**Please read the "Victory & Future" update.**

Have you had more trouble getting a doctor’s appointment lately? It could be because of the MCCQEII exam. Meanwhile, the United States has permanently removed their version of this exam.

At present, this exam is preventing new doctors from entering the workforce, leaving patients with insufficient medical care during the COVID-19 pandemic and beyond. This is because no doctors have been able to complete the exam since October 2019 due to repeated last-minute cancellations. Now, the exam is indefinitely suspended, yet it remains a licensing requirement.

The Licentiate of the Medical Council of Canada (LMCC) was created in the early 1900s to assess medical knowledge and clinical skills, confirming that medical school graduates could safely work as physicians.

Over the past century, medical education has undergone significant structural changes. At present, physicians have their comprehensive medical knowledge and clinical skills assessed at multiple points throughout medical training:

1. Medical students complete exams throughout 3-4 years of medical school and must pass multiple intensive clinical skills (OSCE) exams before they can graduate.
2. Postgraduate trainees (resident doctors) are assessed through standardized frameworks throughout 2-5 years of residency training, including ongoing real-time supervision, regular feedback, regular exams, and remediation for anyone found to not be meeting expectations.
3. At the end of residency training, resident doctors must pass CFPC (family medicine) or RCPSC (specialty) licensing exams. These exams include a written component and a component assessing clinical skills such as physical examinations.

Without succeeding in all 3 of the above categories, Canadian medical graduates cannot be licensed to practice in Canada.

Therefore, the LMCC’s MCCQEII exam is redundant and should be removed from licensing requirements altogether. Its validity has accordingly been questioned repeatedly over many years. Relevant articles can be found here: https://docs.google.com/document/d/18Tij5TZ0bn_9dj8IZ6vTO_sn0knEx8j1ZtuIcp65azo/edit?usp=sharing

As of 2021, the equivalent exam in the United States, the USMLE2, has been permanently cancelled. In lieu, the United States is putting the onus on medical schools and residency programs to provide a thorough assessment of clinical skills before allowing graduation. This is already part of standard medical training in Canada. 

Certain provinces already do not require the MCCQEII; New Brunswick does not require it at all, and Nova Scotia and Ontario have created pandemic exemptions. There is no evidence that these provinces are providing subpar care to the general public compared to other provinces as a result of physicians not having the LMCC designation.

The MCC, an organization that claims to be assessing competence and professionalism in physicians, has demonstrated a serious lack of competence and professionalism throughout the COVID-19 pandemic. The exam has been scheduled and cancelled at 4 different periods since March 2020. At times, the exam was cancelled while candidates were in the middle of writing it.  

Physicians have repeatedly taken time off work, closed their clinics, or experienced excess financial burden in order to prepare for the exam. Countless well-trained physicians have been unable to obtain adequate licensure for independent practice, causing them to be restricted in their ability to help with pandemic efforts or work in under-serviced areas. The general public has ultimately paid the price for these repeated cancellations, and the MCC has therefore sacrificed the wellbeing of the general public in favour of a redundant exam. 

Now, more than ever, the need to abolish this exam is clear. The MCC has recently suspended the MCCQEII exam indefinitely, recognizing that change is needed. We propose that the MCCQEII exam be eliminated from medical licensure requirements in Canada permanently. We need these thoroughly assessed physicians to continue supporting the general public as intended without unnecessary obstacles.