The purpose of the National Assessment Collaboration (NAC) is to enhance the integration of international medical graduates (IMGs) into the Canadian health care system by creating a streamlined process to accurately and efficiently assess IMGs’ medical knowledge and clinical skills. Qualified IMGs will be eligible for supervised and ultimately independent practice while IMGs who have met the minimum criteria but need to improve their clinical skills and medical knowledge will be eligible for additional education and training including postgraduate residency training.
The National Assessment Collaboration is comprised of Health Canada, the Medical Council of Canada, the provincial and territorial governments, the seven regional IMG assessment programs, the provincial and territorial medical colleges, the Federation of Medical Regulatory Authorities of Canada, the Association of Faculties of Medicine of Canada, the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada.
The Collaboration is currently focusing on one part of the continuum of assessment of an IMG – that of creating a national clinical “OSCE” examination (Objective Structured Clinical Examination). This hands-on examination simulates clinical scenarios where standardized patients are trained to portray patients with specific problems. At each station, a physician examiner observes and assesses performance while the candidate interacts with the standardized patient.
The Medical Council of Canada is playing a pivotal role in the NAC by facilitating the development of a central co-ordinating and administrative body to standardize the development, measurement and administration of the OSCE assessment process while maintaining a regional delivery model.
By having a single, national, standardized set of assessments for IMGs, including the NAC OSCE examination, the NAC aims to reduce duplication efforts undertaken by the individual provincial IMG assessment programs, and to provide more mobility for IMGs with a portfolio of nationally recognized credentials.
The Assessment Continuum

The National Assessment Collaboration is developing a streamlined assessment process for international medical graduates. As part of this continuum, candidates are first assessed on their medical knowledge, typically through a multiple-choice examination or equivalent examination format. The assessment of the candidate’s clinical skills is the main focus on the National Assessment Collaboration. As part of this process, the National Assessment Collaboration is concentrating on creating an Objective Structured Clinical Examination. Based on their examination results, candidates will be identified to receive additional training through postgraduate or other remedial education programs. Candidates would also move through the continuum and be assessed through observation of their clinical practice prior to being eligible for a license to practice medicine.