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The College of Family Physicians (CFPC) is committed to providing all examination candidates an equitable opportunity to demonstrate their knowledge, skills, and abilities in the examination setting.  The aim of this policy is to remove barriers to testing, based on protected characteristics under applicable human rights legislation. This policy applies to candidates wishing to sit the Certification Examination in Family Medicine (CCFP) or the Examination of Added Competence in Emergency Medicine (EM).

This document:

  1. Confirms on what basis a testing accommodation will be considered.
  2. Identifies examples of what constitutes a test accommodation.
  3. Outlines the policy and procedures for candidates to request a test accommodation.
  4. Confirms the policy and procedures that the CFPC will follow when considering an accommodation request.


A test accommodation represents any modification to the standard administration of the exam session to address a candidate’s unique situation. Test accommodation may be available to candidates who require accommodation for personal characteristics protected under applicable provincial human rights legislation.  The most frequently requested test accommodations are about disability, religion/creed, pregnancy, and gender.

Examples of situations where candidates may require test accommodations include, but are not limited to, those who:

  • Are lactating* and may require additional break time, a secluded space, and/or electrical outlets
  • Have physical/functional limitations and may require access to assistive devices, ergonomic adjustment, assistive personnel, or the like
  • Experience health or wellness concerns requiring access to medications, nutrition, or extra rest breaks
  • Have specific learning disabilities or medical diagnoses requiring additional testing time or a distraction-free testing environment
  • Adhere to religious observations, which may necessitate examination schedule adjustments

*Please see the CFPC policy on providing test accommodations for lactating individuals.

Submitting a Request

All requests for a test accommodation must be made at the time of application for the examination. This allows the CFPC staff to identify and allocate the required, but potentially limited, resources as equitably as possible, and to assign candidates to appropriate examination locations equipped to meet stated needs.

All requests for test accommodations must be supported by appropriate documentation, as outlined below, to be received by the College no later than 12 weeks before the exam session. Failure to submit supporting documentation will result in no test accommodation being provided on the day of examination for that candidate.

Approval and Acceptance Process

Submitting a request does not guarantee receiving a test accommodation. Test accommodation requests are assessed by the CFPC on a case-by-case basis after careful review of submitted documentation. All decisions are based on current CFPC examination policies and protocols applicable to all candidates and in accordance with the principles of applicable human rights and accessibility legislation. When determining an appropriate accommodation, the College may consider factors such as added costs to the College, health and safety, and the effect of a particular accommodation on the ability to measure clinical competence.

Test accommodations should remove barriers to candidate performance. They should neither advantage nor disadvantage any candidate.  CFPC organizational policies, review of accommodation requests, and subsequent decisions about individual candidate accommodation will meet legislative requirements regarding fairness and duty to accommodate in disability.

After a request is reviewed, if it is approved the candidate will receive an email confirmation of the approved modification to the standard testing procedure (i.e., the test accommodation) that will be made. Candidates must sign and return a copy of this confirmation, within the timeline specified, agreeing to the specified arrangements. If a request is not approved, the candidate will receive an email outlining the rationale for the CFPC decision. If the decision does not match the candidate’s expectation, the candidate must follow up with the College staff immediately so that any misunderstanding can be clarified prior to the examination date.

Candidates must present a copy of their test accommodation confirmation upon arrival at the examination site. Should the agreed arrangement not materialize at the examination site, the candidate should notify the College staff as soon as possible.

Test accommodation arrangements approved by the College are not automatically transferable from one examination to another. A new request must be submitted each time the candidate applies to sit a CFPC examination, and attest that circumstances have not changed. Outdated documentation must be updated before the request is resubmitted.

Supporting Documentation

Accommodations that DO NOT require additional testing time and/or a private testing space

A test accommodation request will be evaluated for needs such as:

  • Additional break time but unchanged total testing time
  • Special ergonomic equipment
  • Religious considerations
  • Access to medication or nutritional needs
  • Assistive devices or personnel
  • Any other need not listed here that does not require additional testing time and/or private testing space

The College must receive the following documentation at least 12 weeks prior to the examination date:

  1. The Request for Test Accommodation form, which must be signed by the candidate and include:
    • A detailed description of the test accommodation requested (what, how much, frequency…).
    • The reason(s) for the requested test accommodation.
    • Any other relevant details to clearly define the arrangement needed.
  2. Accompanying supporting documentation that must be an original letter on office letterhead and signed by the candidate’s fully licensed practising physician, other appropriate licensed health care provider; or for religious considerations, a senior member of their faith that identifies and confirms the need for such accommodations.
    • The supporting documentation cannot be from a relative or spouse of the candidate
    • The College does not require a specific diagnosis, if one exists, but the College does need to understand specifically what the candidate’s functional difficulty is and how the requested modification to the testing environment helps compensate for that functional difficulty

Accommodations that DO require additional testing time and/or a private testing space

To evaluate a test accommodation request for a need that requires additional testing time and/or a private testing space, the College must receive the following documentation at least 12 weeks prior to the examination date.

  1. The Request for Test Accommodation form, which must be signed by the candidate and include:
    • A detailed description of the accommodation requested (what, how much, frequency…).
    • The reasons for the requested accommodations.
    • Any other relevant details to clearly define the arrangement needed.
  2. The name, qualifications, and current contact information (address, email, and telephone number(s)) for each professional expert who provides supporting documentation.
  3. Authorization from the candidate to contact any of the professional expert(s) who have provided documentation on their behalf.
  4. Accompanying supporting documentation, which must be an original letter on office letterhead and signed by the candidate’s fully licensed practising physician, clinical psychologist, or other appropriate licensed health care provider that includes:
    • Confirmation of the existence of the candidate’s functional limitation(s).
    • Confirmation of the exact nature of the candidate’s functional limitation as it impacts the taking of written and/or performance examinations.
    • Confirmation of the nature of the test accommodation requested.
    • A detailed explanation of why the accommodation is required.
    • Specific recommendations for test accommodation/environment modification for the CFPC to consider using for this candidate.
    • Written confirmation from a qualified professional that the underlying cause of the candidate’s present functional limitation is actively being managed if the letter is more than two years old.
  5. Additional documentation if the candidate has previously been awarded accommodations by their university or other medical education program:
    • A copy of the test accommodation(s) previously used.
    • Authorization for the CFPC to contact the organization(s) that provided test accommodations in the past.

Requests and supporting documentation may be emailed to [email protected].

Following the candidate’s initial request for accommodation, the candidate may be asked to provide additional information for the purposes of assessing how the candidate’s needs can be accommodated without undue hardship.


Any information collected for a test accommodation request or the implementation of the accommodation will be shared only with individuals who need to know the information to assess and implement the request. All information collected is subject to the CFPC’s privacy policies and procedures.

Summary of Test Accommodation Request Process

  Responsibility Action Timing
1 Candidate Identify need on exam application Time of application
2 Candidate Provide supporting documentation At least 12 weeks before the exam
3 CFPC Review/determine arrangements that will need to be provided Six to12 weeks before the exam
4 CFPC Confirm or deny requested arrangements via email Approximately six weeks before the exam
5 Candidate Confirm acceptance or provide additional information Approximately five weeks before the exam
6 Candidate Present copy of accommodation letter Day of the exam session
Note: The CFPC response timelines are subject to change and may be extended where necessary to properly assess candidate documentation, or where follow-up information is requested.

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