Therapeutics Decision Making Exam

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

Apply for independent practice

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Apply for independent practice

Apply for independent practice

First, make sure you are eligible to practice independently in Alberta. Review our Family Medicine eligibility requirements and apply for independent practice.

Receive eligibility letter

Receive eligibility letter

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Receive eligibility letter

Receive eligibility letter

After you apply for independent practice, you will receive your CPSA eligibility letter telling you about your eligibility and next steps.

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.

Do you meet the standard eligibility requirements?

Follow these steps to apply for the TDM Exam.

Submit your TDM Exam application

Once the registration dates are open (see chart below), you may apply. All applications must be submitted through this platform.

CPSA reviews application to determine your eligibility to write the exam

You will get an email stating your eligibility.

Pay fee & write exam 

If eligible, you will be instructed to pay the TDM Exam fee(s) online. Then MCC will contact you through physiciansapply.ca before the exam date.

Ready to apply?

The TDM Exam is held three times a year.

  2026
Exam dates June 2, 2026

  • Registration opened on Thursday, March 5, 2026, and closed on Thursday, April 2, 2026.

September 23, 2026

  • Effective September 2026, MCC will manage the TDM Exam application process. See additional details below.

*Exam dates are subject to change

TDM application process updates

In fall 2026, the Medical Council of Canada (MCC) will implement a new application process for the Therapeutics Decision-Making (TDM) Examination. Starting with the September 2026 exam session, candidates will apply for the TDM Examination directly through the MCC, and no longer through the Practice-Ready Assessment (PRA) programs. PRA programs’ approval will not be required to take the exam.

For more information about the changes coming into effect in September 2026, see New application model and eligibility criteria for the TDM Examination.

TDM candidate resources

Review MCC’s exam preparation resources here to help you prepare for your exam. 

TDM Exam fees

Your exam fee is due as soon as CPSA approves your application.

Your spot is not secured until you pay. In certain circumstances, you may be eligible for a refund.

You will forfeit your full application fee if you:

  • Withdraw from your TDM Examination less than 120 hours before your exam appointment time
  • Cancel your exam appointment with Prometric less than 120 hours before your exam appointment time
  • Are absent for your exam

Eligibility for partial refunds

Partial refunds are only available to candidates if you withdraw from your TDM Examination and cancel your exam appointment with Prometric (if applicable) more than 120 hours before your exam appointment time.

  • June 2, 2026, exam withdrawal fee: $400.00
  • September 23, 2026, exam withdrawal fee: $1,425.00

For more information on fees, check out the TDM Exam Candidate Guidelines from MCC.

See CPSA's fee schedule see the most up-to-date TDM fees

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 FAQs

Are 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?

No. This quick resource highlights the basic eligibility criteria for specialist practice.

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 for our Registration Assessments team?

Phone: 780-969-4924
Toll-free: 1-800-320-8624 (in Canada)

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  • Providing your CPSA registration # will help us resolve your inquiry more efficiently.

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