided. You are allowed to take notes while waiting to enter a station.

The following is an example of instructions to candidates for a clinical station:

Jonathan Jones, a 65-year-old man, presents to your office because he has been experiencing abdominal pain.

  • IN THE NEXT 8 MINUTES:
    CONDUCT A FOCUSED AND RELEVANT PHYSICAL EXAMINATION

  • As you proceed with the physical examination,
    EXPLAIN TO THE EXAMINER what you are doing and DESCRIBE ANY FINDINGS.

  • After the 8-minute warning buzzer, the examiner will ask you some questions related to this patient.

  • GIVE ONE LABEL TO THE EXAMINER

A key word in the instructions is FOCUSED. You are expected to conduct a physical examination relevant to assessing abdominal pain. There is no requirement (and no marks are given) for obtaining a history, only for the manner of the physical examination and for the specific manoeuvers that are performed.

Confidentiality of examination materials or content

As part of the exam process, you agree not to disseminate or reveal to others the examination materials and content. This means that you cannot discuss or disclose exam content (including patient portrayals and findings, oral questions, cases, etc.) at any time in any way even after the examination ends.

Examples of breaches in confidentiality include, but are not limited to, comparing patient responses with your colleagues, sharing content with future exam candidates and posting information online.

The MCC actively monitors for breaches in confidentiality, and will seek disciplinary and legal measures against candidates who disclose examination content. Agreeing to maintain confidentiality and then breaking that confidentiality by disseminating exam content is considered a highly unprofessional act.

Breaking confidentiality and disseminating exam content can lead to candidates being denied a standing on the examination and being reported to regulatory authorities and to other medical organizations, and being barred from taking MCC exams in the future.

以下内容来源:StackPath

考试准备资料 飞出国

NAC考试对国际医学毕业生应试者的能力进行评估。具体说来,也就是加拿大研究生培养入门必须具备的知识、技能和态度。下面的资源将有助于应试者准备NAC考试。

考试当天

尽管该考试持续时间大约3个小时,但是应试者参与考试管理的时间是6.5个小时到7个小时。为了安全起见,一些城市的应试者可能需要在考试之前的某个具体时间点到达考试地点,且一直在考试地点等待考试开始。考试到来之前,应试者可以在报名信息中仔细阅读具体的说明。

所有应试者都必须在模拟临床情境下参加考试,必须随身携带一件纯白色实验服、一个听诊器、一个反射锤。为了全面了解NAC考试有关规定,应试者应该仔细阅读在考试当天应该遵守的规定。

** MCC参考资料 **

NAC考试应试者最好能够了解一下在客观结构化临床考试中经常出现的错误。

《资格考试考试目标》

应试者使用《资格考试考试目标》作为学习指南将有助于NAC考试报考。《资格考试考试目标》不仅是MCCEE考试和MCCQE考试第一部分和第二部分的基础,还对NAC考试中可能出现的考试材料进行了总体概括。注意:《资格考试考试目标》编制的内容涉及一些临床表现。

DSM-5过渡

2013年5月美国精神病协会出版了《精神障碍诊断与统计手册》(第五版),即DSM-5。

2014年到2015年,以计算机为工具的MCCEE考题将陆续更新使用最新DSM-5语言。这些更新的考题将仍然使用DSM-IV-TR语言,只不过这些语言将会附在DSM-5术语之后。

应试者回答监考医生提问的问题时,既可以使用DSM-5语言也可以使用DSM-IV-TR语言。

参考书目

考试之前,如果你不熟悉北美疾病管理实践,可以查阅由加拿大药剂师协会出版、Jean Gray主编的《治疗选择》,获取一些基本信息。

有关国际医学毕业生的一般信息

国际医学毕业生还可以在国际医学毕业生页面查看有关获得医学实践许可的流程的概览版块,了解如何在加拿大获得医学实践许可。

以下内容来源:StackPath

评分 飞出国###

概述

NAC考试目标主要通过使用标准化考试管理准则、培训监考医师和标准化病例以及使用预定的评分工具来实现。监考医师针对每位应试者在每个检查点的表现对其OSCE分数进行评估。

为了通过NAC考试,应试者必须获得一个符合加拿大医学院校毕业生特定标准的整体分数。最后考试结果评定阶段,NAC考试委员会还会考虑监考医师对应试者在道德和专业方面的能力的观察结果。

在NAC考试中如何对OSCE进行评分?

