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CDM cases are designed based on the MCC objectives and focused on practical approaches to the diagnosis, best management, and most appropriate treatment of the common medical conditions.

Clinical Decision Making

The clinical decision-making (CDM) section of the MCCQE part 1 exam consists of 38 clinical cases followed by one or more questions; the total number of questions is approximately 60-70. Eight of the 38 clinical cases are pilot cases, but they are not labeled in any way, and their scores do not count. The CDM is intended to assess your clinical decision-making and problem-solving abilities, so you should expect questions ranging from clinical ethics and clinical diagnosis to appropriate management and treatment. Clinical scenario questions will be presented in two formats: write-in and short menu. You have 3.5 hours to complete this section of the exam.

  1. Short-Menu Question: Short-menu questions will usually contain multiple answer possibilities. Therefore, it is crucial to read the question instruction carefully. Follow the instructions, and choose an appropriate number of options based on the questions and clinical scenarios presented.
  2. Write-in Question: You are expected to type in the correct answer to write-in questions. When answering a question about medications, avoid typing the brand name; instead, use generic names. If you are asked about the route of medication administration is posed, be specific and avoid abbreviations. Medication doses are not required for the MCCQE part 1 exam.

CDM score:  The CDM scoring system is significantly different from MCQs. Every question has a single score; however, selecting too many answers or options that are deemed harmful or dangerous to patient health will result in a zero score.

Clinical decision-making process

The key to providing patients with high-quality healthcare is good decision-making. As a result, the CDM attempts to assess individuals’ abilities to apply their knowledge to make the decisions needed to provide high-quality patient care. Your decisions can be evaluated at each critical stage of the diagnostic and management process. Clinical decision-making consists of three interconnected phases: diagnosis, severity assessment, and management.

The best approach to clinical decision making (CDM) is an analytical methodology that can assist you in applying evidence-based medicine principles and clinical guidelines to rule out potential disease mimics and confirm the diagnosis.

At Ace Qbank, we understand how difficult the MCCQE part 1 exam can be, so we take all key aspects of clinical decision-making into account and develop CDM cases based on the MCC objectives to facilitate and speed up necessary preparations for the MCCQE1 examination.

Ace Qbank CDM

The first question bank to promote a new approach to CDM

Contain over 140 high yield realistic clinical scenarios with a marked emphasis on patient management. The case-based approach was preferred to accurately simulate a real situation on the Medical Council of Canada Qualifying Examination (MCCQE) part 1 exam. The active-learning question-and-answer format following the patient presentation was selected to ensure the rapid comprehension of essential material needed to do well on the second part of the MCCQE 1 exam, based on recent evidence-based guidelines. Our objective is to reproduce the clinical decisions that a physician is required to make daily. Ace Qbank’s aim is to dramatically increase your confidence in practical features of diagnosis, best initial treatment, most accurate treatment, and best management in a concise form for each clinical vignette to ensure mastery of the Clinical Decision Making (CDM).

Clinical Decision Making - Doctor of CDM section
correct answers
Correct answers

The chosen option is the correct answer of a clinical vignette.

Was correct answer
Was correct answer

The correct answer of a clinical vignette that was not chosen.

Wrong answer
Wrong answer

The chosen option is the wrong answer of a clinical vignette.


Clinical scenario

Each case consists of extensive history and physical for a presenting patient, multiple diagnostic studies or other options are provided to choose from

Summary table

All highlighted key concepts which commonly question on board exams are summarized in the table to enhance memory retention and recall on exam day


Following each case, full- length Explanations of the correct answer is reviewed, and the reason why each diagnosis is correct or incorrect is explained


Simplified sophisticated clinical diagnostic steps with a focus on the best initial diagnostic test and step-by-step approach to diagnosis and management


Clinical cases are designed based on the Medical Council of Canada objectives and target what you need to know for the CDM section



Several up to date references are provided at the end of each clinical presentation for further study

CDM case - Clinical Decision Making


A higher score on the exam

To improve and maximize your performance and score, practice with incredibly high-quality CDM cases. Our high-yield CDM cases are being processed in a stepwise manner based on clinical guidelines and MCC objectives. In a critical patient, for example, it is crucial in trauma patients to do ABCs, examine the airway, administer oxygen if necessary, and monitor air exchange (breathing). Following that, if hypotension or symptoms of poor perfusion are present, circulatory assistance is administered. Start properly preparing with ACE Qbank today.

Tips to pass the CDM component of the MCCQE1 exam

Time management

The afternoon CDM component of the MCCQE1 exam is more relaxing than the morning MCQs part, and you seem to have plenty of time, but it doesn’t mean you should lower your guard. People tend to underestimate the CDM section since it lasts 3.5 hours and only contains 70 questions. To succeed, you’ll want to focus on managing your time through 70 questions, which each has between 10 and 30 options, and it is best to avoid re-reading questions, and if you find yourself spending too much time on one, flag it, and move on


To succeed on the MCCQE1 exam, you need to follow the instructions when you are selecting the correct answer. Each question of the clinical case has followed by specific instructions, and you need to pay attention to instructions. Whether it’s a multiple-choice menu question, or one requiring a written answer, there will be specific instructions on how to answer each individual question. These instructions must be followed exactly. Your final score will reflect both tested knowledge and how well you followed the question instructions.

Read more about tips for better preparation

Patient history

Everything in the clinical case and questions is important, and you should pay close attention to the facts. Because clinical decision-making is a constant and dynamic process, the CDM part of the MCCQE1 exam evaluates candidates’ clinical skills in a contiguous set of questions based on the clinical scenario given. Each question will contain additional information that you must comprehend and assess in order to choose the correct answer from the options provided.


It is also very important to understand how the examination will be scored. Negative marks are not given; you either get one point for being correct or zero if you’re not. Partial marks are also sometimes awarded when more than one answer is being scored. Additionally, there are two other situations in which you could receive a zero. Assume the number of responses you provide in your answer exceeds the number specified in the question. In addition to this, if you select or list an item that could hurt or injure a patient, you will receive a zero.

Benefits of Ace Qbank's CDM

your chances of passing the exam by improving your clinical decision-making skills. The cases are challenging and require careful thought processes to solve them correctly.

  • Over 140 high yield clinical cases
  • Accurate simulation of the MCCQE1 exam
  • All possible case scenarios that are most likely to arise on the CDM section
  • An in-depth explanation for each CDM case
  • Reference for further study
  • Self-Paced Online Learning
  • Designed based on the MCC objectives

Ace Qbank CDM cases provide you with a better chance of preparing for the CDM component of the MCCQE1 exam; it is the best study tool for the MCCQE1 exam. Sign up now to ensure a high score on your CDM part.

$2493 months
  • Over 2000+ Questions
  • Access to Qbank for 3 months

  • Based on MCC Objectives
  • Simple explanations
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  • Summary tables & algorithms
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$169144 clinical cases
  • High yield vignettes
  • CDM 1 & 2 full access

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  • Simple explanation
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  • Full access for 2-weeks each
$159240 high yield questions
  • MCCQE1 Simulation
  • Self-assessment 1 & 2 full access

  • NO Reset Option
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