TDM – Therapeutics Decision Making

> 80% Success Rate in TDM Exam 4 years in a row

If you are getting ready for the TDM Exam in September 2024, we have just opened a new course.

Please register as soon as possible to ensure no delay in your preparation.

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Drastically Increase Your Odds in Just 5 Days

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Apr. 01, 2024

The Last

2024 June

I passed the TDM exam recently (2023 Jan)!

In my view, the Smart IMG Academy TDM course is the easiest and most effective way to prepare for the exam.

I’m grateful to Dr Sam for giving me vital tips to write this exam. The orientation session, by Dr Mike, at the beginning of the course gave us a sneak peak into what is required for preparing for TDM!

Thumbs up to the Smart IMG team !

Dr Zenab Khan, TDM 2023 Jan

Dear Smart IMG Academy,

I, Simply, feel forever in debt to you guys for my pass standing in TDM at my first attempt, despite working night shifts, very short amount of time at hand to prepare, etc.

I loved the fact that the course was designed in a smart way to address important topics so that we could gain a concise and working understanding of the high yield parts, instead of feeling drowned or lost in the various textbooks and resources.

It goes without saying that your course played a pivotal role in my preparation and success. On top of that, I received tremendous emotional Support at every step and turn of this endeavor which meant the world to me.

To me, joining the Smart IMG Academy TDM Intensive Course which I came to know only by a simple google search, was the best decision I ever made. Now I would highly recommend your course to any colleagues who are preparing for TDM, PERIOD!.

Drs. Kobra A., TDM 2022- Jan

Dear Smart IMG Academy,

I would like to express my gratitude and appreciation for your great TDM course and the way you have designed this brilliant online course.

I really thank you for the material you provided us which not only helped us to prepare for the exam,  but also gave us a great insight into the commonly prescribed drugs and their uses which definitely help any IMG to get more exposure to disease management and medications use .

Dr. Sam was such a professional doctor who has dedicated himself to explain, teach , and motivate all the candidates during the online course and his humbled personality and patience are extraordinary.

Dr. Mike has always been there to guide us how to prepare,  create a strategy, and anticipate the obstacles to perform better in the exam and overcome the hardships of study plan and time management.

Finally words cannot describe how this TDM course has pushed us to succeed and go forward to achieve our goals and start our family medicine practice.

I highly recommend this course for those who are writing the TDM exam soon.

Dr. Salah Greish, TDM 2022- Jan

Dear Smart IMG Academy

Thank you for every effort and every class. Dr Mike and Dr Sam, I would likely not have passed the TDM without your guidance and motivation.

Dr Sam puts so much effort and time into creating up to date class notes. The notes are concise and easy to study. And sometimes also include mnemonics and tips to help you remember.

Dr Sam also makes huge effort to create new case scenarios for students to practice and get used to the exam format, and this is perhaps the most valuable part of the course!

Thank you Thank you! I would recommend you on any day, to anyone that asks!

Drs. Marzanne O., TDM 2022- Jan

Dear Smart Academy  teams

I would like to thank you for your efforts. The course was really good and helped me to pass TDM exam. It is focused on important topics for this exam and save my time. It’s really smart course which I recommend for any doctors who wants to pass TDM exam.

Finally, I am really appreciate Dr Same and Dr Mike efforts in this course.

Dr. Ezo H., TDM 2022- Jan

I want to thank Smart IMG Academy for helping me pass my TDM exam.

Before joining the course, I was completely clueless but the course gave me orientation.

I completely trusted their notes and did not read a single thing from anywhere else. Dr. Sam’s style of teaching is amazing.

I am truly thankful to Dr. Mike and Dr. Sam for bringing this course to life and making things easier for us. I highly recommend this course to everyone as it is 100% worth it.

Drs. Seyeda Aimen W., TDM 2022- Jan

Thank you Smart IMG Academy,

I am delighted to let you know that I have passed my TDM Exam.

Team of Smart IMG Academy shows you ways to fly through a turbulent flight smartly and land securely by achieving a passing grade.

Everything they offer is relevant, beneficial, and worthwhile.

Of all the services offered I liked and enjoyed the mock exam the most – smartly setup very relevant scenarios that will spin your mind in all directions.

Way to go!!!


Drs. Seyeda Maaria H., TDM 2022- Jan

I just wanted to let you know that I passed the exam! I was worried! Still can’t believe it. I’m just glad I had the notes and classes.

Thank you so much for the course. It really helped me pass. I only really focused on the notes and the classes.

So I’ll definitely be recommending the course to others! The topics your are covering were asked in the exam… And your tips on understanding how to answer questions are helpful in aligning how you should be writing down answers.

Drs. Lynn M., TDM Review Course 2019

I am delighted to inform you that I was successful in the last TDM examination.

