A current pass standing on the Therapeutic Decision Making examination is required for acceptance to SIPPA. SIPPA applicants who have successfully completed the saskdocs pre-screen are eligible to sit the TDM examination. In the event that SIPPA receives more applications to sit the TDM examination then there are available seats priority will be given to applicants who have a "Final Ruling for Eligiblity of Educational License" from the College of Physicians and Surgeons of Saskatchewan as well as those who have their LMCC.

Applicants to SIPPA should be aware that it is a competitive process and that achieving a pass standing on the TDM examination does not guarantee selection for the SIPPA program. All applicants to SIPPA must meet eligibility requirements as set out by saskdocs and the College of Physicians and Surgeons of Saskatchewan.

What is the Therapeutics Decision Making (TDM) examination?

Therapeutics is defined as the application of knowledge in the pharmacological and non-pharmacological management of medical conditions. The Therapeutics Decision Making Examination aims to assess the competence of candidates at the level required of a family physician practicing independently and safely in Canada. It consists of patient-based scenarios representing common or important clinical presentations and problems that family physicians practicing in Canada should be able to competently manage in the following dimensions of medical care: health promotion and illness prevention, acute illness, chronic illness, and safety and adverse effects.

The examination is comprised of 40 cases with approximately 100 short-answer write-in questions. Candidates are allowed up to three hours to complete the examination. The content is developed by the Medical Council of Canada (MCC) and the examination is administered by the Practice-Ready Assessment (PRA) programs for use in the selection of candidates into PRA programs. If you obtain a pass result, you will not be allowed to retake the examination in an attempt to get a higher score. 

The pass score is established through a rigorous standard setting exercise by a panel of physician subject matter experts from across the country.

Results are valid across jurisdictional PRA programs that require the TDM examination. Candidates are required to declare previous TDM examination attempts.

 Please see the Candidate Information Sheet here.

Therapeutic Decision Making Exam Fee and Dates:

Effective January 1, 2022 all applicants who sit the NAC PRA TDM Examination will pay a fee of $2140.

All other associated costs (travel, accommodation, etc.) are the responsibility of the physician applicant writing the examination.

TDM examination dates for 2022 are:

  • January 18
  • June 7


The 2022 NAC PRA TDM Exam Score Recheck will be $256.

Important Updates for the TDM Exam can be found here.


 Withdrawing from the TDM Exam:

Candidates who withdraw more than 120 hours prior to the exam date will receive a partial refund of the full exam fee minus $400. 

Candidates who withdraw less than 120 hours of the exam date, will forfeit the full exam fee. 

All fees will be forfeited if:

  • you did not withdraw before the withdrawal deadline date, or
  • you are absent on the day of the exam

Transfer of registration or fees to a future TDM examination date is not permitted. Should you choose to withdraw, you must receive an invitation for a future examination. It is important that candidates review and are familiar with the Medical Council of Canada Test Security Guidelines prior to writing the TDM exam.

Extension of the TDM Exam Result Validity Period:

Due to the impacts of COVID-19 causing PRA Program intakes to be postponed and/or cancelled, the MCC and PRA Programs have decided to extend the exam result validity period from two years to three years for individuals currently holding a valid pass result.

If you received a pass result from one of the following exam administrations, your result validity period has been extended to three years:

TDM Exam administration

Three-year result validity period ends:

Fall 2018 (September 05, 2018)

September 30, 2021

Fall 2018 (October 15, 2018)

October 31, 2021

Winter 2019 (January 17, 2019)

January 31, 2022

Spring 2019 (June 25, 2019)

June 30, 2022

Winter 2020 (January 21, 2020)

January 31, 2023

Once the Validity Period has expired, you will need to retake the examination should you wish to be considered once more for a practice-ready assessment. You are allowed a maximum of two pass results per lifetime. If you obtain a pass result, you will not be allowed to retake the examination in an attempt to get a higher score within the two-year period. 

TDM Exam attempts:

The current policy remains unchanged. If you obtain a fail result, you may attempt the examination once more within the two-year period but no earlier than seven months from your previous attempt. You cannot apply to consecutive exam sessions. You are permitted a maximum of four lifetime attempts. 

If you obtained a fail result on the January 2020 exam, you are not eligible for the next examination (Fall 2020) even though the postponement surpasses the minimum seven month waiting period. You would be eligible to apply to the January 2021 exam session.

TDM Exam Results:

Results are released to the PRA Programs within four to six weeks of the examination date. No scores will be reported to you; only the pass/fail result will be communicated through the PRA programs. Only your most recent result will be valid regardless of previous scores and pass/fail status.

How do I request a score recheck?

