IGOEE General MCQ and TPAO: format, exam-day rules and pacing

The two written exams at a glance

The General MCQ and the TPAO (Therapeutics Prescribing Assessment for Optometry) are taken online from home on March 3–4, 2027, under a live remote proctor. For the OSCE, see the OSCE guide.

Touchstone doesn't publish topic weights or a pass mark. Dates, fees and the other two parts are in the IGOEE exam guide.

How the questions look

Every question is linked to a case: patient details, the main complaint, ocular and medical history, clinical findings and sometimes an image. One case can carry several questions. You pick the single best answer. Touchstone's samples mostly ask "Which of the following is the MOST appropriate…?", so expect several options that are possible and one that is best for this patient right now.

Read the question first, then the case. You'll know which findings matter before you start reading the chart. An acronym sheet is built into the exam, and the proctors can't answer content questions.

On the TPAO, the limits of an Ontario optometrist's prescribing scope are often the point of the question: which drugs are allowed, the oral-drug limits and when glaucoma must be referred. The Ontario scope guide covers O. Reg. 112/11.

Pace yourself

You can't tell which questions are pilots, so treat every question as scored. A simple rule is about one minute per question.

• General MCQ: about 40 questions by minute 40, 80 by minute 80 and 120 by minute 120. That leaves about 10 minutes for bookmarked questions.
• TPAO: about 40 questions by minute 40 and 80 by minute 80. That leaves about 20 minutes for bookmarks.
• If a question takes more than 90 seconds, choose your best answer, bookmark it and move on. Don't leave any blank.

Practise at this speed before the day. OptoReady's full-length mocks run at the real length and pace.

Set up your computer early

The exam runs on Mettl's proctoring platform. Run Touchstone's system check well before exam day, on the computer and network you'll use.

• A desktop or laptop. No tablets or phones, and only one monitor.
• The latest Google Chrome. Touchstone says Safari, Edge and Firefox won't work.
• Screen resolution of at least 1024 × 768 (1920 × 1080 recommended).
• A webcam you can move to show the room, and a working microphone.
• Wired internet if possible. Otherwise at least 10 Mbps upload and 20 Mbps download, close to the router, with streaming and gaming in the house turned off.
• On a Mac, allow Google Chrome to record the screen in System Settings → Privacy & Security.
• Close every other program, including email, before you log in.

Check-in and the room scan

1. Log in with the username and password from your exam invitation and share your whole screen.
2. Show government photo ID with a signature: a passport, Canadian PR or citizenship card, Canadian driver's licence or Canadian photo ID card. The webcam takes a photo of you and of the ID.
3. Answer the proctor's questions in the chat.
4. Turn the camera slowly through a full circle to show the room, then your desk. Empty your pockets on camera.
5. The proctor gives you a PIN, and the timer starts when you click start.

Audio and video stay on for the whole exam, and the session is recorded. The proctor can ask for another room scan at any time. Choose a bright, quiet, private room, face the door, and don't sit with a window behind you.

What you can and can't have

Allowed without asking: a few clean tissues, lip balm, mints or lozenges, medication, a drink in an unlabelled container, a small snack in a clear bag, a mouse and mouse pad, and the Functions and Features sheet Touchstone sends you.

Not allowed: phones, tablets or any second device, watches of any kind, paper, pens, notes or books, bags, hats, tissue boxes, other people and pets. Mobility aids and medical devices need written permission in advance.

There's no scrap paper: use the exam's typed notes and calculator instead.

On-screen tools

• A question list on the left. Scroll to reach every question.
• Three bookmark icons (ribbon, star and heart). For example, use one for "guessed" and another for "check later".
• A highlighter for the case text, a calculator and a typed notes area.
• The acronym sheet.
• To finish, click "Ultimately End Exam" and confirm. You can leave once you've submitted.

OptoReady's exam-day simulator rehearses the check-in and this layout, so nothing is new on the day.

Breaks and disconnections

Washroom breaks: tell the proctor in the chat and wait for confirmation. Leave the session open with video on. The clock doesn't stop, and you may get a room scan when you return. Touchstone suggests going before the exam, or taking one break at most.

If your connection drops: your answers are saved and the exam pauses. Log back in with your exam-day link and redo the authorization and room scan. You may get the lost time back. If you can't get back in, check your phone: a text from Touchstone means the problem is system-wide. If there's no text, call the exam-day hotline on your Functions and Features sheet straight away.

If something goes wrong that could affect your score: tell the proctor before you leave, or call the hotline within 1 hour of finishing. Then file the online incident report within 48 hours. Send questions about the exam to Touchstone at least 3 days before the exam. Questions sent later won't be answered.

Practise under exam conditions

Knowing the material isn't enough if you run out of time or misread a case. Do several full timed mocks at a desk, in Chrome, with no notes and no phone. Then review every question you got wrong or guessed. Start with the free practice test and follow the week-by-week study plan.

Official sources

• Touchstone Institute: IGOEE (format, dates, fees and samples)
• TPAO and General MCQ orientation (2025)
• Virtual MCQ computer set-up guide (2026)
• Sample General MCQ question and sample TPAO questions

Summarized from Touchstone Institute's public documents, checked October 27, 2026. Rules can change each sitting, so read your exam invitation and Touchstone's current documents.

Questions