You played no small role in this success and I want to say a very big THANK YOU!

May you be blessed and rewarded for all you do in helping us all in our struggle for licensure here in Canada.

Thank you! Thank you! Thank you!!!

Dr. Ambrose, TDM Review Course 2020

I am grateful that, at the last minute, your team gave me chance to organize my knowledge and help me to focus on the exam!

Your notes are concise and straight to the point and mostly pertinent and anxiolytic.

Your course is value for money! Keep up the commitment and the highest standard.

I am happy I attended the course!, I PASSED

Dr. Palangi, TDM Review Course 2020

I am so pleased to let you know that I could pass the TDM exam on my first try.

I should acknowledge that without your help it was barely possible to do that.

I believe, especially for this kind of exam, reviewing the material through a concise and still comprehensive note is essential.

I also found the Question & Answer part of your course very helpful. Thanks for your great job!

Dr. Arian R, TDM Review Course 2020

Initially, I had no idea about this website and the TDM course, made a blind trust which turned out to be worthwhile.

I was completely lost when I read CTC book and thought I never can make it. The TDM course materials were effectively concise and relevant.

The instructor expertise in teaching and the course material had put my mind at ease that I could memorise the huge number of solid facts in the limited amount of time.

I passed TDM test in the first attempt, which wouldn’t be possible without taking this course.

I strongly recommend the TDM course to the test takers.

Thanks for all of your efforts and supports.

Drs. Elham R., TDM Intensive Review Course 2020

I would like to express my most sincere gratitude to Dr. Mike and Dr. Sam in putting together an absolutely comprehensive yet concise course material that did not require my searching for other resources.

Thanks to the question and answer sessions that were especially helpful for the real exam and I never felt particularly apprehensive about the exam.

Beside your course, your professional mentoring helped me foster continuous learning, making it a passing exam at first attempt.

Once again thank you and wishing your team continued success!!

Drs. Mozhgan Y. - TDM 2020, TDM Intensive Review Course 2020

Dear Smart IMG academy,

First of all, I would like to admire and appreciate all you did and are doing to help the IMG people in their tough endeavor and efforts to get their practice license in Canada.

The teachers were very friendly, willing to help, knowledgeable, the most important one, very enthusiastic to teach the applicants how they need to think during the exam.

I can say it’s an 80% of the materials in the notes which 50% of them will come on the exam. So, it’s a very comprehensive complementary note in addition of the book.

The note and the class helped me to make the course in pieces that I could handle it.

Again, I am really happy I had the chance to take part in the training classes.

Dr. M M, TDM Review Course 2020

Course material and the mentoring approach were excellent.

I learnt a lot and it helped me in passing the exam on my first try. I have learnt so much from all of your constructive input and guidance throughout the course. Thank you

Dr. K. A, TDM Review Course 2019

With Smart IMG Academy’s guidance I have cleared my TDM exam in first attempt.

When I started preparing for this exam I was lost as to how to prepare and what will be tested in the exam but after taking the course with Dr. Mike and Dr. Sam I knew which areas I have to focus on and it helped me clear this exam in very little preparation time.

I would definitely recommend other candidates planning on taking this exam to benefit from this course.

Drs. Nida Z., TDM Review Course 2019

I passed. I am so grateful for the course.

That excellent note and the lovely Q&A parts helped me a lot.

When I think about it, honestly, the strategy session saved my life.

Thank you so much

Drs. Karen B., TDM Review Course 2019

Thanks to this course, I passed!!

The notes were very detailed, daily questions and answer sessions were very helpful.

This was my very first attempt, after attending the course, I went to the exam with confidence.

Greatly appreciated all the help by Dr Sam and Dr Mike.

Once again thanks a lot to both of you. I am very happy I attended the course and I believe it helped me pass in my first attempt.

Drs. Sukhvir G., TDM Review Course 2020

The TDM course which I took was the main booster to ace my exam.

The questionnaire session with Dr. Sam was the best.

Secondly the session with Dr. Mike about approach to study and time Mx was the main factors for me to pass this TDM exam.

Thanks Dr. Sam and Dr. Mike

Dr. Srini X., TDM Review Course 2020

I passed TDM on the first attempt, all thanks to Dr Sam and Dr Mike. Dr Sam had a systematic approach and emphasized the essential topics.

We usually started the class with a Q&A session every morning from the previous day’s lesson. It helped me gain a better understanding of the TDM exam. Throughout the teaching process, we were offered tips on the techniques.

Thank you for your help.

Dr. S. Rahman, TDM Intensive Review Course 2020

Taking the SmartIMG course made the difference & delivered a pass result for me.

The concise note summaries, daily Q & A sessions, and exam tips were very helpful.

It was an eye-opening experience worth having!

I definitely recommend this course.

