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NAC OSCE Preparation 2026:
Complete Guide for IMGs

The NAC OSCE is one of the most important — and most misunderstood — exams in the Canadian IMG pathway. Here is everything you need to know to pass it the first time.

12
Stations
11 min
Time per station
In Canada
Only available

What Is the NAC OSCE?

The National Assessment Collaboration Objective Structured Clinical Examination is a requirement for IMGs applying to Canadian residency programs through CaRMS. It tests your ability to function as a first-day resident in Canada — not just your medical knowledge. It is only offered in Canada, a few times per year.

What Gets Scored

History Taking
Open-ended questions, systematic exploration, patient ideas and concerns, social history
Physical Examination
Correct technique, narrating findings, hand hygiene, patient comfort
Clinical Reasoning
Differential diagnosis, investigation plan, management approach
Communication
Clear language, empathy, checking understanding, avoiding jargon
Professionalism
Introduction, consent, patient-centered approach, time management

High-Yield Station Types

Chest pain
Shortness of breath
Abdominal pain
Headache
Depression / suicidal ideation
Chest pain (cardiac)
Breaking bad news
Pediatric fever
Obstetric history
Ethical dilemma

How to Use Your 11 Minutes

0:00–0:30Knock, enter, introduce yourself, wash hands
0:30–2:00Open question — let the patient talk without interruption
2:00–7:00Focused history — OPQRST, red flags, social, family, ICE
7:00–9:00Physical exam — narrate findings aloud
9:00–10:00Summary + differential + investigation plan
10:00–11:00Management, patient education, safety netting

Most Common Mistakes

Not introducing yourself or asking permission before examination
Jumping to diagnosis before completing history
Missing ICE — patient Ideas, Concerns, and Expectations
Forgetting to address empathy explicitly — examiners score it
Running out of time — no management plan in last station
Using medical jargon with the patient
Not summarizing back to the patient before ending

Practice NAC Stations with AI

Our AI plays the standardized patient and gives you real-time feedback on history taking, communication, empathy, and clinical reasoning. No tutor needed. Free to start.

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