Licensing in Canada: national exams, provincial licences

Medical and health education in Canada

Canadian medical school is a four-year MD programme, usually entered after at least three years of university study. Quebec also admits students directly from college for a longer course. There are 17 medical schools, accredited by the Committee on Accreditation of Canadian Medical Schools (CACMS). Instruction is in English, or in French at schools in Quebec and the University of Ottawa.

Graduates enter residency through CaRMS, the national matching service. Family medicine residency is two years and other specialties usually take five or more. Licensing is provincial, but the national credential is the Licentiate of the Medical Council of Canada (LMCC), based on the MCCQE Part I and completion of the required training. Provincial and territorial colleges issue the actual licence.

Nursing is typically a four-year bachelor’s degree, and the NCLEX-RN is used for registered nurses outside Quebec. Pharmacy is a four-year bachelor’s or PharmD, followed by Pharmacy Examining Board of Canada (PEBC) exams. Dentistry is a four-year DDS or DMD after prior university study, with the National Dental Examining Board (NDEB) exams. Check the provincial college for exact rules.

A federation with national exams

Canada has no national licence. Each province and territory regulates its own health professionals, and a licence from one province does not automatically open another. What Canada does have is a set of national examining bodies, so an applicant in Nova Scotia and one in British Columbia usually prepare for the same paper. The system is a federation with shared tests, which is why this page is organized by exam body and not by province.

Two other features define the Canadian picture. First, it is bilingual: the nursing and midwifery exams are offered in English and French. Second, Quebec stands apart. It has its own professional orders, and its nursing and pharmacy registration do not follow the same route as the rest of the country, so applicants aiming for Quebec should start from the Quebec order and not from the national body.

Who needs a licensing exam in Canada

Physicians: MCCQE Part I and the NAC

The Medical Council of Canada (MCC) sets the MCCQE Part I, the national standard for medical knowledge and clinical decision-making. It is a multiple-choice exam of 230 items in two sections of 115, with up to two hours and forty minutes per section, taken in one day at Prometric centres in Canada and in more than 70 other countries. It is offered four times a year.

The MCC also lists the NAC Examination, an assessment of readiness for international medical students and graduates who want to apply to a Canadian residency program, and the TDM Examination, which helps select candidates for provincial practice-ready assessment programs by testing competence at the level of an independent family physician. The format and current administration of the NAC are described on the MCC's own NAC page, and we have not confirmed them here, so read that page before planning around it.

Residency entry is through CaRMS and does not involve a separate exam. A pass on the MCCQE Part I is also one of the written exams that the New Zealand Medical Council accepts as a prerequisite for NZREX.

1. Open an MCC account and have your medical credentials verified.
2. Book MCCQE Part I for one of the four annual sessions and choose a Prometric centre.
3. Check NAC and residency requirements on the MCC and CaRMS sites if you plan to apply for training.
4. Apply to the provincial regulator in the province where you intend to practise.

Nurses: NCLEX-RN across provinces

Canadian registered-nurse regulators have used the NCLEX-RN since 2015. It is computer adaptive, includes Next Generation case studies, and is available in English and French. Internationally educated nurses first go through the National Nursing Assessment Service (NNAS) or the provincial equivalent, which compares your education with Canadian standards, and the regulator then authorizes you to test.

Quebec is the exception. The Ordre des infirmières et infirmiers du Québec (OIIQ) runs its own licensing exam in French. We have not researched the Quebec requirements in detail, so use the OIIQ site as the source. The NCLEX-RN is also the exam used in the United States and in Australia's outcome-based assessment, so Canadian candidates are preparing for a test with value in three countries.

Midwives: the Canadian Midwifery Registration Exam

The Canadian Midwifery Regulators Council (CMRC) runs the Canadian Midwifery Registration Exam (CMRE). It is a multiple-choice exam with four options per question, about half of them case-based, over four hours and forty-five minutes with a 30-minute break. Items are available in English and French. Candidates are Canadian graduates and internationally educated midwives who are in an approved bridging or assessment program. The profession is small, so cohorts are small and sittings are limited.

Pharmacists: PEBC Part I and Part II

The Pharmacy Examining Board of Canada (PEBC) sets the Qualifying Examination. Part I is a computer-based multiple-choice exam sat in a single 4.5-hour day. Part II is an OSCE and is open to candidates who have passed Part I. Both Canadian and international pharmacy graduates sit the same Qualifying Examination.

The route for international graduates has changed: the Evaluating Examination is no longer required for eligible applicants under the new pathway described on the PEBC site. Check which pathway you fall under before paying for any step. Quebec pharmacists register through the Ordre des pharmaciens du Québec.

Dentists: the NDEB and a shared Canada-New Zealand exam

Graduates of programs that are not accredited in Canada or the US complete the National Dental Examining Board of Canada (NDEB) Equivalency Process. It has three parts. The Assessment of Fundamental Knowledge (AFK) and the Assessment of Clinical Judgment (ACJ) are computer-based written exams at Prometric centres. The National Dental Examining Board Clinical Competency (NDECC) is a practical clinical exam in Ottawa.

The same process counts as the NZDREX for registration with the Dental Council of New Zealand, so one preparation effort serves two countries. The AFK is a large multiple-choice market, with many candidates from India, Iran and the Middle East.

Graduates of accredited programs, and those who finish equivalency, take the NDEB Certification virtual OSCE, which is sat in Canada, the US and Australia.

Physiotherapists: the CPTE

The Canadian Alliance of Physiotherapy Regulators sets the Canadian Physiotherapy Examination (CPTE), formerly the PCE. Both Canadian-educated and internationally educated physiotherapists sit it, after a credential assessment. The Alliance describes the written exam on its site. We could not confirm the exact item counts or the status of a clinical component, so take those details from alliancept.org.

Exams compared

Sequencing a Canadian application

Because the licence is provincial and the exam is national, the order of steps matters more here than the choice of exam. A sensible sequence has four stages.

1. Choose the province. Fees, wait times, supervised-practice rules and language expectations differ, and a Quebec choice changes the route for nurses and pharmacists.
2. Start the credential assessment. NNAS for nurses, MCC verification for doctors, NDEB and PEBC applications for dentists and pharmacists. These take the longest and cannot be rushed by studying.
3. Book the national exam once you are declared eligible, choosing a language where the exam allows it.
4. Apply to the provincial regulator for a licence, with language evidence and any jurisprudence or orientation requirement it sets.

Dentists and pharmacists should also note that one exam can serve more than one country: the NDEB equivalency exams count for New Zealand, and the NCLEX-RN counts in the United States and Australia.

Language and recognition

Canada is officially bilingual, but most health regulators outside Quebec expect proficiency in English or French, and exam bodies publish approved language tests. Several exams, including the NCLEX-RN and the CMRE, are available in both languages. Check each regulator for its accepted tests and scores, because they vary by province and profession.

Recognition of foreign credentials in Canada happens through the national bodies above, plus provincial processes. For nurses that means the NNAS. For doctors it means MCC credential verification and, for those entering practice without residency, provincial practice-ready assessment programs. The best use of a first week is to name the province, the regulator and the national body, and read their requirements side by side.

TriagePass is independent of the MCC, NCSBN, PEBC, NDEB and every other body named here. Our practice questions are original.

Last reviewed October 2026