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MedCognito’s TDM preparation course gives PRA program candidates everything needed to pass — expert-led case walkthroughs, live sessions, mock exams, and the clinical decision-making framework the exam demands.
The TDM is a PRA program requirement — not a general IMG licensing exam
Unlike the MCCQE or NAC OSCE, the Therapeutics Decision-Making exam is specifically required for provincial Practice-Ready Assessment (PRA) programs. The TDM is used by most PRA programs for applicant selection. Candidates should review the requirements of their intended provincial PRA program and confirm their eligibility before applying. Review your intended PRA program’s requirements to confirm eligibility — then apply and prepare.
The Therapeutics Decision-Making (TDM) Examination is designed to evaluate a candidate’s clinical competence at the level expected of an independent, safe family physician in Canada. It is administered by the Medical Council of Canada (MCC) and is a required component of most provincial Practice-Ready Assessment (PRA) programs.
The TDM tests your ability to apply clinical knowledge to real patient scenarios — covering the breadth of conditions a Canadian family physician manages daily: health promotion and illness prevention, acute illness, chronic disease management, safety, and adverse effects. It is a challenging, scenario-driven exam that rewards clear clinical reasoning and structured thinking under time pressure.
Because the TDM is specifically designed around the independent family physician role in Canada, preparation must go beyond general medical knowledge. Understanding the Canadian primary care context, relevant guidelines, and how to reason through patient-based multiple-choice and short-menu scenarios is essential — and is exactly what MedCognito’s course delivers.
Who takes the TDM?
55 patient-based clinical cases containing multiple-choice and short-menu questions. Candidates select the safest and most appropriate management options based on the scenario.
Approximately 110–140 questions across 55 cases. Questions assess clinical decision-making, therapeutic management, counselling, follow-up, safety, and adverse effects.
Up to 3 hours of exam time, delivered in two 90-minute sections with an optional 20-minute break. The overall MCC appointment is four hours.
Health promotion and illness prevention, acute illness management, chronic disease, and safety and adverse effects — all within the Canadian primary care framework.
TDM eligibility and PRA eligibility are separate. Review the MCC TDM eligibility requirements and the requirements of your intended PRA program before applying.
Once your application is reviewed and accepted in your physiciansapply.ca account, scheduling is done online through Prometric on a first-come, first-served basis. Register early — seats fill quickly.
The TDM assesses candidates at the level expected of a family physician practising independently and safely in Canada.
MedCognito’s TDM course is designed specifically for clinically experienced IMGs — physicians who know medicine but need targeted preparation for Canada’s family physician standard and the the exam’s multiple-choice and short-menu question format.
55 cases, approximately 110–140 MCQs and short-menu questions, and two timed sections — preparation structured around the current MCC TDM format.
We don’t just teach facts — we teach you how to reason through a TDM case. Dr. Broni walks through clinical decision-making in real time so you internalise the process, not just the answers.
Timed mock exams under real exam conditions — so time pressure, case format, and question style are completely familiar before you sit the actual TDM.
Connect with other PRA program candidates who are at the same stage of preparation — experienced clinicians navigating the same milestone on the path to independent practice in Canada.
A focused, case-driven curriculum — everything aligned to the TDM format, nothing that wastes your limited preparation time.
14 high-yield clinical topic areas organised by MedCognito and mapped to the MCC TDM blueprint — presented as case-based walkthroughs that teach you how to reason through each scenario, not just what the correct answer is. Dr. Broni talks through his clinical thinking in real time.
Interactive live sessions with Dr. Broni and the MedCognito team covering high-yield TDM cases, clinical reasoning frameworks, and common pitfalls. Recordings available for every session so you never miss a class.
Receive personalised feedback on your clinical reasoning, therapeutic decisions, and approach to TDM-style questions.
Learn how to interpret TDM question stems, identify the number of selections required, prioritise safe management decisions, and avoid common errors in multiple-choice and short-menu questions.
Extended access to mock exam results and detailed explanations for 90 days — so you can revisit, review, and deepen your understanding of cases you found challenging long after the live session has passed.
Join a private group of TDM candidates preparing alongside you — experienced IMGs at the same stage of the PRA journey. Share case insights, support one another through the preparation period, and learn from collective experience.
TDM registration follows a different process from MCCQE or NAC OSCE.
Confirm the eligibility criteria, timelines, and TDM requirements for your intended provincial PRA pathway.
Complete the MCC application process and follow the instructions provided through your physiciansapply.ca account.
Once scheduling is available in your physiciansapply.ca account, book your examination through Prometric.
