Scoring
The MCCQE Part II is scored independently of the MCCQE Part I; the scores are not combined for the purpose of awarding the Licentiate of the Medical Council of Canada (LMCC). The candidate must pass both the MCCQE Part I and Part II.
Objectivity of the Objective-Structured Clinical Examination (OSCE) is achieved through the use of standardized guidelines for the administration of the examination, the training of Physician Examiners and Standardized Patients, and the use of predetermined station-specific scoring instruments. OSCE scores are awarded to a candidate by the Physician Examiners on the basis of the candidate’s performance at each station. Each station is worth the same as every other station and a candidate’s total score is the sum of his or her station scores.
A candidate must achieve an overall score and pass a set number of stations as determined by the Central Examination Committee (CEC). These cut points may vary from year to year and from examination to examination, depending on the difficulty and content of the particular examination. Historically, the percentage of stations required to pass the examination has been 64 per cent. Candidates cannot compensate for low performance on most stations with high scores in a few stations, nor can they compensate for a low overall performance by passing just enough stations.
In awarding the final standing on the examination, the CEC also considers any observations made by the Physician Examiner at each of the stations with regard to a candidate’s approach to the patient. Candidates are expected to demonstrate ethical and professional behavior appropriate for a physician entering independent practice.
How is an OSCE station scored?
The OSCE stations are scored using a checklist of tasks entitled an Examiner’s checklist (for examples of the checklist, see the history-taking couplet station example, the physical examination couplet station example, and the ten-minute station example). Each task-specific item on the checklist is weighted, meaning that some items are worth more than other items. The Examiners are not given the weight for the items, and do not know the pass mark for the station.
In the case of the couplet stations, the candidate is also scored based on his or her answers in the Post-Encounter Probe. These five-minute written encounters are worth 50 per cent of the score at the couplet station. Physicians score candidates' answers following the examination. For examples of the Post-Encounter Probe questions and the correct answers, click on Post-Encounter Probe (history-taking station) or on Post-Encounter Probe (physical examination station).
In addition, for each station, the Physician Examiner is asked to make a global assessment of a candidate’s performance at the station, at the end of the patient encounter and on each Post-Encounter Probe.
The first question asked of Examiners is:
Did the candidate respond satisfactorily to the needs or problem(s) presented by this patient?
If the Examiner believes that the candidate performed in a satisfactory manner, he or she then must determine whether his or her performance was “borderline”, “good” or “excellent”. Similarly, if the Examiner believes that the candidate performed in an unsatisfactory manner, he or she must determine whether his or her performance was “borderline”, “poor” or “inferior”.
The following definitions are the guidelines given to Examiners:
Satisfactory
“Satisfactory” candidates sufficiently possess and are able to demonstrate the knowledge, skills and attitudes that all physicians are expected to have as they enter independent medical practice. They must be able to practice medicine in a safe, efficient and caring manner. |
Unsatisfactory
“Unsatisfactory” candidates do not sufficiently possess the knowledge, skills or attitudes that all physicians are expected to have as they enter independent medical practice. These candidates demonstrate one or more of the following problems: provide misinformation, perform potentially dangerous act(s), have inadequate medical knowledge, have an uncaring attitude toward patient needs, are unable to focus in on the patient's problem, are poor communicators, and/or are unable to address the patient’s complaint. |
In almost all stations, the Examiner also scores selected rating scale items, which are worth 10 to 50 per cent of the station score. Click here to view the rating scale.
The results of the global assessment for each station are used to determine the station’s passing standard which is then used to determine each candidate's pass/fail status for each station, as well as overall status on this examination.
The second question asked of Examiners is:
Do you have concerns regarding this candidate’s ethical and/or professional behavior at this station?
Yes or No.
If yes, please specify reasons:
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A response in the affirmative to this question leads to a review of the candidate’s performance overall by the OSCE Test Committee and the Central Examination Committee on an individual basis where warranted.