监考医师首先观察应试者与标准化病人之间的接触,然后对应试者在发现问题和完成临床任务方面能力进行评分,具体包括病史理解、身体检查、组织技巧、沟通技巧、语言流畅性、诊断、数据解读、调查以及治疗与管理这9项能力。OSCE分数是监考医师能力评分的平均分。所以,应试者OSCE分数是各个检查点分数平均分

NAC分数采用什么样的报告形式?

NAC考试分数分布于0到100分之间。合格分数标准是加拿大医学院校毕业生的表现。应试者考试表现依据该考试的合格分数进行判断,而不考虑其他应试者的表现。

应试者除了得知自己总分数外,还会收到有关自己考试表现的补充性反馈报告。该报告中包含一个图表,说明应试者在各个能力方面的具体表现。

由于能力分数不是在观察的基础上得出的,所以,能力分数和整体分数在准确性方面存在差异。

自2015年起关于补充性反馈报告的变化

之前的补充性反馈报告包含一个图表,该图表依据考试表现好坏依次列出各个检查点。自2015年起,MCC将该图表从补充性反馈报告中删除,因为图表包含的信息尽管正确但容易解读错误和/或容易误导人。

该图表将各个检查点划分了等级,但是,实际上应试者在各个检查点的表现在某些情况下是相同(接近相同)或者没有差异的。 出现这样的变动之后,2015年的补充性反馈报告将由2页内容变成1页内容。

以下内容来源: StackPath

###考试成绩 飞出国###

考试成绩公布

重要提示: 考试之后6周到8周,通过physiciansapply.ca account个人账户可以查看考试成绩。所以,9月12日和13日参加考试的应试者回比9月19日和20日参加考试的应试者早些收到考试结果。

NAC考试委员会负责确认考试成绩,MCC负责于考试之后6周到8周通过physiciansapply.ca公布考试成绩。此外,MCC还负责通过physiciansapply.ca对应试者的考试表现进行补充性反馈。之后,应试者的考试成绩将与CaRMS以及其他physiciansapply.ca注册机构分享。出于保密需要,该考试成绩不会通过口头、传真或电子邮件传播。

NAC考试合格成绩有效期

应试者最近的考试成绩将长期有效,不会失效。如果应试者参加NAC考试次数超过1次,那么,只有其最近的考试成绩才会保持长期有效。

重考

自2011年起,每年只有一次机会参加NAC考试,且每个人最多只能参加3次NAC考试。此外,自2015年起,凡是已经通过NAC考试的应试者(根据最近考试成绩显示)都将不能再参加该考试。

请求重新评分

只有没有通过考试的应试者才可以请求重新评分,考试合格的应试者不可以请求重新评分。 **注意:**考试成绩公布之前会经过多次核查。如果应试者希望对自己的考试表现进行重新评分,必须:

  • 在考试成绩公布之后一个月内,通过个人账户递交请求,该请求必须包含请求重新评分的原因、应试者的姓名、MCC应试者编码、地址以及手机号码。
  • 递交书面请求时,必须使用信用卡(维萨信用卡或万事达信用卡)支付一定费用。经过重新评分之后,无论考试成绩还是考试状态发生变化,该费用都将会全部退还。

重新评分包括以下步骤:

  • 鉴定所有考试环节,包括复审所有考试文件,例如事件报告和医师评论。
  • 验证所有计算机扫描的答题纸的异常现象,包括破损的答题纸、偏离的笔画、墨痕等等。
  • 根据医师完成的答题纸验证原始计算机数据。
  • 根据考试结果信中的分数验证计算机存储的分数。

重新评分并不意味着让其他监考官重新评价应试者的考试表现。重新评分请求被接收之后必须经过4周到6周的处理时间。**注意:**经过重新评分之后,考试分数可能比原来的分数高,也可能比原来的分数低,甚至可能和原来的分数一样。

