The LMCC (Licentiate of the Medical Council of Canada) is the nickname the majority of students give to the Medical Council of Canada (CMC) qualifying exam. The LMCC comes in two parts.

The LMCC I is a computer-based, multiple-choice theory exam taught to all medical graduates across Canada. The LMCC II is an ECOS-style examination (objective structured clinical examination) which is awarded in the first year of residency. Upon successful completion of both exams, the Medical Council of Canada grants the candidate the title of Licentiate of the Medical Council of Canada and enters it in the Council’s register.

The LMCC objectives are available on the CMC website: LMCC objectives.

In addition to the famous Toronto Notes, other books are recommended for the study of LMCC



The LMCC I is a computer-based, 7.5 hour exam that takes place over one day and is divided into two parts. It should be noted that at any time, the student can switch from the French version to the English version of the exam and vice versa.

Multiple choice questions

This segment of the exam is 4 hours in length and consists of 210 multiple choice questions (MCQs). For each question, you are presented with 5 answer choices, of which only one answer is correct. All MCQs are presented in a single block. It is therefore possible to navigate freely between the questions and to mark a question to return to it later. Note that, from 2019, the level of difficulty of the questions does not vary according to the number of right and wrong answers to the previous questions.

Prise de décisions cliniques

This part of the exam lasts 3.5 hours. It assesses the student’s ability to resolve clinical situations and make decisions. In this section, 38 clinical cases are presented to you and you must answer one or a series of questions relating to each case. The answers are in the form of short menu questions or short open-ended questions. Short menu questions usually include a list of multiple answer choices (similar to a multiple choice question) in which you are instructed to choose 1 answer, choose a specific number of answers (e.g. choose 3 answers), choose a maximum number of answers (for example, choose up to 3 answers) or choose all the answers you think are appropriate. In total, there will be between 60 and 70 questions relating to the 38 clinical cases.

Tips and tricks

(source : KAPLAN, USMILE, Step 2 CK QBook, Fourth Edition)

  1. Think about the answer as you read the question. The first line, which describes socio-demographic factors, is always crucial.
  2. When writing exam questions, authors must meet certain criteria. Indeed, the wrong answers must be wrong or clearly inferior to the correct answer for someone well informed. So, if you think two answers are plausible, chances are neither is right.
  3. Use the rule of three: Never choose an answer based on just one piece of information. You need at least three pieces of information that are consistent with the answer for it to be correct.
  4. Start reviewing early!
  5. Chat with students who took their exam in previous years.
  6. Plan your study time. Take a 10-minute break every hour, and get enough sleep, as this allows more information to be transferred from short-term memory to long-term memory.
  7. Make study groups; make presentations to each other.
  8. Schedule more time to study the topics in which you have the least interest or ease, and spend less time on the topics with which you are comfortable.


* For more details on the exam visit the Medical Council of Canada website.