1. Main 200-MCQ exam-domain breakdown
The real exam distribution is blueprint-based. Exact item counts may vary, but the following ranges are the practical planning targets for a 200-question exam.
| CONO Blueprint Area | Percentage of Exam | Approximate Questions out of 200 | Practical Study Priority |
|---|---|---|---|
| Assessment & Diagnosis | 30–34% | 60–68 MCQs | Clinical reasoning, history, physical exam, labs, imaging, differential diagnosis, red flags, monitoring, and prognosis. |
| Modalities | 55–59% | 110–118 MCQs | Highest-yield section. Focus on nutrition, botanicals, homeopathy, physical medicine, counselling, TCM/acupuncture, Chinese patent formulas, and pharmacotherapy. |
| Critical Care & Public Health | 9–13% | 18–26 MCQs | Emergency recognition, referral, CPR/BLS, oxygen, infection control, biohazard safety, communicable disease reporting, and adverse reaction reporting. |
2. Condition categories tested across the exam
CONO does not organize the full exam only by organ systems. The blueprint uses condition categories that cut across systems, presentations, and modalities.
| Condition Category | Percentage Range | Approximate MCQs out of 200 |
|---|---|---|
| Vascular | 9–11% | 18–22 |
| Infectious | 9–11% | 18–22 |
| Neoplastic | 4–6% | 8–12 |
| Degenerative | 9–11% | 18–22 |
| Inflammatory / Immunologic | 9–11% | 18–22 |
| Congenital / Developmental | 6–8% | 12–16 |
| Autoimmune | 8–10% | 16–20 |
| Toxic / Environmental | 6–8% | 12–16 |
| Traumatic | 4–6% | 8–12 |
| Endocrine | 9–11% | 18–22 |
| Metabolic | 6–8% | 12–16 |
| Psychosomatic / Psychiatric | 9–11% | 18–22 |
3. Modalities: tested topics and practical distribution
Modalities is the largest section of the exam, representing approximately 110–118 questions out of 200. CONO does not publish an exact question number for each individual modality, so the numbers below are practical study targets.
| Modality Topic | What Can Be Tested | Practical Target in 200-MCQ Mock |
|---|---|---|
| Botanical Medicine | Safety, side effects, contraindications, interactions, toxicity, pharmacognosy, therapeutic effects, indications, mechanism of action, route, posology, and prescribing abbreviations. | 14–16 MCQs |
| Homeopathy | Acute prescribing, keynotes, timing, sidedness, intensity, aggravating and ameliorating factors, classical Hahnemannian prescribing, potency, and posology. | 12–14 MCQs |
| Clinical Nutrition / Nutraceuticals / Therapeutic Diets | Nutritional assessment, intake, absorption, utilization, loss, nutrient safety, side effects, contraindications, interactions, toxicity, bioavailability, food sources, macronutrients, micronutrients, and therapeutic diets. | 22–24 MCQs |
| Physical Medicine | Orthopedic tests, osseous manipulation, soft tissue manipulation, therapeutic devices, TENS, interferential current, microcurrent, light therapy, ultrasound, hydrotherapy, therapeutic exercise, and MSK prevention. | 17–19 MCQs |
| Counselling & Health Psychology | Counselling principles, lifestyle counselling, health promotion, chronic disease prevention, mind-body techniques, lifespan and developmental issues, and psychological assessment tools. | 10–12 MCQs |
| Traditional Chinese Medicine / Acupuncture / Chinese Patent Formulas | Ten questions, pulse, tongue, eight principles, vital substances, organs, meridians, five elements, Zang-Fu diagnosis, Chinese patent formula safety and prescribing, acupuncture prescription, point location, angulation, depth, clean needle technique, moxa, cupping, electro-acupuncture, and laser. | 22–26 MCQs |
| Pharmacotherapy | Pharmaceutical safety, side effects, contraindications, interactions, toxicity, therapeutic effects, indications, mechanism of action, route, and therapeutic drug monitoring. | 8–12 MCQs |
Clinical nutrition, TCM/acupuncture/Chinese patent formulas, and physical medicine.
