OutLoud MD

How hard is the RCPSC anesthesia exam?

The published pass rates are high, but that does not make the exam easy to sit. First-attempt, Canadian-trained candidates pass the written at 95.6% and the applied at 97.8%, as a three-year average (2023-2025), per the Royal College. The difficulty is not the odds, it is the skill the applied exam measures: reasoning out loud in real time, not recall.

At a glance

  • Written pass rate 95.6%, applied 97.8% (first-attempt, Canadian-trained, 3-year average 2023-2025, per the Royal College).
  • Those figures are for that cohort only; they do not imply repeat or internationally-trained rates.
  • Pass is 70% on each component, set for readiness to practise unsupervised.
  • The applied exam is hard because it tests live reasoning out loud, not recall.
  • Examiners stay neutral and probe you, and each scenario has critical features you must cover.

What the numbers mean

The Royal College publishes pass rates for fully-Canadian-trained, first-attempt candidates, averaged over three years (2023-2025): written 95.6% and applied 97.8%. Read those with the cohort in mind. They describe residents who trained in a Canadian program and sat the exam for the first time, and they do not tell you about repeat attempts or internationally-trained candidates. High rates reflect strong preparation across the cohort, not a low bar.

Why the applied exam is still hard

The applied exam does not ask you to recognize an answer. It asks you to talk through a case out loud while an examiner probes your reasoning, stays neutral, and gives no feedback, and to cover the pre-designated critical features, some of which are mandatory to pass a scenario. That is a performance skill, and it is different from knowing the material. Many strong residents find the live, spoken format the genuinely demanding part. See the applied exam stations for what each one asks.

How to close the gap

The way to get comfortable with reasoning out loud is to do it, repeatedly, before exam day. Drill oral stations, rehearse critical features, and verbalize a structured approach; see how to prepare. OutLoud MD is a practice tool, not affiliated with the Royal College, and its feedback is not an official or predictive score; for official rules, dates, and fees, see royalcollege.ca.

Frequently asked questions

What is the pass rate for the Royal College anesthesia exam?
First-attempt, Canadian-trained candidates pass at high rates: written 95.6% and applied 97.8%, as a three-year average (2023-2025), per the Royal College. Those figures are for that cohort only and do not imply repeat-attempt or internationally-trained rates.
If pass rates are high, why is it hard?
Because the applied exam tests live reasoning out loud, not recall. You must articulate a sound, structured plan while an examiner probes you and stays neutral, and cover the critical features of each scenario. That performance skill is different from knowing the material.
What score do I need?
The pass standard is 70% on each component, set to reflect readiness for unsupervised practice. The written and applied are decoupled, so a pass on one is banked. For official standards, see royalcollege.ca.

Key takeaways

  • Written 95.6% and applied 97.8% pass rates (first-attempt, Canadian-trained, 3-year average 2023-2025, per the Royal College).
  • Those rates are cohort-specific and do not imply repeat or internationally-trained figures.
  • The applied exam is hard because it tests live reasoning out loud, not recall.
  • Practise the spoken format before exam day; see royalcollege.ca for official standards.

Updated September 2026