Enrol in MedCognito's TDM course as soon as you have your exam date confirmed — and begin structured preparation with Dr. Broni and the team.
Dr. Broni is a practising Canadian family physician and the founder of MedCognito. His CCFP designation reflects the very standard the TDM is designed to assess — he teaches from inside the role the exam is testing you for, not from a distance. Having navigated the Canadian licensing process as an internationally trained physician himself, he brings both clinical authority and personal empathy to TDM preparation.
For the TDM specifically, Dr. Broni focuses on what experienced IMGs find most challenging: not clinical knowledge itself, but the Canadian family medicine framework, the MCC’s multiple-choice and short-menu question format, Canadian family medicine framework, and therapeutic decision-making approach, and the specific reasoning process examiners are looking for. His structured, case-based teaching approach has helped hundreds of PRA program candidates pass the TDM and take the next step toward independent practice.
Choose your plan and enrol today. Your full TDM video library, mock access, and student community are available immediately from day one.
Follow Dr. Broni's structured case-based curriculum — covering MedCognito’s 14 high-yield clinical topic areas, mapped to the MCC TDM blueprint
Complete full-length TDM mock exams, get personalised feedback on your clinical reasoning and TDM-style question performance
Real words from experienced IMGs who prepared with MedCognito and passed the Therapeutics Decision-Making exam.
“Coach, I have good news for you. I passed the TDM. Thanks for your support through the journey — the course was exactly what I needed to prepare.”
“Thank you so much, Dr. Broni and all of the doctors of MedCognito group. I’m proud to tell you that I passed the TDM. I prepared for the test by watching your videos, which were so helpful. Thank you Dr. Broni for calling me and allowing me to join the online course in a very short time before the test.”
“Dr Bronnnniii, Just received a notification from PRA BC that I passed the TDM Exam. Thanks a lot for your help and support. Your course was just amazing.”
“I wanted to express my sincere gratitude for your exceptional teaching and guidance throughout the TDM Course. Your unique approach to teaching and the comprehensive content you covered have been instrumental in helping me prepare for the exam. Thank you for your dedication, expertise, and support. I am grateful to have had the opportunity to learn from you.”
“I passed the TDM exam. Thank you so much Dr. Broni. Thank you to the facilitators and staff of MedCognito! Only exam left now is CCFP. We move”
“Dear Dr. Broni and Dr. Prosper, by the grace of God, I passed the TDM exam. All praise goes to the God, then to the group members who were engaged in the group discussion while preparing for the TDM. Regards, Rina.”
All plans include live sessions, recordings, and mock exams. Full access from day one.
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Leave your details and one of our advisors will call you within 1 business day. They will walk you through the TDM course, confirm what you need based on your PRA program, and help you build a preparation plan for your exam date.
We follow up promptly at a time that works for you
A clear conversation about your TDM preparation and PRA timeline
Our advisors understand the PRA process and the TDM exam
MedCognito has partnered with Windmill Microlending to help International Medical Graduates fund their entire exam prep, so you can start studying now and pay later.
Common questions from PRA program candidates preparing for the TDM with MedCognito.
The Therapeutics Decision-Making (TDM) Examination is an MCC exam used by most Canadian Practice-Ready Assessment (PRA) programs. It assesses whether you can make safe therapeutic and management decisions in a Canadian family medicine setting.
From the September 2026 session onward, candidates apply directly through the MCC using their physiciansapply.ca account. Check your intended PRA program’s requirements separately, as PRA eligibility varies by province.
Most provincial family medicine PRA programs use the TDM as part of their selection process. Always confirm the requirements, deadlines, and eligibility criteria with your intended provincial program.
The MCCQE tests broad medical knowledge and clinical decision-making. The TDM focuses specifically on therapeutic management in family medicine, including treatment choices, medication safety, counselling, follow-up, acute care, and chronic care.
The TDM includes 55 patient-based cases with approximately 110–140 multiple-choice and short-menu questions. It is completed in two timed sections of up to 90 minutes each, with an optional break.
Most candidates prepare for 6 to 12 weeks, depending on their clinical experience and familiarity with Canadian practice. Focus on therapeutic decision-making, medication safety, family medicine management, and timed TDM-style questions.
You can enrol at any time and begin immediately. The course includes high-yield video lessons, TDM-style practice, mock exams, personalised feedback, live support sessions, and access to the student community.
Eligible candidates may be able to access funding through Windmill Microlending for exam-preparation and licensing-related costs. Check the funding link in the pricing section for eligibility details.
Prepare with case-based teaching, targeted TDM practice, live support, and structured guidance for the MCC’s current exam format.
