Medical School Exams (A Beginners Guide!)

Medical school exams are a tricky and (sometimes) 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!

In this article I’m going to dive more into the subject. You’ll learn:

  • What types of exams you take in med school
  • If med school exams are hard (are what subjects are hardest)
  • Tips on how to do well
  • Things to watch out for

As a med student myself, I probably could have done with reading over a guide like this just as I was getting started. Knowing what to expect beforehand, can put you at a big advantage!

Ready to get started? Let’s go!

What tests do you take in medical school?

You’ll take a variety of different tests in med school, probably completing hundreds before the time you graduate!

For the most part, the topics of these exams (no matter what country you study in) are fairly standard.

You’ll have pre-clinical subject exams, followed by clinical/shelf exams.

Pre-clinical exams are based on theoretical knowledge of core subjects like anatomy, physiology, pharmacology, microbiology etc. Clinical exams focus on hospital rotations; topics surrounding obstretrics and gynecology, psychiatry and surgery etc.

Each school (and each country) has slight variations on these curriculums and topics, as well as the way they’re taught and examined.

But, for the most part, “studying medicine” looks the same no matter where you are in the world!

Note: to really understand exactly what tests you’ll do in med school, it’s very important you review your school’s own independent materials, curricula and schedule. Most schools will have a “handbook” or something similar you can refer to. Check out Harvard Med’s grading and examination guide as an example.

Block exams

In US med schools it’s very common for students to face “block exams”.

This is typically a dedicated week (or other fixed time period) of exams with different subjects/courses being tested each day.

Depending on the med school curriculum, these can be organ-based exams (all subjects are tested on one system at a time – i.e. anatomy and physiology, pathology and pharmacology of the heart etc.) or subject based.

You can find a breakdown of the different med school curriculum types here.

Do you have to write essays?

Some med schools will have you writing essays. Although it’s not common for all subjects of a medical curriculum, certain ones do lend themselves well to this mode of testing.

Often times you’ll have to pick a topic or have one assigned to you.

The point is not to stress. These aren’t research papers. Nor are they expected to be.

I go into all this in much more detail in this article…

Related: Do You Have To Write Essays In Medical School? (Explained Plus Tips!)

Medical school STEP exams

Possibly the most important exams you’ll face in med school are your board (STEP) exams. Your scores here play a huge part in determining where you’ll match for your residency.

The first biggest exam you’ll face is the USMLE Step 1. This takes place after year 2 of med school (M2), when your school is expected to have covered all pre-clinical subjects and materials.

Going into detail about the STEP exams is beyond the scope of this article. You can find all the relevant information on the United States Medical Licensing Examination’s official site.

Just know that your preparation for this will be integrated into your medical degree and that you’ll have a set amount of time (“dedicated”) to study after your second year.

When do you take USMLE Step 2?

This is a two-day test you’ll take in year 4 of study. It’s another board exam that’s necessary to get medical licencing in the US.

Students typically do this at some point during the year; usually after their residency application or in the opening months of the first semester.

Medical school exams in the rest of the world

Medical school exams are a consistent expectation of all schools, no matter where they are in the world.

They’re necessary for school’s to ensure their students meet the standards expected of international doctors. And so that the institution’s reputation does not get damaged (hopefully so they can attract new students!)

For the sake of making this guide short, I’ll take a took at the two most common questions surrounding med school outside the US.

Medical school exams in the UK

In the UK med students cover the same content and material as everywhere else. Depending on their school, they are examined regularly throughout term on the subjects they are covering.

The finals are the most important exams students in the UK will face. These occur at the end of the final year of study and revise everything covered in the preceding years.

The examination formats and times differ between Universities (Source).

The UKMLE, a board licencing exam similar to the USMLE series, is also set to come into play for all UK-based students (and graduates planning to work in the UK).

Medical school exams in Europe

Studying medicine in Europe is no different to the rest of the world. You’ll be doing them from the first few weeks of med school (typically a 6 year program), right up until the end.

Grades in European schools are scored on a 1-6 scale. 3 is a passing grade. 6 is the equivalent to an A.

There are also two main exam periods, one at the end of each semester. Most schools factor in a re-sit period directly before the start of new semesters too.

