FIlipe Santos MD

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06/11/2026

Pinching myself 🤏🏻

$1 for a full official set of MCCQE Practice Test?!
And it’s not a scam?
Almost seems too good to be true, but it’s for real!

Can’t wait for July 20! If you are planning on buying one full set, maybe wait til they release the LOONIE version and save your money! 🤑

The MCC just changed how you apply for the TDM Examination.It is not the shortcut it might look like at first. I’ll expl...
06/11/2026

The MCC just changed how you apply for the TDM Examination.
It is not the shortcut it might look like at first. I’ll explain! 👇🏻

From September 2026, internationally trained physicians apply for the TDM Examination directly through the MCC. No Practice-Ready Assessment for Family Medicine (PRA-FM) program has to approve you first, and a passing result no longer expires. That is a real change, and it is good news. But some are reading it as a way to replace other requirements needed to get into a PRA-FM program. It is not.

The change is only about the application to sit the exam. Every other requirement still stands.

What changed:
→ You apply for the TDM straight through the MCC, not through a PRA-FM program.
→ No PRA-FM program approval is needed to sit it.
→ A passing result no longer expires. It used to be valid for three years.

What did not change:
→ Every PRA-FM program keeps its full list of requirements.
→ Your provincial medical regulatory authority keeps its licensing criteria.

→ The TDM is one box on that longer list. Clearing it clears one box. The rest are still yours to meet.

A requirement is not an acceptance.

Comment “LICENSING” and I will send you the free MCC e-book that lists the requirements for the PRA programs and the provincial medical regulatory authorities, so you can check them before you apply.

Save this for before you apply. Send it to another internationally trained physician on the PRA-FM route.

Are you a family doctor or hospitalist who trained outside Canada?Dreading the residency redo and the exams the usual Ca...
06/11/2026

Are you a family doctor or hospitalist who trained outside Canada?

Dreading the residency redo and the exams the usual Canadian routes demand? This is for you!

This post is especially for those in these situations:

(1) You completed family medicine or general practice training in a jurisdiction the College of Family Physicians of Canada does not recognize, OR
(2) You trained in family medicine, general practice, or internal medicine in a jurisdiction the Canadian colleges do not recognize, and you practise exclusively in the hospital,

AND

* You have 24 months of training and 12 months of independent practice, or 12 months of training and 24 months of independent practice, and you are current in practice.

In these situations, the usual Canadian routes can mean redoing residency or passing the MCCQE first.

But Nova Scotia has opened a route that asks for none of that!

Its Physician Assessment Centre of Excellence (PACE) runs a Practice Ready Assessment for family medicine, in two streams: office-based and hospitalist. You are assessed treating real patients in the PACE clinic, not in an exam hall. No MCCQE. No NAC. No TDM.

How the route works:

→ You apply to one of the two streams. Applications are ongoing, with rolling entry into the program.
→ PACE assesses you treating real patients, supervised by trained assessors, over about 12 weeks.
→ If you are successful, the College issues you a Restricted licence (unsupervised). You practise the full scope of family medicine, on your own, in the setting you were assessed in.
→ You complete a 3-year return of service in a priority Nova Scotia community.

→ One workplace-based assessment takes you from internationally trained to independently licensed.

PACE could be your way in!

Comment “Licensing” for the free guide to physician licensing in Canada in your DM.

If your situation is complicated, I run 1:1 sessions to help find a route through the Canadian system, if one exists. Booking link in my linktree.

Save this for when you are ready. Send it to a family doctor or hospitalist who trained abroad.

A woman got 30 years in prison for having a miscarriage.Real court, El Salvador, 2008. Her name was Manuela, she died in...
06/11/2026

A woman got 30 years in prison for having a miscarriage.

Real court, El Salvador, 2008. Her name was Manuela, she died in prison, and in 2021 the Inter-American Court of Human Rights condemned the country over her case.

I went down a rabbit hole on who controls medical and s*xual decisions around the world. Some of what I found I had to read twice:

→ Japan still requires a husband’s written signature for an abortion. The same country debated birth control pills for 9 years and approved Vi**ra in about 6 months.
→ Bahrain has the world’s highest age of consent: 21. Two 20-year-olds dating are technically breaking the law.
→ Saudi Arabia has no age of consent at all, because all s*x outside marriage is a crime there. At any age.
→ In Indonesia, s*x outside marriage became a crime on January 2, 2026. Only your spouse, parent, or child can report you.
→ In India, a doctor who learns a 16-year-old is s*xually active must report it to the police, or face jail themselves.
→ And the UK rule that protects teen access to contraception is named after the woman who sued to ban it. She lost.

Every one of these laws answers the same question: who decides? The patient, the parents, the spouse, or the state.

Canada’s answer surprised me most when I got here. There is no age of consent for medical care at all. Capacity, not birthdate. Slides 13 to 16 walk through how that works, and the Supreme Court case that set its limit.

If you’re an internationally trained physician heading for the MCCQE, this is the part that counts: the Canadian framework can be the opposite of the instincts you trained under. I wrote it into one book, Ethics for MCCQE and NAC, Volume 2 of the Path to Practice Series.

Comment “ETHICS” for the book link in your DM.

Save this one. Send it to someone in medicine.