以下内容来源:StackPath

与实习项目相关的信息 飞出国###

NAC考试对即将进入加拿大实习计划的国际医学毕业生进行评估。这是一个泛加拿大标准考试,为实习计划负责人提供一些客观信息,这些信息将反映申请加拿大研究生培训的国际医学毕业生的技能、态度和知识水平。

NAC考试内容由NAC考试委员会负责制定。NAC考试委员会由来自加拿大全国各地的医师组成,这些医师都拥有多个医学领域的专业技术。

考试背景与考试目的

在NAC考试成立之前,许多省份都曾组织并实施单独临床考试对国际医学毕业生进行评估。之所以组织NAC考试,既是为了避免不同省份之间的国际医学毕业生评估项目出现重复现象,也是为了为加拿大全国实习计划负责人提供标准的考试成绩。考试结果将会为实习计划负责人提供一个综合评价,涉及国际医学毕业生的技能、态度、知识以及进入研究生培训项目达到加拿大医学毕业生水平的意愿。为了全面了解申请者的技能,可以同时参考该信息和其他信息,例如,实习申请信或者MCCEE考试结果。

考试范围与考试形式

NAC考试是一次临床评价,共包含12个不同的临床检查点,每个检查点考试时间11分钟,每个检查点都有一个标准化病例和一位监考医师。

尽管该考试总时间是大约两个半小时,但是由于考试管理需要应试者可能会在考试现场停留更长的时间。

有关考试形式更多信息,请访问OSCE页面。

评估与评分

考试成绩合格/不合格主要依据是应试者的考试分数是否等于或高于NAC考试合格分数。而这个标准是基于与加拿大医学院校毕业生考试表现的比较。NAC考试还会收集来自监考医师对应试者在道德和专业方面的能力的观察结果信息。

OSCE分数组成

监考医师将对应试者的9项能力进行评估,这些能力包括:

  • 病史理解
  • 沟通技巧
  • 数据解读
  • 身体检查
  • 语言流畅性
  • 调查
  • 组织技巧
  • 诊断
  • 治疗与管理

应试者在每个检查点的分数是在该检查点各个能力评分的平均分。应试者的整个OSCE分数是所有检查点分数的平均分。

最后考试结果评定阶段,NAC考试委员会还会考虑监考医师对应试者在道德和专业方面的能力的观察结果。

考试内容的制定

NAC考试内容由NAC考试委员会负责制定。NAC考试委员会由来自加拿大全国各地的医师组成,这些医师都拥有多个医学领域的专业技术。NAC考试委员会定期制定和审查考试内容,并依据加拿大医学院校毕业生的预期表现制定考试标准。

考试地点

NAC考试目前通过省级IMG评估项目来举行,涉及的省份包括艾伯塔、不列颠哥伦比亚、安大略、曼尼托巴、新斯科舍和魁北克。

以下内容来源:StackPath

Exam preparation resources

The National Assessment Collaboration (NAC) examination assesses the competence of international medical graduate candidates; specifically, the knowledge, skills and attitudes essential for entrance into postgraduate training in Canada. The following resources will aid candidates in preparing for the NAC examination.

Examination day

The duration of the examination itself is approximately three hours. However, candidates should anticipate six and a half to seven hours for the administration of the exam. For security reasons, candidates in certain cities may be required to arrive at a designated time prior to the examination and remain on site until a designated time following the examination. Specific instructions will be provided with the registration package prior to the examination date.

All candidates are required to function in a simulated clinical situation and must bring with them a plain white lab coat, a stethoscope and a reflex hammer. For a complete overview of the NAC examination regulations, candidates are encouraged to review the guidelines to follow on the day of the examination.

Medical Council of Canada (MCC) reference documents

NAC examination candidates are encouraged to review common mistakes made on objective structured clinical examination stations.

