What is the TDM exam?
The Therapeutics Decision Making (TDM) Exam is for international medical graduates (IMGs) in Family Medicine who are not eligible for the Provisional Register through CPSA’s Accelerated Jurisdiction Route.
The TDM Exam, available through the Medical Council of Canada (MCC), tests clinical skills and knowledge to ensure you can practice at the level we expect of physicians in Canada. Learn more at MCC’s TDM Exam Information.
Apply for the TDM Exam
CPSA has the same basic expectations of all applicants.
All applicants must meet the following standard requirements before applying for the TDM Exam:
Standard eligibility requirements
Apply for independent practice
Read More
Receive eligibility letter
Read MoreDo you meet the standard eligibility requirements?
Follow these steps to apply for the TDM Exam.
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Submit your TDM Exam application
CPSA 
Pay fee & write exam Ready to apply?
The TDM Exam is held three times a year.
| 2026 | |
| Exam dates | January 14, 2026
June 2, 2026 September 23, 2026 |
*Exam dates are subject to change
For more information about the TDM Exam scheduling, please visit MCC’s TDM Examination webpage.
Application tips
- Use the same email you used to apply for independent licensure.
- If you are receiving the “oops” error on the Oats Tracking System when trying to apply for the TDM Exam, please clear the cache on your web browser and press ‘Ctrl+R’ to refresh browser and try again.
TDM candidate resources
Review MCC’s exam preparation resources here to help you prepare for your exam.
Apply for the next TDM Exam here >
TDM Exam fees
Your exam fee is due as soon as CPSA approves your application.
Your spot is not secured until you pay. If you withdraw 5 days (120 hours) or greater prior to the exam date, you will receive a partial refund of the full exam fee, minus the $400 withdrawal fee. If you withdraw within 5 days (120 hours) of the exam date, all fees are non-refundable.
For more information on fees, check out the TDM Exam Candidate Guidelines from MCC.
Did you write the exam?
Follow these next steps to take after the exam.
If you passed the TDM Exam
Congratulations!
Once you pass the TDM Exam:
- MCC will upload your Result Letter to your physiciansapply.ca account.
- You will need to upload the Result Letter to the Application Tracking System so our Registration Team receives it.
- If you haven’t already obtained sponsorship, you first need to do so by going to doctorjobsalberta.com and applying for physician postings eligible for sponsorship. If you’re hired for that posting, they will sponsor you. Refer to your eligibility letter for more details.
- When our Registration team receives both your TDM Exam pass result letter and sponsorship form, you will receive more information on which documentation is required to continue with registration on our Provisional Register.
If you didn't pass the TDM Exam
You have a maximum of 4 TDM Exam attempts, which includes a maximum of 2 pass results.
If you receive a failing result:
- You are ineligible to apply to the next scheduled examination session, since the TDM Exam cannot be taken in consecutive sessions.
- If you do not pass, your registration file will close after 1 year. Once your file has closed, you can then re-apply for independent licensure at any time. You must meet our current registration requirements at that time.
For more information on the TDM exam, reconsideration or validity periods, visit TDM Examination Results.
TDM Exam FAQs
All FAQsAre there any TDM exam exemptions?
- Family Medicine physicians with CFPC-recognized training/certification outside Canada may be exempt from the TDM exam. Apply to the College of Family Physicians of Canada (CFPC) for certification without examination before applying for the TDM. If CFPC issues a recognition/certification notice, you may be exempt.
- Once you have the CFPC notice and meet all other CPSA registration requirements, submit a Review of Qualifications through physiciansapply.ca and email the notice to registration@cpsa.ab.ca.
- Family Medicine physicians who completed Canadian postgraduate training but have not passed the LMCC or CCFP are exempt from the TDM exam.
Can CPSA increase the frequency of the Therapeutics Decision Making (TDM) exam?
The National Assessment Collaboration’s (NAC) Practice Readiness Assessment offers this exam 3 times per year in all jurisdictions starting in 2024. The Medical Council of Canada sets the exam schedule.
Do I need to take this exam if I am a specialist?
How long does it take to receive my TDM Exam results?
You should receive your TDM Exam results within approximately 8 weeks of writing the exam. MCC will upload a TDM Results Letter to your physiciansapply.ca account.
How long is my Therapeutics Decision Making (TDM) exam result valid for and how many times can I take the exam?
Candidates have a maximum of 4 TDM exam attempts, which includes a maximum of 2 pass results. Candidates who receive a fail result are ineligible to apply to the next scheduled examination session, since the TDM exam cannot be taken in consecutive sessions.
A pass result will be valid for 3 years. For more information on TDM exam results or validity periods, visit the MCC’s TDM Examination Results.
When can I apply to take the Therapeutics Decision Making (TDM) exam?
We update our website a week before exam registration opens or closes. Check in regularly for the most up-to-date information on exam registration details.
Where else can I take the Therapeutics Decision Making (TDM) exam?
TDM is a national exam offered through the Medical Council of Canada and is available in 9 jurisdictions. For more information, visit MCC NAC PRA.
Questions or feedback? We'd love to hear from you.
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