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First rewrite doesn't go on the MSPR, so study hard and pass and the only lasting impact will be some stress and lost time. No idea on the format. Judging by the preclerkship grade curves failures are rare (not to minimize anyone who had it happen to them) and the impression we were given is the school doesn't view a failure as a "you" problem but as a "what affected you that will be different next time" issue since getting in means they're confident you're academically strong enough. 

The actual policy appears to be the same for clerkship/preclerkship:

https://med.uottawa.ca/undergraduate/policies-and-procedures/requirements-passing-pre-clerkship-policy

https://med.uottawa.ca/undergraduate/policies-and-procedures/summative-written-examination-policy-3rd-year-clerkship

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Your transcript (functionally speaking) is your MSPR.

I don't know for sure, all I have is the same links. There might be some confusion here because undergrad courses offered through the faculty do note supplemental exams but on the page noting this there is a statement that this doesn't apply to the MD program which follows a different set of rules. 

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