Case-based treatment selection, safety, contraindications, interactions, monitoring, and referral risk.
A complete Modalities mock block should contain approximately 112–118 questions.
4. Chinese patent herbal formulas
Chinese patent herbal formulas are tested under Modalities, especially within Traditional Chinese Medicine. They may appear as direct formula questions or as case-based Zang-Fu diagnosis and safety questions.
Estimated exam weight
TCM + acupuncture + Chinese patent formulas: about 22–26 MCQs in a 200-question exam.
Chinese patent formulas alone: approximately 6–10 direct or indirect MCQs.
What is usually tested
Pattern-to-formula matching, Zang-Fu diagnosis, contraindications, pregnancy caution, toxicity, herb-drug interaction risk, and wrong-formula traps.
Release the Exterior
- Ma Huang Tang
- Gui Zhi Tang
- Chuan Xiong Cha Tiao San
- Sang Ju Yin
- Yin Qiao San
Clear Heat
- Long Dan Xie Gan Tang
Purge
- Ma Zi Ren Wan
- Da Huang Fu Zi Tang
Harmonizing
- Si Ni San
- Xiao Yao San
- Jia Wei Xiao Yao San
Expel Dampness
- Ba Zheng San
Transform Phlegm
- Er Chen Tang
Warm the Interior
- Si Ni Tang
- Dang Gui Si Ni Tang
Tonify Qi
- Bu Zhong Yi Qi Tang
- Si Jun Zi Tang
Tonify Blood
- Si Wu Tang
Tonify Qi and Blood
- Ba Zhen Tang
- Gui Pi Tang
Nourish and Tonify Yin
- Liu Wei Di Huang Tang
- Zuo Gui Yin
- Da Bu Yin Wan
- Zhi Bai Di Huang Tang
Tonify Yang
- You Gui Wan
- Jin Gui Shen Qi Wan
Regulate Qi
- Ban Xia Hou Po Tang
- Ding Chuan Tang
Warm Menses / Dispel Blood Stagnation
- Sheng Hua Tang
- Gui Zhi Fu Ling Wan
Nourish Heart / Calm Spirit
- Suan Zao Ren Tang
- Tian Wang Bu Xin Dan
- Gan Mai Da Zao Tang
Release Wind from Skin and Channels
- Xiao Feng San
Extinguish Internal Wind
- Tian Ma Gou Teng Yin
5. Assessment & Diagnosis: tested topics
This section is about clinical reasoning: history, physical examination, lab selection, imaging selection, differential diagnosis, red flags, prognosis, complications, and monitoring.
| Tested Area | What CONO Can Ask | Approximate MCQs in 200-Question Exam |
|---|---|---|
| Patient evaluation | Medical history, psychosocial history, ethical doctor-patient interaction, and physical examination. | 12–16 |
| Lab testing | Select appropriate lab tests, collect and prepare specimens, interpret lab results, and identify factors interfering with labs. | 12–16 |
| Imaging studies | Select imaging, interpret basic imaging findings, and know when imaging is urgent. | 6–10 |
| Common acute and chronic conditions | Recognize signs, symptoms, risk factors, comorbidities, pathogenesis, and etiology. | 12–16 |
| Differential diagnosis | Generate the most likely diagnosis and important alternative diagnoses. | 8–12 |
| Prognosis, complications, monitoring | Predict complications, sequelae, prognosis, and follow-up requirements. | 5–8 |
| Evidence-informed practice | Interpret and critique research and apply research to patient care. | 3–5 |
Practical system distribution for a 60–68 MCQ Assessment & Diagnosis block
| System / Clinical Area | Approximate MCQs |
|---|---|
| Cardiovascular / Vascular | 6–8 |
| Infectious Disease | 6–8 |
| Endocrine / Metabolic | 7–9 |
| GI / Hepatobiliary | 5–7 |
| Respiratory | 4–6 |
| Neurology | 4–6 |
| Musculoskeletal / Rheumatology / Autoimmune | 6–8 |
| Renal / GU / Reproductive | 5–7 |
| Pediatrics / Developmental | 4–6 |
| Psychiatric / Psychosomatic | 4–6 |
| Oncology / Neoplastic Red Flags | 3–5 |
| Toxic / Environmental / Trauma | 3–5 |
6. Critical Care & Public Health: tested topics
This is the smallest section, but it is high-yield because questions often test safety, emergency recognition, immediate referral, public health reporting, and infection control.