Objectives for the Qualifying Examination

Using the Objectives for the Qualifying Examination as a study guide may be helpful for candidates taking the NAC examination. The Objectives serve as the basis for the Medical Council of Canada Evaluating Examination (MCCEE) and the Medical Council of Canada Qualifying Examination (MCCQE) Part I and Part II. These Objectives also serve as a general overview of possible test material that may appear on the NAC examination. Note that the Objectives are organized in terms of clinical presentations.

Transition to DSM-5

In May 2013 the American Psychiatric Association published the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Over 2014 and 2015, the MCCEE computer-based questions will be updated to include the new DSM-5 language. These updated questions will still include the DSM-IV-TR language, which will be featured in brackets after the DSM-5 terminology.

Candidates answering questions asked by the physician examiner can use either DSM-5 or DSM-IV-TR language where appropriate.

For more information, please visit Medical Council of Canada transition to DSM-5.

Reference books

Prior to the examination, individuals who are unfamiliar with disease management practices in North America may wish to consult Therapeutic Choices edited by Jean Gray, published by the Canadian Pharmacists Association, as a source of general information.

General IMG information

IMGs can also visit our Overview of the process of obtaining a licence to practise medicine for IMGs page for general information on beginning the process of obtaining a licence to practise medicine in Canada.

以下内容来源:StackPath

Scoring

Overview

Objectivity on the NAC examination is achieved through the use of standardized guidelines for the administration, the training of physician examiners and standardized patients, and the use of predetermined scoring instruments. The OSCE component is evaluated by physician examiners based on the candidate’s performance at each station.

To pass the National Assessment Collaboration exam, a candidate must achieve an overall score that is set at the standard of a graduating student from a Canadian medical school. In awarding the final result on the examination, the NAC Examination Committee also considers any physician examiner observations on the candidate’s ability to demonstrate the appropriate ethical and professional behaviour.

How are OSCE stations scored on the NAC exam?

Physician examiners observe candidates interacting with standardized patients and provide ratings on up to nine competencies relevant to the presenting problem and clinical task. These competencies are history taking, physical examination, organization skills, communication skills, language fluency, diagnosis, data interpretation, investigations, therapeutics and management. The OSCE station score is the average of a physician examiner’s competency ratings. A candidate’s score on the OSCE is the average of the station scores.

How are NAC scores reported?

NAC exam scores are reported on a scale with a distribution ranging from 0 to 100. The pass score is based on a performance equivalent to a graduating student from a Canadian medical school. A candidate’s performance is judged in relation to the exam pass score and not judged on how well other individuals have performed.

In addition to the total score, candidates are also provided with supplemental feedback on their exam performance. This report consists of a graphical display of the candidate’s performance on the competencies assessed.

Since competency scores are based on few observations, they do not have the same precision as the total score.

New in 2015 – Changes to the supplemental feedback report

Candidates from previous sessions may recall that their report contained a table with stations listed from high performance to low performance. As of 2015, the MCC has removed this table from the supplemental feedback report as the information it contained, while correct, could be misinterpreted and/or misleading.

The table provided a rank order of stations, but candidate performance in some cases was equal, close to equal, or not equidistant across all stations. As a result of this change, in 2015 the report will be one page instead of two.

以下内容来源: StackPath

Results

Release of results

Important: Results will be available in your physiciansapply.ca account, 6 to 8 weeks after the date of your exam. Therefore, candidates who took the exam on Sept. 12 or Sept. 13 might receive results prior to candidates taking the examination on Sept. 19 or Sept. 20.

Examination results are confirmed by the National Assessment Collaboration (NAC) Examination Committee and are released by the Medical Council of Canada (MCC) through physiciansapply.ca six to eight weeks after the examination date. The MCC also provides supplemental feedback on candidates’ examination performance through their physiciansapply.ca account. Candidates will be able to share their results with the Canadian Resident Matching Service (CaRMS) and other organizations registered with physiciansapply.ca. For reasons of confidentiality, results cannot be given verbally, by fax or by email.

Validity period of a pass result on the NAC examination

A candidate’s most recent result remains valid indefinitely (no longer expires). If a candidate takes the NAC examination more than once, the most recent result will be the only valid result.

