OutLoud MD

The RCPSC anesthesiology exam explained

The Royal College of Physicians and Surgeons of Canada (RCPSC) anesthesiology certification exam has two components: a written exam, then an applied exam (the orals). You sit the written first, and only candidates who pass it are invited to the applied. Success leads to the FRCPC designation. For official dates, fees, eligibility, and rules, see royalcollege.ca.

At a glance

  • Two components: the written, then the applied (oral) exam.
  • Written = two multiple-choice papers, about three hours each.
  • Applied = a structured oral of roughly two hours.
  • Pass = 70% on each component, set for readiness to practise unsupervised.
  • Written first; only written-passers are invited to the applied.
  • Decoupled: pass the written, fail the applied, and you do not re-sit the written.

The written exam

The written is two multiple-choice papers, each about three hours, using single-best-answer items and combined into one written score. (The older format included a short-answer paper; that paper has been dropped in the current decoupled format, so the written is now multiple-choice only.) Because the two components are decoupled, passing the written banks that result: if you later fall short on the applied, you re-sit only the applied.

The applied (oral) exam

The applied exam is a structured oral of roughly two hours. You rotate through timed, equally-weighted stations where an examiner presents a scenario and asks you to reason through it out loud. It is the part OutLoud MD is built to rehearse. For a station-by-station look at what each asks, see the applied exam stations.

Where it sits in training

Anesthesiology was one of the first two disciplines to adopt Competence by Design in July 2017. The exam was retained under Competence by Design, with its timing moved to the final year of a five-year residency. Separately, residents complete CanNASC, a set of standardized mannequin-based simulation scenarios, as a residency-completion requirement delivered by programs. CanNASC is training context, not a station inside the certification exam. OutLoud MD is a practice tool, not affiliated with the Royal College; for official rules, dates, and fees, see royalcollege.ca.

Frequently asked questions

What are the parts of the Royal College anesthesiology exam?
Two components: a written exam of two multiple-choice papers (about three hours each), then an applied exam that is a structured oral of roughly two hours. You must pass the written to be invited to the applied.
What score do I need to pass?
The pass standard is 70% on each component, set to reflect readiness for unsupervised practice. The two components are decoupled, so if you pass the written and fail the applied, you do not re-sit the written on a later attempt.
Did Competence by Design remove the exam?
No. Anesthesiology was one of the first two disciplines to adopt Competence by Design in July 2017. The written and applied exam was retained, with its timing shifted to the final year of residency.
Is CanNASC part of the exam?
No. CanNASC is a set of standardized mannequin-based simulation scenarios that programs deliver as a residency-completion requirement before certification. It is training context, not a station inside the certification exam. For official rules see royalcollege.ca.

Key takeaways

  • The exam is a written component (two MCQ papers) then an applied oral of about two hours.
  • Pass is 70% on each; the written comes first and the two are decoupled.
  • Competence by Design (July 2017) kept the exam and moved it to the final year.
  • CanNASC is a training requirement, not an exam station; check royalcollege.ca for official details.

Updated September 2026