Thank you Dr Sam and Dr Mike.

Dr. Meck Chongo, TDM Intensive Review Course 2020

Dear Smart IMG academy,

I am delighted to inform you that I was successful in passing my TDM examination.

Words could not describe the gratitude that I have towards the Smart IMG academy team and I am ecstatic to write to you my success story.

The TDM course provided me with the most recent and relevant knowledge and information to not only pass the exam but also be the best General practitioner that I can possibly be.

The Questions and answer sessions further expanded my knowledge and was extremely helpful in guiding me on areas that needed improvement.

Thank you for the effort and time you took in helping me prepare for this exam.

I will forever be grateful towards the Smart IMG team!

Please continue the excellent work.

Drs. Dalaine Naude, TDM Intensive Review Course 2020

I found the TDM course to be comprehensive and well organized.

It oriented me well to the exam pattern and helped me reach the desired outcome, passing TDM on my first attempt.

Dr. Mukesh G., TDM Review Course 2019


1. What is MCC TDM?2019-01-29T15:47:24+03:30

TDM which stands for “Therapeutic Decision Making” is another exam in the pathway of Practice Ready Assessment for IMGs. Supposedly, this is the last examination just before entering the Clinical Field Assessment in Saskatchewan – SIPPA Program, Manitoba – PRA-FP program (previously called IMGACL), British Columbia – PRA-BC program, and soon PRA programs in other provinces

2. Why is it so important to pass the MCC TDM Exam?2019-01-29T15:46:12+03:30

With too few available opportunities for an IMG in Canada, it is detrimental not to safeguard it. In fact, it is prudent to take strong measures to stack the odds in your favor.

Since the NAC PRA TDM Exam is the penultimate stage and the most intimidating one in an IMG’s path towards receiving their license to practice in Canada which is known to have the highest failure rate, it is highly recommended not to take it lightly.

3. What are the pitfalls of failing the MCC PRA TDM Exam?2019-01-29T16:42:46+03:30

In case of an unsuccessful attempt on the TDM Exam;

  1. You may have to endure another emotional PTSD.
  2. You will have to wait to have an income as a practicing physician.
  3. It is also obvious that you are going to keep supporting yourself financially out of your own pocket.
  4. Another pitfall is that there is an ineligibility period of at least 6 months before one would be eligible for another attempt.
  5. Practically, you might not even be eligible sooner that a period of 8-12 months time, depending on the number of TDM Exams offered per year by the IMG’s program of interest as well as the possible domino effect of a soon to expire validity period of IELTS and recency of practice on the eligibility.

In short, there could be a tremendous financial burden on top of the emotional one as well as losing yet another unreplaceable year of one’s remaining productive life as a result of such a possible domino effect.

4. Is self-study enough to prepare for TDM Exam?2019-01-29T16:44:06+03:30

While this is ultimately a personal decision, objectively the following are the major key factors:

  1. The level of your Fresh Medical Knowledge.
  2. How well you are familiar with the format of the MCC NAC PRA TDM Exam.
  3. Your previous successful exposure to similar exams in other countries.
  4. The amount of time you need and have available to gather all the information needed to plot and execute an efficient study plan.
  5. Your personal preparation style; i.e.; the speed of study, efficient note-taking skills, and the number of revisions you need to feel exam ready.
  6. The availability of any preparation courses in your reach.

Whatever you do, make sure you have taken all the measures to prepare yourself the best you can.

  Self-Study Any Well-organized Course
Money – Upfront Pay No Yes
Minimum Time needed to study 1 main source once only ≥ 1000 hours – Effective intensive Study based on 8 Hr./Day non-stop study & 2 Pages/Hr. (≥4 Months) Usually ≥ 65% of the High Yield Topics discussed & summarized in less than a Month.
Revision needed ≥ 2 ≥ 1
1st read Time-Wasting Huge – Re-inventing the wheel – Trial & Error Minimum – Led by Instructor
Main Source Selection Subjective – Individual Experience Objective – Feedbacks & Instructors’ Team Experience
Multiple References Integration Time Killer, almost impossible Swiftly integrated into courses
High Yield Topic Selection Subjective – Individual Experience Objective – Feedbacks & Instructors’ Team Experience
Misunderstanding the info Happens a lot; Time Consuming, Multiple Source research needed Usually discussed by instructors.  As quick as raising a question
Support ? friends Ongoing Emotional and informational


5. What are the relevant resources to prepare for TDM Exam?2019-03-22T19:33:32+03:30

Official TDM Exam Guide/ Resources – Latest Update 2019

1. Alberta
2. British Columbia
3. Saskatchewan
4. Nova Scotia

1. Alberta TDM Exam Study Resources – CPSA

2. British Columbia Candidate Information Sheet PRA-BC

3. Saskatchewan TDM Guide for Candidates – SIPPA
And the second half of the page bellow


6. How to prepare for TDM Exam if I am doing a self-study?2019-01-29T15:20:30+03:30

There are key factors that could play a pivotal role in maximizing your effort in preparation for TDM Exam. In fact, the following is a summarized version of key points and common strategies expressed in multiple interviews with those who successfully dealt with an intensive exam such as TDM in a short period of time.

