A Rough Guide to European Medical School Exams

Medical school exams are a tricky and annoying affair. Knowing what to expect when it comes to them; what different types there are and how they are assessed? Can prove very useful. Of course they’re not standard across the board – but generally they all follow the same format.

In this article I intend to give anyone interested in medical school a brief run down of certain aspects of international student life. These are the types of things I wished someone would have told me before I started. Things that could be the main source of stress or debate.

So what better place to start than dissecting exams?

European Medical School Exams – An Overview

Chances are if you’re keen on becoming a doctor you probably know you’re going to have to do a sh*t load of exams. And if you didn’t know that? I’d be a bit worried. 🤦‍♂️

Studying medicine in Europe then, is no different. Exams? You have a lot of them. They get annoying. And you have to pass them (with contingencies) to progress to the following year.

Most medical subjects, on Bulgarian University programs at least (where I have direct experience), are organised by their individual faculties. Anatomy, for example, has its own course director. And these are the people responsible for formatting and delivering exams. As well as working out how to assess students.

How each subject is assessed is generally (more on this later), decided at the start of the year. Most of the time? It’s just a re-do on the year that’s gone before. But sometimes these can change half-way through a course (corona etc). So it’s your duty to stay on top of these changes!

Grades in international schools are usually scored on a 1-6 scale. One is a basic failure to use a computer. Six is the equivalent to an A.

You want to aim to get at least a three.

If you don’t want to extend your summer doing re-takes that is. Or, if you like money. Because re-siting exams (depending on how many times you fail) often involves paying too!


Yeah, I’d never heard this word either.

Colloquiums basically are mini-tests that happen throughout a semester. Think of them like mid-terms. But with less importance and less consistency.

These are the bane of an international medical students’ life. And often fall between important social events.

Passing them, for some courses at least, is wholly unimportant. Your score on these won’t be reflected in the final grade. Which will often times leave you wondering what the point of doing them was at all.

Other times the score does matter. And, provided you average a score high enough (usually 5 or 6), they’ll often exempt you for certain parts of a final too (yippee).

The format is almost always a computer-generated multiple choice question (MCQ) quiz. Which you’ll do in a normal class in a limited time-frame (often 30 minutes). Each student logs in to their individual University account prior to do this.

Others time it to the exact second of the friend sat next to them. 😎

Here’s a few tips on how to pass medical school colloquiums:

  • Understand the topics that each colloquium will cover
  • Recognise what each colloquium counts for (a certain percentage of the final grade etc)
  • Schedule in revision time a week in advance
  • Practice with sample questions (previous years questions, question banks/books etc)
  • Collect potential question topics from seminars (note-taking) and store them in a spreadsheet/notebook


As stated before, these are the staple of an international medical university course. As well as almost every other country too.

How they work? Doesn’t take a genius.

You choose from what you feel is the right answer from a multiple (usually) of four. Or you guess. Either way you have to take a punt. And are often timed in the process.

Usually you can’t go back (but there are odd exceptions). While the question selection – unless there’s a really small question bank – are random also. A crafty deterrent on the University’s behalf to prevent you from cheating.

Sometimes, depending on the organisation of the subject, these MCQs remain unchanged from year to year. Naughty professor!

One last thing? There’s also the odd rough translation (if you go to school on an international program). Making your chances of actually getting a six on a test sometimes feel like a chance game of Russian Roulette.

Obviously this is much easier with the image-based questions however. Unless you don’t know your islets of Langerhans from the isles of Scilly. Silly.

Here I’d also like to throw in an additional point. Based on what I know about medical licencing exams. USMLE (US), PLAB (UK) etc.

Getting good at MCQ’s? Super beneficial. A skill that can be practised. One that’ll help you strategically whittle down your options on harder board exams also.

Here are my tips to approach them:

  • Practice medicine-related MCQ questions every day (see my handy little Whatsapp group for more info)
  • Learn to recognise patterns in questions (repeated themes/topics)
  • Create your own MCQ-style questions to understand how examiners think
  • Practice from varied sources (MCQ’s with 4 possible answers, 5, 6, 7 etc)
  • Use free online question banks for extra training


Ah yes, the exam format that’s perhaps the most feared. Based largely on the idea that passing is dependent on whether the examiner has had their cheeky cigarette break recently or not.

The oral part of the European medical school exam involves getting up close and personal. Uncomfortable to say the least. Unless you’re looking to get intimate of course. Medical school can be a lonely place.

It usually works by having you write an essay or two beforehand. Then having said essay ignored on the grounds of your own illegibility and stick-man drawings. All while you get grilled by the course lecturer for any amount of time they see fit.