| Tested Topic | What CONO Can Ask | Approximate MCQs in 200-Question Exam |
|---|---|---|
| High-risk patients | Identify unstable or high-risk patients. | 4–6 |
| Critical conditions | Recognize emergency presentations and red flags. | 4–6 |
| Referral / emergency management | Decide when to refer, call EMS, or send for urgent hospital care. | 3–5 |
| CPR / BLS | Cardiopulmonary resuscitation principles. | 2–3 |
| Oxygen administration | Oxygen delivery type, oxygen flow, and patient safety. | 2–3 |
| Sterilization / disinfection / universal precautions | Infection-control procedures and safe clinical practice. | 2–4 |
| Biohazard management | Sharps, blood or body-fluid exposure, and contaminated materials. | 1–3 |
| Communicable disease counselling | Isolation, prevention, and patient counselling. | 2–4 |
| Communicable disease reporting | Reporting to the local public health authority. | 2–4 |
| Adverse reaction reporting | Reporting serious adverse reactions to Health Canada. | 1–2 |
High-yield clinical systems for Critical Care & Public Health
MI, cardiac arrest, hypertensive crisis, stroke/TIA, pulmonary embolism, and DVT.
Severe asthma, anaphylaxis, hypoxia, and respiratory distress.
Sepsis, meningitis, measles, TB, and reportable infections.
Hypoglycemia, DKA, adrenal crisis, and severe electrolyte abnormality.
Stroke, seizure, altered level of consciousness, and severe acute headache red flags.
Head injury, fracture red flags, poisoning, and toxic exposure.
Ectopic pregnancy red flags, preeclampsia, dehydration, and safeguarding concerns.
Suicide risk, violence risk, duty to protect, and mandatory reporting.
7. Best study plan from this distribution
First priority
Modalities because this section may contain more than half of the real exam.
Second priority
Assessment & Diagnosis because it tests clinical reasoning, labs, imaging, and red flags.
Third priority
Critical Care & Public Health because it is smaller but safety-focused and easy to lose marks if not reviewed.
| Practice Block | Recommended Number of Practice MCQs | Goal |
|---|---|---|
| Modalities | 300–500 | Build treatment selection, contraindication, interaction, and modality safety skills. |
| Chinese Patent Herbal Formulas | 100 | Master Zang-Fu diagnosis, formula matching, safety, and wrong-formula traps. |
| Assessment & Diagnosis | 200–300 | Improve clinical reasoning, lab interpretation, imaging selection, and differential diagnosis. |
| Critical Care & Public Health | 100 | Strengthen emergency recognition, referral, infection control, reporting, and BLS/oxygen knowledge. |
| Full 200-MCQ Mock Exams | Multiple timed mocks | Practice stamina, timing, blueprint balance, and review-mode learning. |
References
- College of Naturopaths of Ontario. Clinical Sciences Examination Blueprint and Reference Guide. Toronto: CONO; 2026.
- College of Naturopaths of Ontario. Ontario Clinical Sciences Examination information for applicants. Toronto: CONO; accessed 2026.
This page is an original BoardQBank educational summary prepared for CONO-style exam preparation. It is not affiliated with or endorsed by the College of Naturopaths of Ontario.