Avoid “re-inventing the wheel”.  Let us help you save your valuable Time & Energy

Here is what they did when they didn’t have any courses available:

Planning Part:

  1. Based on the time in their hand they start the selection and deselection processes.
  2. Based on the info from their friends or what they have heard they selected their main source of study. Then categorized the topic into the most important topics, not sure and not important ones.
  3. Then they deselect by filtering out those not sure ones into topics should study and those I would study only if I have time. And as it is usually the case you will never have enough time, so basically it means deselecting those topics which took them a few days, but it was well worth it.

Doing the hard work: Trial & Error;

  1. Getting the whole picture
  2. They all took notes during their study.
  3. They refined their note taking focus and structure time and time again until it felt sufficiently efficient. Moving forward they gained a sense of what the key points vs trivial information are.
  4. Sometimes they had to rewrite the whole note as many a time they misunderstood the point in the first place or at least restructure it to make it clear and to the point.
  5. While time consuming the process of note-taking was, they emphasized, this proved to be instrumental in their revisions to be more efficient and less painful.

Real Deal

  1. They made sure of going through notes at least a couple of times to know them by heart
  2. Time Management on the Exam Day
  3. Being able to convey a short yet complete response

Honest feedback; Lessons Learned from those who passed.

  1. Those who passed had strong academic background to begin with.
  2. Planning ahead of time, allocating ample time and resources.
  3. Despite mentioning a few of those topics they thought were not important turned out to appear on the exam and they have been asked points they felt they are trivial, they all admitted that if they knew where to focus more and what should have been in their notes from the beginning or even better if they somehow had such organized notes handy, it would have cut their suffering, time and energy in half while multiplying their efficiency.
  4. Considering the fact that no courses can eliminate the need for putting sufficient personal effort to memorize key points, when asked whether they would have attended any prep courses had it been available, almost all emphatically said they would have. They reasoned that any well-organized courses can certainly cut the needed time and energy in half by pointing the High-Yield key materials, summarizing them, explaining confusing/ delicate differences in choices, clearing up misunderstandings and possibly providing a structured summary note. This simply enables you to put your personal time and energy to where it should be.
7. TDM Courses, Duration & Fees:2022-02-26T07:56:07+03:30

It varies depending on which TDM Review Course you would choose. Here is the Fee in 2018.

  TDM Final Days Review TDM Weekend Rapid Review TDM Concise/ Intensive Review
Fee $1250 Not Available Anymore $1850
Total Hours 36 60 60
Session/ day 2 1 1
Hr/Session 3 5 4/3
Days 6 12 15/20
Best if Completed own self-study Busy during the week Study while having the course
Pace Very Fast Fast & Condense Balanced


An ideal Time-efficient Final Days Review on Topics of highest yield in Just 1 wk
A Strategic approach to re-shape your perspective on High Yield Topics in 6 wk
A balanced Focus in reshaping your perspective on The High Yield Topics in 3 wk/ 4 wk

Whether you have already started to put serious effort in your TDM preparation or not, any well-organized prep. course will save you tremendous time and energy in how to effectively and efficiently tackle the TDM exam preparation by providing you a quick review for topics with the highest impact in short period of time.

Our TDM Prep Course would emphasis on how it is expected of a candidate to have the required medical knowledge organized. Therefore, it becomes easier to apply such medical knowledge on the TDM exam day

8. Which factors should I consider before deciding on a suitable course?2019-01-29T15:10:10+03:30

It is important to have an honest evaluation of yourself, how well you have studied so far- if any, your previous exam attempt/experience and the realistic expectations of the achievable goals within the available time frame.

  1. If there are no courses available and you have not studied enough, do not take the exam, simple as that.
  2. If you have studied well in advance, depending on the exam date enhance your chances and boost your confidence level by taking one of the Final Days Review or Rapid Review TDM Courses.
  3. If you want to study with the course, your best bet is to attend one of our Concise or Intensive TDM Review TDM Courses.
9. Do I have to finish studying Therapeutic Choices once before attending your courses?2019-01-29T16:45:02+03:30

It is undeniably true that a general overview ahead of time would ensure a better understanding of the topic, however, a pre-reading of the CTC, while highly recommended, is not mandatory.

10. Do you offer any private one-on-one TDM Review Course?2019-01-29T14:46:06+03:30

Yes, we do. Please contact us for more information.

A must-take course for MCC TDM


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