Often likened to prolonged torture, these are made worse by the fact they often take place in a lecture hall in front of a whole bunch of other students. Each silently waiting their turn. Judging your incompetence.

So make sure you’ve had a good general anaesthetic beforehand.

Some tips to improve your oral skills (please, be grown up):

  • Dress reasonably respectfully (no baseball cap, shorts etc.)
  • Be patient with an examiner (often they’ll be speaking in a second language)
  • Ask for clarification on anything you don’t understand (politely, obviously)
  • Aim to talk precisely rather than dropping off-topic information bombs
  • Be honest with the limitations of your knowledge (don’t waste the professors time)
  • Keep eye contact and try be friendly as possible


European medical school essays are a funny affair. A lot of care and attention will be given to the amount of pages, the essay title and the University logo being on the front page etc. And pretty much zero in terms of the content.

Thankfully at least, you won’t have to do a whole bunch of these. But when you do be very sure they won’t get read – or, at the very least, mildly stroked or skimmed. So choose a good printer paper at least.

Often times you’ll pick a topic or have one assigned to you. Don’t expect these to be exciting. And don’t expect to find a neat, downloadable link to a free sample either. Unless you’re Swedish and creative.

The point is not to stress. These aren’t research papers. Nor are they expected to be. Nor should they warrant hours and hours of work.

Sometimes these will be to a deadline. Other times you’ll be expected to do them on the spot (before an oral/after an MCQ session). Know what’s expected.

Here’s how I’d recommend approaching medical school essays:

  • Aim to know a little about a lot (writing 300-400 words on a list of 250 potential subjects is a tough affair)
  • Include diagrams/charts/graphs if possible (this breaks up the formatting and makes things easier to read)
  • Short sentences and proof-read work
  • Correct house-style formatting (footnotes with sources)
  • Quality over quantity always

General Tips

As for how to smash these exams and seize the day? I’m guessing that’s what you really came for.

Here are some more general suggestions on what to do at the start of each course, ahead of any exams:

  • Study the syllabus and outline at the start of each course. That way you’ll know what’s at stake, how many points you’ll need and what you need to do to get a cheeky exemption.
  • Ask your professors/teachers what the best resources are to use to score high. Then ignore their wisdom with your foolishness. But follow their advice on the re-take.
  • Take individual responsibility for your own education. Never copy your friends. But if you do? Have a complicated hand-signalling code that only you can decipher.
  • Get really good at rote-memorisation. Stick all the previous years exam questions directly into Anki. Rinse and repeat.

Obviously I’m joking with the last couple of points here. But, for some exams at least (low priority subjects), I still stand by my argument that medical school grades don’t matter.

So shortcuts can be valid. Sometimes. Because they’ll give you more time and energy to focus on the subjects that actually are important.

Difficulty Ranking

This is how medical school exams usually rank in terms of difficulty (hardest to easiest). Of course this is my opinion. Others will disagree!

I’ve also only included the ones I see as “serious” subjects. The types that will be better represented on a medical board exam – and not the lower-yield subjects like medical ethics, statistics etc.

  • Anatomy
  • Pharmacology
  • Physiology
  • Microbiology
  • Pathology

Obviously these are from the pre-clinical years too. Predominantly because (at the time of writing) I haven’t reached the serious clinical subjects yet. Or at least tough clinical subjects.

Hopefully in the future I’ll have more individual guides on each of these discussing how I approached them too.


The last topic to mention in this rough guide? Exam finals.

These are where sh*t really hits the fan and all your semesters work comes into play. Best be prepared for these.

In European medical schools final exams will often be a mix of the testing formats described above. Because of that they can also be very long. Sometimes taking entire an entire morning or afternoon.

This is why I favour the approach of volunteering to do my final exam as fast as possible. When my energy levels are high and I haven’t had too long to get overly anxious.

Sometimes though this might not be an option. This is because there can be an ordering system when it comes to student turn-taking. So be aware of that.

As for general tips when it comes to finals? Here are some practicalities:

  • Try to be well-rested. Get enough sleep the night before.
  • Go in on a full stomach. Not overly full but with enough energy to help your stamina.
  • Take some health snacks to keep your energy levels up in the waiting periods. Water too!
  • Focus on your own game play. Forget everyone else.
  • Have confidence in your own preparation. Especially if you know you’ve put in the work and haven’t been a lazy medical student.

And that’s it for our rough guide!

Good luck now fellow medic. Here’s hoping I won’t have to see you in the re-take.