Where Canada differs: an MCCQE quick reference

Quick reference for MCCQE, about 3 minutes to read. Canadian practice, checked against current guidelines as of November 2026.

Written to help you answer exam questions. Before treating a patient, check the current guideline and local policy. Medical disclaimer

When Canadian practice differs from US or UK practice, choose the Canadian answer. These are the differences candidates most often miss.

Guidelines and who writes them

Hypertension Canada, Diabetes Canada and the Canadian Cardiovascular Society set heart, blood pressure, diabetes and lipid targets.
The SOGC (Society of Obstetricians and Gynaecologists of Canada) writes pregnancy, contraception and menopause guidance.
The Canadian Paediatric Society writes most child health guidance, including its 2024 statement on febrile infants aged 90 days or younger.
NACI and the Canadian Immunization Guide set vaccine advice; provinces set their own schedules.
CANMAT writes depression and bipolar guidance. CRISM writes the national guidelines for opioid and alcohol use disorders.
PHAC publishes the Canadian guidelines on sexually transmitted infections and the Canadian TB Standards.
Screening advice came from the Canadian Task Force on Preventive Health Care, replaced by a new national advisory committee in June 2026; provincial programs run the actual screening.

SI units: glucose and cholesterol in mmol/L, creatinine in umol/L, hemoglobin in g/L.
ASA, not "aspirin". Low-dose ASA is 81 mg; the chewed dose for a heart attack is 160 mg.
Acetaminophen, not "paracetamol". Salbutamol, not "albuterol". Epinephrine, not "adrenaline".
Drugs are approved by Health Canada; check the Canadian product monograph.

Gonorrhea: ceftriaxone 500 mg IM alone (PHAC), with a test of cure.
Latent TB: 4 months of rifampin is preferred over 9 months of isoniazid.
Opioid use disorder: buprenorphine-naloxone first (CRISM); withdrawal management alone is not recommended.
Alcohol: Canada's 2023 guidance puts low risk at 2 drinks or fewer a week.
Newborn eye prophylaxis: the CPS advises against it routinely, though Ontario still requires it by law with a written opt-out.
Head injury in children: the CATCH rule, developed in Canada, guides CT.
Concussion: the Parachute guideline; school before full return to sport.

The Canada Health Act (1984): public administration, comprehensiveness, universality, portability and accessibility, with no extra-billing or user charges for insured services.
It covers medically necessary hospital and physician services, but not outpatient prescription drugs or most dental care. National pharmacare (2024) begins with contraception and diabetes medicines; the Canadian Dental Care Plan covers uninsured people with family income under $90,000.
Provinces deliver care. The federal government covers First Nations on reserve and Inuit (with the Non-Insured Health Benefits program), the military, federal inmates and refugees (the Interim Federal Health Program).
Physicians are licensed by provincial colleges and advised and defended by the CMPA.

Consent: disclose what a reasonable patient would want to know (Reibl v. Hughes). A capable adult may refuse any treatment, including blood (Malette v. Shulman).
Minors: capacity, not age, decides in most provinces; Quebec sets 14.
Substitute decisions: follow the patient's known prior capable wishes, then best interests. In Ontario, disputes go to the Consent and Capacity Board.
Involuntary care is set by each province's Mental Health Act, and admission is not consent to treatment except in British Columbia.
MAiD: adults 18 or older who are capable, with a grievous and irremediable condition; 2 independent assessors; at least 90 days of assessment when death is not reasonably foreseeable. Mental illness alone is excluded under current law, and advance requests are not allowed federally.
Disclosure of harm: disclose and apologize; apology laws in most provinces mean an apology is not an admission of liability.

Jordan's Principle: First Nations children get needed services without delay over which government pays.
Joyce's Principle: equitable care for Indigenous people, free of discrimination.
The TRC Calls to Action (2015), Calls 18 to 24, set out what health care must do. Cultural safety is judged by the patient.