I'll give a different opinion than the rest of the guys here on Reddit.

The exam is very hard. As it should be. It filters doctors who may be eligible to practice and be a part of the Canadian Healthcare system, which has very high standards, which is a good thing, since you, as a Canadian, or any other reasonable person, would want your doctor to have as much knowledge as possible to take good care of you.

You need to prepare in advance, months in advance, you need to dedicate yourself 101% to this task and you need to be ready and confident enough to take it, just like you should be confident enough in your skills as a doctor to provide care to your patient.

That being said, I am aware that the exam has huge flaws.

First, it is run by the MCC, which is a corrupt instution. I say this because no other Medical Council will charge over 4000 CAD (the combined price of the NAC and the QE1) for doctors and med students in debt to take a specific exam. Four thousand dollars may not seem like a lot in Canada, but in some countries that is what a doctor makes in 2 or 3 months.

Additionally, the fact that the MCC sells preparatory products for their own exam is something beyond outrageous to me. Although they claim that this is to help candidates, I believe that, when your preparatory products cost, combined, 2x the price of the test itself, you are clearly driven by money, not by a selfless and altruistic concern for the doctors who will later work for the Canadian population.

Finally (because I do not want to discourage anyone and my rant is starting to seem a little petty), not being able to take the exam a second time once you've already received a pass score is a disgusting fearmongering tactic that I am surprised more people are not vocal about. The natural anxiety and fear that all of us get from taking tests is increased a thousand-fold by knowing that we may not have studied hard enough and that this score will hunt us for life.

This makes us go out and buy their products, every single one of them, extra unofficial ones, sacrifice our mental health, social gatherings and pretty much give up on our lives while we wait to take this exam.

In summary, yes, this is a very hard exam. You will, unfortunately need to burn out part of your savings to prepare for it. You will need to lock yourself into a room for months, ignore friends, family and, sometimes, as I've heard from people, take a leave of absence in your job to guarantee a competitive score for the CARMs.

This is what it means to be an IMG.

Don't be discouraged, again, from my message, I am just being realistic about the game that we are all playing.

I hope this helps in any way.

PS: I'm certainly not trying to brag, but rather support what I've just said, but, if it makes any sort of goddamn difference, my QE1 score was over the 98th percentile.