Retaking the examination

The NAC examination can be attempted once per calendar year and can be taken a maximum of three times (effective from 2011). Eligible candidates who have a pass standing on the NAC examination (most recent result) will not be eligible to retake the exam (effective from 2015).

Rescore requests

Only candidates who have failed the NAC examination can request a rescoring of their examination; candidates with a pass result are not eligible for the rescoring service. Please note that scores are verified several times before results are released. Candidates who wish to have their examination rescored must:

  • Submit a message through your account within one month of the results release date indicated on the Statement of Results. The request should include an explanation for the rescore request, the candidate’s name, MCC candidate code, address and phone number.
  • Accompany the written request with payment of the applicable fee by credit card (Visa or MasterCard). Fees are refunded if a rescore procedure leads to a score or status change.

A rescore includes the following steps:

  • Authentication of all parts of your examination, including a complete file review (incident reports and physician comments)
  • Verification of the computer-scanned answer sheets for anomalies (torn sheets, stray marks, ink marks, etc.).
  • Verification of raw computer data against physician-completed answer sheets.
  • Verification of the computer file scores against those reported in the result letter

A rescore does NOT include a re-evaluation of the candidate’s performance by additional examiners.

Rescores are processed within four to six weeks from the date they are received. Please note that the new score could be higher, lower or the same as the original score received.

以下内容来源:StackPath

Information for residency program directors

The National Assessment Collaboration (NAC) examination assesses the readiness of an international medical graduate (IMG) for entrance into a Canadian residency program. It is a pan-Canadian, standardized examination that provides residency program directors with objective information on the skills, attitudes and knowledge level of IMGs applying for postgraduate training in Canada.

It is developed by the NAC Examination Committee, a group of physicians and medical educators from across the country with expertise in assessment and clinical content.

Background and rationale

Prior to the creation of the NAC examination, a number of provinces developed and delivered individual clinical examinations to assess IMGs. The NAC examination was developed to reduce duplication between provincial IMG assessment programs and offer standardized results to Canadian residency program directors across the country. The exam results provide residency program directors with a comprehensive assessment of an IMG’s skills, attitudes, knowledge and readiness at the level of a recent Canadian medical graduate for entry into postgraduate training. This information can be used in concert with other information – such as a residency application letter or results from the Medical Council of Canada Evaluating Examination (MCCEE) – to obtain a comprehensive view of an applicant’s skill set.

Scope and format

The NAC examination is a clinical evaluation that consists of up to 12 different 11-minute clinical stations, each with a standardized patient and a physician examiner.

In total, the duration of the exam is approximately 2.5 hours. However, the candidate may be on site for a longer period of time for administrative reasons.

Visit our OSCE station page for more detailed information on the format of the NAC examination.

Evaluation and scoring

The pass/fail result is based on whether a candidates’ examination score is equal or higher than the pass score established for the NAC examination. The standard is based on the level of performance compared to a graduate from a Canadian medical school. The NAC examination also collects information from physician examiners on the candidate’s ability to demonstrate ethical and professional behaviour.

OSCE component scoring

Candidates are rated by physician examiners on up to nine different competencies per station. These competencies include:

  • History taking
  • Communication skills
  • Data interpretation
  • Physical examination
  • Language fluency
  • Investigations
  • Organizational skills
  • Diagnosis
  • Therapeutics and Management

A candidate’s score for each station is the average of all competency ratings measured on the station. A candidate’s score for the entire OSCE is the average of the station scores.

In awarding the final result on the examination, consideration is given to any observations made by the physician examiner at each of the stations regarding the candidate’s ability to demonstrate the ethical and professional behaviour needed to enter postgraduate training.

More detailed information on NAC examination scoring can be found on the Scoring page.

Content development

Content for the NAC examination is developed by the NAC Examination Committee – a group of physicians from across the country with expertise in multiple medical disciplines. The Examination Committee meets on a regular basis to develop and review content and set standards based on the expected performance of a graduate from a Canadian medical school.

Learn more about the NAC Examination Committee.

Testing locations

The NAC examination is currently delivered through provincial IMG assessment programs in Alberta, British Columbia, Ontario, Manitoba, Nova Scotia and Quebec.

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