You may request to have your exam rechecked only if you failed the TDM exam. If you received a pass result, you are not eligible for the score recheck service. Rechecking your examination is unlikely to change your final TDM exam result because your results are verified at least twice before they are sent to your PRA Program.

A recheck includes:

  • Verifying the electronic marking data file and confirming it is for the right candidate
  • Checking the marking data file to confirm it is complete and that there are no errors in data capturing
  • Recalculating and verifying the examination score 
  • Verifying the final pass/fail result reported against the results obtained through MCC's centralized scoring procedure
  • Checking the results against those contained in the excel file provided to the PRA Programs
  • Informing PRA Programs of the outcome

A recheck does not include a re-evaluation of your exam responses.

If you still wish to have your TDM exam rechecked, you will need to follow the steps below the steps below within 15 calendar days from the date you received your result from the PRA program.

  • Send a message to your PRA program using TDM Exam Recheck as the subject line and indicate that you understand that there is a recheck fee of $240 (2019). Effective 2022, the NAC PRA TDM Exam Score Recheck will be $256.
  • Once the email is received, your PRA program will communicate with you regarding further steps.

NOTE: Candidates will not be granted requests to view/review their examination.

Candidates cannot appeal based on examination content. Appeals will be handled through the PRA program responsible for administeirng the examination regardless of the jurisdiction where the examination took place.

 For more information about the TDM Examination, please visit the MCC’s TDM Examination webpage.  

Additional Resources:

Suggested reference materials to help you study for the TDM exam. The MCC does not require candidates to purchase or use any particular reference. The following textbooks may be used by MCC test committees to validate examination questions.

  • ICD 11: International Statistical Classification of Disease and Related Health Problems, 11th edition, (World Health Organizaiton 2018)
  • UptoDate.com
  • Textbooks related to Family Medicine
    • McWhinney, Ian R., A Textbook of Family Medicine, 3rd Edition, (Oxford University Press, 2009)Rakel, Robert, Textbook of Family Medicine, 9th Edition, (Saunders Elsevier, 2015)
      • There is a revised version by Freeman, Thomas R., McWhinney's Textbook of Family Medicine, (Oxford University Press, 2016)
    • Rakel, Robert, Textbook of Family Medicine, 9th Edition, (Saunders Elsevier, 2015)
    • Evans, M., Meuser, J. (eds), Mosby Family Practice Sourcebook; An Evidence-Based approach to care, 4th edition, (Elsevier Canada 2006)
  • Medicine
    • Goldman, L., Schafer, A., Cecil Textbook of Medicine,25th Edition (Elsevier Canada, 2015)
      • There is another version by Andreoli and Carpenter's Cecil Essentials of Medicine, 9th Edition, (Elseveir Canada, 2015)

The Orientation to Family Practice in Saskatchewan is to familiarize IMG physicians to the unique aspects of practicing medicine in Saskatchewan. The Orientation to Family Practice in Saskatchewan is not a review of core family medicine knowledge.

Orientation Topics Include:

  • Indigenous Culture in Saskatchewan
  • Chronic Care of Children, Adults and the Elderly in Saskatchewan
  • Saskatchewan Formulary and Controlled Medications
  • Provincial Emergency Services
  • Consultation and Patient Referral Process
  • HIPA and Record Keeping
  • Public Health and Infectious Disease Reporting
  • LEAN Basics
  • Electronic Medical Records
  • Clinical Screening Programs
  • Physician Support Program
  • Medico-Legal Issues
  • Collaborative Care Discussion Panels

The Clinical Field Assessment (CFA) is a 12-week competency assessment that occurs outside of the community to which the physician is recruited. The CFA involves direct and indirect candidate supervision and evaluation of patient care by SIPPA approved physician faculty. The CFA candidate evaluation occurs in multiple settings (ambulatory/clinic, ER, hospital inpatient ward and long term care) and involves multiple assessors and typically will occur in more than one community. SIPPA does not specify a minimum or maximum number of assessments in each specific practice setting; rather, it is expected that candidates will be assessed in the typical practice settings that the physician assessor works in.

After an orientation to the CFA site, including local and regional healthcare services, candidates are assessed to determine their “practice readiness.” Candidate assessment encompasses a global review of practice including communication skills, information gathering, learning techniques, prescribing, case management and readiness for independent practice. Candidates are assessed at the level of A CANADIAN TRAINED FAMILY PHYSICIAN ENTERING PRACTICE.

The reference document for evaluating competence in the CFA is 'Defining competence for the purposes of certification by the College of Family Physicians of Canada: the evaluation objectives in family medicine.'

Candidate performance is reported using: