Passed MCCQE1 (486) - older IMG
I recently passed the MCCQE1 with a score of 486, and I wanted to give back because posts like these helped me a lot during my own preparation.
A little background: I’m an older IMG. English is my second language, and I completed all of my medical training in my native language.
When I first came to Canada, I knew becoming a physician here would take time because I had to adjust to a new language, a new healthcare system, and a different style of clinical reasoning. I didn’t want to rush the process. I wanted to rebuild my foundation step by step and do it properly.
My journey was much longer than most people’s, so don’t compare your timeline to mine.
1. UWorld (My foundation)
First pass
Time: ~3 years on and off
Average: ~65%
Completed: ~90%
The first pass took me much longer than it should have because my studying was very inconsistent. I was working shifts in the hospital, dealing with family responsibilities, and later became pregnant and had a baby.
Second pass
Time: 2–3 months
Average: ~70–80% (incorrect questions only)
Once I booked my QE1, everything changed. I became much more focused and only reviewed incorrect questions from high-yield subjects such as psychiatry, OB/GYN, pediatrics, and family medicine.
I treated UWorld as a learning resource, not a score predictor. Since I learned medicine in another language and much of my knowledge was outdated, I used it to rebuild my foundation one topic at a time. Every incorrect question became an opportunity to understand the concept rather than memorize the answer.
Overall, I would say about 70% of the knowledge I needed for the MCCQE1 came from UWorld.
Looking back, I do think some sections (especially neurology, infectious diseases, nephrology, and rheumatology) are more detailed than what the MCCQE1 expects. If I could do it again, I would finish UWorld much earlier and spend less time on those lower-yield topics.
2. ACE QBank (Started ~4 months before the exam)
First pass: 63%
Second pass (incorrect questions only): ~80%
I thought ACE was closer to the MCCQE1 than UWorld.
It focuses much more on management, next best step questions, and Canadian practice. I also found the questions slightly harder than the real exam, which made the actual test feel a bit easier.
The only downside is that I wasn’t a fan of the explanations. I found them long and difficult to read.
3. CanadaQBank (Started ~2 months before the exam)
I only used it for Ethics and Public Health.
I thought those sections were worthwhile because they helped me learned ethics.
4. CMPA eLearning
I completed most of the CMPA ethics modules.
For me, this was a must for ethics preparation.
5. Official MCC Practice Exams (Started ~2 month before the exam)
These were by far the best predictor of my readiness and the closest thing to the real exam.
I treated every practice exam like the real test by doing it under timed conditions.
After each exam, I carefully reviewed every incorrect question and every question I wasn’t completely confident about.
My scores:
101: 67%
102: 70%
103: 69%
324: 73.5%
401: 72%
402: 74%
424: 75%
425: 81%
One week before the exam, I repeated all of them and was scoring around 90–95%.
I also completed most of the CDM cases.
6. AMBOSS MCCQE1 QBank (Started ~1 month before the exam)
Completed: ~50%
Overall correct: ~73%
I had already finished most of the other question banks and decided to give AMBOSS a try.
I ended up liking it much more than I expected.
The explanations were much better than ACE, and I really liked the interface.
AMBOSS also estimates your readiness and predicts your percentile. It predicted I would score around the 75th percentile, while my actual MCCQE1 result ended up around the 88th–90th percentile, so in my case it was a little conservative.
Another feature I really liked was creating 105-question blocks, which helped me simulate the length and mental fatigue of the real exam. It also resembles the real exam interface!
7. ChatGPT (Used every day)
Honestly, once ChatGPT released, it completely changed how I studied.
Whenever I got a question wrong, I used it to:
explain why each option was right or wrong, summarize Canadian guidelines, simplify difficult concepts, quiz me until I truly understood the topic.
As an IMG whose first language isn’t English, it saved me hours of searching through different resources.
8. Anki - Janki deck
Since I was on maternity leave with a newborn, I rarely had long uninterrupted study sessions.
Anki was perfect because I could review cards whenever I had a few free minutes. I tailored the deck based on my wrong questions.
What I would do differently
Finish UWorld much quicker.
Skip some of the overly detailed UWorld topics.
Use AMBOSS earlier and spend less time on ACEqbank.
Start the official MCC practice exams earlier.
One thing I learned
One thing I learned during my preparation is that the MCCQE1 is heavily focused on primary care. It trains you to think like a good frontline physician, especially in family medicine and the emergency department.
The exam wants you to practice safe, evidence-based medicine and avoid unnecessary investigations or treatments. Don’t order every test just because you can. Keep Canada’s publicly funded healthcare system in mind.
Whenever you don’t know the answer, ask yourself: What would a safe family doctor do? What’s the most appropriate next step, not the most expensive/definitive workup?
That mindset helped me answer a lot of management questions.
Final thoughts
If you’re an older IMG or English isn’t your first language, don’t let your timeline discourage you.
You’re not just preparing for one exam. You’re also rebuilding medical knowledge, adapting to a new healthcare system, and learning to think clinically in another language. That takes time.
When I first came to Canada, I genuinely didn’t think becoming a doctor again was realistic because of the language barrier. Looking back now, I’m glad I didn’t give up.
Keep moving forward. Small improvements every day eventually add up.
I hope this post helps someone the way Reddit helped me throughout my own MCCQE1 journey. Good luck to everyone preparing for the exam!