NAC OSCE Practice Cases: 92 High-Yield Stations for IMGs
Three complete NAC OSCE practice cases in the exact exam station format — free to use below. All 92 stations, covering 8 core specialties and aligned with the 2025–2026 MCC blueprint, are in the NAC OSCE: A Comprehensive Review (2nd Edition).
How NAC OSCE Practice Cases Are Structured
Every NAC OSCE station lasts exactly 11 minutes. Before entering the room, you have 2 minutes to read the candidate instructions posted on the door. Inside, you interact with a standardised patient (SP) — and in some stations, respond to a physician examiner's oral questions at the end.
The cases below follow the same six-section format used throughout NAC OSCE: A Comprehensive Review — the same structure you will encounter at each door on exam day:
- Overview — clinical context, what type of station it is, and which competencies are likely being assessed
- Candidate Instructions — the exact text you would read outside the station door
- Clinical Approach — how to open the encounter, structure your history, and conduct any physical examination required
- Differential Diagnosis — ranked by probability, with key discriminating features for each
- Management — investigations, treatment, and Canadian-specific guideline recommendations
- Counselling — what to communicate to the patient, including communication frameworks (Calgary-Cambridge, SPIKES, NURSE where applicable)
Work through each case with a timer set to 11 minutes. Read the candidate instructions, then practice your opening line aloud before entering. The clock doesn't pause while you're thinking. After each run, review the management and counselling sections to check what you missed — that is where most marks are lost.
3 Free NAC OSCE Practice Cases
These three cases cover the three highest-frequency presentations on the NAC OSCE — cardiovascular, neurological, and respiratory. Each is a complete, exam-ready station written to current Canadian guidelines.
Chest Pain
58-year-old male with 45 minutes of central chest pain. STEMI work-up, Canadian ACS management, and family counselling.
Read the full station → NeurologyHeadache — Worst of Life
32-year-old female with sudden-onset severe headache during exercise. Thunderclap presentation, SAH work-up, and neurosurgery pathway.
Read the full station → Internal Medicine · RespirologyShortness of Breath
67-year-old male smoker with 3-day worsening dyspnea and purulent sputum. COPD exacerbation, GOLD-aligned management, and smoking cessation counselling.
Read the full station →What's Inside the Full NAC OSCE Book — All 92 Stations
The three free cases above cover the cardiovascular, neurological, and respiratory presentations that appear on virtually every NAC OSCE. The remaining 89 stations span seven additional specialties. Here is the full breakdown:
| Specialty | Stations in the book | Sample presentations |
|---|---|---|
| Internal Medicine | 18 | Chest pain, hypertension, dyspnea, abdominal pain, diabetes, renal failure, hepatitis, HIV counselling |
| Neurology | 10 | Headache, stroke (TIA and ischemic), seizure, dementia, tremor, limb weakness, syncope |
| Emergency Medicine | 10 | Acute chest pain, trauma, acute abdomen, overdose, anaphylaxis, resuscitation counselling |
| Obstetrics & Gynecology | 12 | Antenatal visit, postpartum depression, contraception, abnormal uterine bleeding, menopause, prenatal counselling |
| Pediatrics | 12 | Well-child visit, febrile infant, respiratory distress, behavioural concerns, developmental delay, failure to thrive |
| Psychiatry | 12 | Depression, suicidality assessment, anxiety, psychosis, substance use, capacity assessment, MAID counselling |
| Surgery | 10 | Acute abdomen, breast lump, vascular claudication, urologic presentation, post-op complication |
| Population Health & Ethics | 8 | Informed consent, capacity and substitute decision-maker, mandatory reporting, public health scenarios, disclosure of error |
How This Compares to Other NAC OSCE Practice Resources
There are a handful of NAC OSCE practice case resources available. Here's how they compare on the factors that matter most for IMG preparation:
| Resource | Cases | Canada-specific guidelines | Communication frameworks | Format |
|---|---|---|---|---|
| NAC OSCE: A Comprehensive Review (2nd Ed.) | 92 | ✓ CFPC, CCS, CAEP, Choosing Wisely | ✓ Calgary-Cambridge, SPIKES, NURSE — embedded in cases | Paperback (Amazon.ca) |
| MedCoach 45 Cases (1st Ed.) | 45 | Partial | General | Paperback (Amazon) |
| CrackTheNac | ~10 free | Partial | General | Website / PDF |
| Geeky Medics | 1,300+ (subscription) | ✗ UK / international focus | General | Online subscription |
The key differentiator for the NAC OSCE is Canadian guideline alignment. The exam standard is a recent Canadian medical graduate — not a UK registrar or US resident. Management plans that follow UpToDate, NICE, or US guidelines are not wrong clinically, but they may differ from what the MCC physician examiner is marking against. Every station in NAC OSCE: A Comprehensive Review is reviewed against current CFPC, CCS, CAEP, and Choosing Wisely Canada recommendations.
What the MCC Physician Examiner Is Looking For
At each station, the physician examiner uses a structured checklist to score you across up to seven competencies:
- History taking — efficient, patient-centred, appropriately prioritised
- Physical examination — correctly selected, properly described or performed
- Communication — Calgary-Cambridge framework behaviours (open-ended questions, active listening, summarising, closure)
- Diagnosis — reasonable differential, most likely diagnosis stated
- Investigations — appropriate, ordered in a logical sequence
- Data interpretation — results provided mid-station are interpreted correctly
- Management — aligned with Canadian guidelines, including non-pharmacological and pharmacological options
Communication and history taking together are the highest-frequency competency domains — every station assesses them. Management and investigations each appear in a minimum of three stations. This is why practising cases aloud, with a partner, is more valuable than silent reading: the marks are in the interaction, not just the knowledge.
Starting Your NAC OSCE Practice Case Preparation
Three free cases are a start. To prepare effectively for an exam with 10 scored stations, most candidates need 40–60 complete practice stations before exam day — enough to encounter each major specialty, practice the communication frameworks in different registers, and build the pattern recognition that makes 11 minutes feel long rather than short.
The NAC OSCE: A Comprehensive Review (2nd Edition) gives you 92 exam-ready stations in the exact format used above. It ships worldwide via Amazon. For context on the overall exam structure and scoring, see the NAC OSCE exam blueprint guide. For a full preparation schedule, see the 8-week NAC OSCE study plan.