Active recall works just as well as practicing questions and is a huge addition since they work even better when coupled...
06/11/2026

Active recall works just as well as practicing questions and is a huge addition since they work even better when coupled together!

Be efficient: more hours of study does not necessarily mean better scores in the exam!

“Provider” treats every clinician as interchangeable.Patients are the ones who need to tell them apart.This week the Ame...
06/11/2026

“Provider” treats every clinician as interchangeable.
Patients are the ones who need to tell them apart.

This week the American Medical Association adopted policy to oppose the term “provider” when it is used to include physicians, and to prioritize the word “physician” for those who hold an MD or DO. The reasoning was patient safety and transparency. When the language flattens everyone into one role, a patient can no longer tell who trained for what.

This is not about hierarchy. It is about clarity. Every member of a care team has a defined scope, defined training, and a title that signals to the patient what to expect. Naming those roles accurately is part of how a patient gives informed consent.

Internationally trained physicians understand the weight of precise titles, because they have lived on both sides of them. The word a person carries should match the training and the role behind it.

Why the language matters:

→ A title tells a patient who trained for what. That is information, not formality.
→ “Provider” erases the line between physician-led care and other roles on the team.
→ Clear roles support informed consent. This is not a turf war.

→ Precise language protects the patient first.
Clarity is a safety measure.

I trained as a doctor in Brazil. Then I started over in Canada, and five things genuinely stopped me in my tracks.None o...
06/10/2026

I trained as a doctor in Brazil. Then I started over in Canada, and five things genuinely stopped me in my tracks.

None of them were the medicine. The medicine travels. What does not travel is everything around it: who does which job, how a licence works, how you get paid, what counts as an ethical line, and how much independence a nurse has at the bedside. Those are the things no one warns you about until you are standing in the room.

So I wrote down the five that surprised me most, with how each one actually differs from where I trained.

The five that caught me off guard:

→ Professions I had never heard of are established here. Respiratory therapists manage ventilators in the ICU and the OR. Massage therapy is a College-regulated health profession with a protected title.
→ Every province issues its own licence classes, some more than ten, and a licence can carry specific restrictions.
→ Almost everyone bills by production, and you cannot bill patients privately for insured care.
→ Prescribing for yourself, family, or friends is treated as an ethical breach, not a favour.

→ And the one that surprised me most: for many hospitals the recovery room nurses must be ICU-trained, and they have real latitude to manage opioids within the physician’s parameters.

Same profession. Different system. You learn it by living it.

If you trained abroad and now work here, you already know the feeling.

Which one surprised you most? And what shocked you when you started practising in Canada? Tell me in the comments.

Save this for the move. Send it to an internationally trained physician about to start here.

The two study methods you rely on most are also the weakest.Highlighting and rereading feel productive. They are familia...
06/09/2026

The two study methods you rely on most are also the weakest.

Highlighting and rereading feel productive. They are familiar, they are easy, and they make a page look known. But a landmark review of 10 common study techniques placed those two at the very bottom for how much they actually improve learning.

Here is where they landed, by evidence:

→ Highest: practice testing and spaced practice.
→ Moderate: elaborative interrogation, self-explanation, interleaving.
→ Lowest: summarizing, the keyword mnemonic, imagery for text, highlighting, and rereading.

This is not good methods versus bad methods. Most of these help, and several work well in combination. The point is that they are not equal, and the real mistake is leaning on rereading and highlighting as your main method when they do the least.

Why those two fall short: recognizing a page is not the same as recalling it. Familiarity is not memory.

So lead with the two that carry the most weight. Close the book and write what you remember. Then space your reviews across days, not minutes. Make testing and spacing your backbone, and let the rest support them.

The research: Dunlosky et al. (2013).

That is how I build my study plans. They use several of these techniques together and lean hardest on the two with the strongest evidence, self-testing and spaced review. The 100-Day MCCQE Study Plan wires that into a daily schedule, so you do not have to design it yourself.

Comment “100QE” for the book link in your DM.

Save this. Send it to someone who highlights everything. And tell me below: which one surprised you?

You don’t forget because you studied too little.You forget because you reviewed at the wrong time.Many of us pick a revi...
06/09/2026

You don’t forget because you studied too little.
You forget because you reviewed at the wrong time.

Many of us pick a review schedule by feel. We cram in the final week, or reread a little every day with no real logic to it. Both can leave a lot of what we studied on the table by exam day. The science points to something simpler. Long-term memory tracks the gap between your reviews more than the total hours you put in.

Here is the rule, from the research on spacing:

→ Space each topic at 10 to 20% of the time until your exam.
→ Exam in 30 days, review every 3 to 6 days. 90 days out, every 9 to 18 days. 180, every 18 to 36 days.
→ Review a topic again just as it starts to fade, not long after it is gone.

Same hours. Spread right. More retained.

The rule comes from Cepeda et al. (Psychological Science, 2008) and Dunlosky et al. (2013).

This is just one of the study technique principles my 100-Day MCCQE Study Plan is built on. The daily schedule already spaces every topic for you, so you can put the science to work without mapping the timing yourself.

Volume 4 of the Path to Practice Series.

Comment “100QE” for the book link in your DM.

Save this for your study desk. Send it to an ITP preparing for the exam.

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