Therapeutics Decision Making Exam

New TDM exam process

On March 1, 2018, CPSA required all international medical graduates (IMGs) in Family Medicine who weren’t eligible for our General Register to pass the Therapeutics Decision Making (TDM) exam before submitting a Review of Qualifications for independent practice in Alberta.

As of October 1, 2020, IMGs who wish to practice independently in Family Medicine in Alberta must be eligible for our Provisional Register requirements and submit a Review of Qualifications before applying and taking the TDM exam.

If you are a Family Medicine physician and you want to join our temporary Provisional Register, you will need to pass the TDM exam and get AHS sponsorship within 1 year of receiving your CPSA eligibility letter. Once you have both, your Registration Administrator will send you a letter outlining which documentation we need before you register for our Provisional Register.

Why the change?

  • This change helps us avoid delays in recruiting physicians to Alberta.
  • Applicants understand their CPSA-eligibility before writing the TDM exam.
  • The updated process better aligns with PRA programs across Canada.

What is the TDM exam?

The Therapeutics Decision Making (TDM) exam is for International medical graduates (IMGs) in Family Medicine, and is available through the Medical Council of Canada (MCC). Through the TDM exam, your clinical skills and knowledge are reviewed to ensure you can practice at the level we expect of physicians in Canada. It standardizes the selection process for practice readiness assessment (PRA) programs across Canada.

The TDM exam is not required for physicians who are eligible for our Provisional Register and who have Recognized Training and Certification Outside Canada through the College of Family Physicians of Canada (CFPC).

For more information on the exam, visit MCC’s TDM Exam Information.

Keep reading to learn more about TDM exam, the application process, fees, study resources, next steps and more.

How to apply

First, make sure you are eligible to practice independently in Alberta. Review our Family Medicine eligibility requirements and apply for independent practice. You will receive your CPSA eligibility letter telling you your eligibility and next steps.

The TDM exam is held twice a year.  If you are planning to apply, we recommend you keep an eye on this webpage for updates—this is where we post the date the application is opening. Once the application is open, you may apply through this webpage at the “Apply” link below. You will use the same email you used to apply for independent licensure, and you will be asked to provide:

  • MINC Number
  • Previous PRA and TDM exam attempts
  • Test Accommodations

After you submit your application, we review it and determine your eligibility to write the TDM exam. You will get an email stating your eligibility.  If eligible, you will be instructed to pay the TDM exam fee(s) online. Once this payment is received and processed, your spot to write the exam is secure. You will receive emails throughout this process informing you of the next steps. Please note: if your eligibility letter expires after you apply for the TDM exam but before you write, you will need to reapply for independent practice.

Next exam dates

Because there is a limited window for registration, we approve all applications on a first-come, first-served basis.


  • June 7, 2022
    Registration is now closed.
  • January 11, 2023
    Registration will open Fall 2022.
  • June 6, 2023

Exam details

If you are eligible to write the online TDM exam, the MCC will send you a message through your account a few weeks before the exam date. This message will include:

  • your Authorization to Test (ATT) number
  • instructions on how to schedule your exam
  • when the scheduling period will begin

The TDM exam will be offered at Prometric test centres across Canada. In addition to ensuring security and quality control, Prometric test centres adhere to local health authority guidelines. Sessions will have physical distancing and personal protective measures in place to help keep candidates safe.

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

TDM exam fees

2022 2023
Exam fee $2,190 + GST $2,405 + GST
Score re-check fee $256 + GST $256 + GST
(Jan – Mar)

$270 + GST
(Apr – Dec)*

Withdrawal fee $400 + GST $400 + GST

*MCC’s fiscal year will begin in April starting in 2023.

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.

TDM candidate resources

We strongly recommend reviewing MCC's candidate information sheet and preparation resources to help you prepare for your exam. MCC's TDM exam resources include exam info, withdrawal policies, what to expect on the day of your exam, scoring and results, and test accommodations.

All Resources

Next steps: after the exam

If you passed the TDM exam

Congratulations on passing your exam! Once you pass the TDM exam, you will receive a result letter. This letter will be sent to you via email and added to your CPSA file and account.

If you haven’t already got Alberta Health Services (AHS) sponsorship, you need to get it by going to and applying for physician postings eligible for AHS sponsorship. If you’re hired through AHS, 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 AHS 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 may reattempt the exam in the following calendar year. You cannot apply for consecutive exam 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 recheck, reconsideration or validity periods, visit TDM Examination Results.

FAQ about TDM

All FAQs

Are there any TDM exam exemptions?

Yes, Family Medicine physicians who have Recognized Training and Certification Outside Canada through the CFPC may be exempt from writing the TDM exam. To get exemption, we encourage you to apply to the College of Family Physicians of Canada (CFPC) for certification without examination before applying for the TDM exam. If CFPC sends you a notice recognizing your training, you may be exempt from writing the TDM exam. Once you get this notice and you meet all the other CPSA registration requirements, submit a Review of Qualifications through and mail a copy of your CFPC notice to:

Also, Family Medicine physicians who complete their postgraduate training within Canada, but do not pass the LMCC or CCFP, are exempt from writing the TDM exam.

Can CPSA increase the exam frequency and number of spots for the exam?

Every jurisdiction has a differing number of spots for the exam. This is because of logistics, resources and average exam applicants. NAC PRA only offers this exam two times per year.

How long does it take to receive my TDM exam results?

You should receive your TDM exam results within 8 weeks of writing the exam. We’ll send it to you by email and it is automatically uploaded into your physiciansapply account.

How long is my TDM exam result valid for and how many times can I take the exam?

If you pass, you can use those results on Canadian registration applications for two years.

If you fail, you can take the test once more, at least seven months after your first attempt. You can’t take two back-to-back tests.

You can write the TDM exam a maximum of four times in a lifetime.

Due to the impacts of COVID-19 causing some PRA program intakes to be postponed and/or cancelled, the MCC and PRA programs have decided to extend the TDM Examination result validity period from two years to three years for individuals currently holding a valid pass result. For those who wrote and passed the TDM exam administrations between Fall 2018 to Winter 2020, please see the TDM Exam Guidelines for more information.

Find other important information in the TDM Candidate Guidelines.

Is there a waiting list for the TDM exam?

If you apply for an exam and it fills up before MCC’s cutoff date, we place you on a waiting list for that specific exam and contact you if someone withdraws.

Where else can I take the TDM exam?

TDM is a national exam offered through the Medical Council of Canada. In addition to Alberta, you can take this exam in British Columbia, Saskatchewan, Manitoba and the Maritimes. For more information, visit MCC NAC PRA.

Questions or feedback? We'd love to hear from you.

Local: 780-969-4924
Toll-free: 1-800-561-3899 ext. 4924 (in Canada)
Fax: 780-424-5859

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