The equivalent of STEP exams in Europe are state exams. Generally these are done in the final (usually 6th year) of study.

What are medical school exams like?

Medical school exams, although they generally cover the same material, can be very different.

There can be different formats of assessment (more on this later), while different topics might be examined at different times.

There is also a mix between practical and theoretical assessment.

The video below is probably one of the best explainers on what exams are like in med school, especially when it comes to these differences!

Ollie Burton is British medical student at Warwick…

How hard are medical school exams?

Again, this is super subjective.

You’ll get mixed answers, depending on who you ask.

Things that usually determine how easy/hard you’ll find exams are pretty obvious! They include:

  1. How much you studied
  2. How effectively you studied
  3. What your prior background is in the topic

And although some people will argue attendance in class and reading all class materials are two major contributing factors, I tend to disagree.

Personally I think it’s entirely possible to do well in a pre-clinical exam studying only from home and choosing the right materials.

As long as you’re disciplined and cover the right things!

What are the hardest subjects?

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

  1. Anatomy
  2. Pharmacology
  3. Physiology
  4. Microbiology
  5. Pathology

Obviously these are all subjects from the pre-clinical years of med school. But clinical year subjects also lean a huge amount on the things you’ll learn in your first couple of years of school.

So it’s definitely worth going “all-in” to master these topics the first time around. Doing so, will save you precious time.

Especially as a lot of content/material is repeated during different courses!

Where can I find medical school exam questions?

Probably the best place to find questions is from older year students. Typically they’ll have a list of questions that you can study from for each subject that’ll best guide your preparation (sometimes these questions might even be repeated in your actual test!)

Other than that, there are a ton of resources out there that you can find subject-specific questions for.

I cover a whole bunch of excellent free question banks in the following article…

Related: 17 Free Medical School Question Banks

Besides these, make sure you do the practice questions in any subject-specific books you’re learning from.

What about old medical school exams?

If your school grants you access to previous years exams or sample questions make sure you take full advantage of them. These will be the best primer on what you can expect and the types of topics they’ll likely cover.

Also remember that Googling around could lead to useful links to old medical school exams too.

But they might not always be recent (or specific) to your set of circumstances.

Do you have to do exams after medical school?

Yes, you’ll have to do exams after medical school. All medical residencies and specialisms call for extra assessment.

Don’t think your last day of med school will be the end of exams!

Different Types of Medical School Exams


These are basically “mini-tests” that take place throughout a semester. Sometimes they carry weight in final exams, where an average score can exempt you from certain sections or make an overall contribution to your final grade.

These are the bane of most medical students’ life! And often fall in-between important social events.

The format is usually an multiple choice question (MCQ) quiz which you’ll often do in scheduled class time. You’ll have a a fixed amount of time to complete exam and sometimes a specific amount alloted to each question.

Tips for Mid-Terms/Colloquiums

  • Understand the topics that each exam will cover (ensure you read the syllabus)
  • Recognise what each test counts for (if it contributes to a certain percentage of the final grade etc.)
  • Schedule in extra study time at least 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
  • Learn to see what your professor/teacher talks or mentions most (this will likely be tested!)


As stated before, these are the staple of a medical university course.

You choose from what you feel is the right answer from a multiple (usually; 4-5) list of possible answers. Or you guess!

Sometimes you’ll be allowed to go back and check over answers, other times you won’t be. This is up to the rules of the class, faculty or University. Make sure you know the format beforehand.

The questions will be generated randomly – a crafty deterrent on the University’s behalf to prevent you from cheating or copying anyone!

Depending how large the question pool is, you might see/hear questions repeated by your colleagues (or students in previous years). If you get really lucky (or a faculty is particularly lazy) some MCQ’s can remain unchanged from year to year.

Many questions can also cribbed (or copied) from popular resources, textbooks or online question banks.

If you do study at an international school as a foreign student, watch out for translations also.

Tips for MCQ’s

Getting good at MCQ’s is a skill that can be practised. Don’t think otherwise!

  • Practice medicine-related MCQ questions every day (see my 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

Oral Exams

Perhaps the most feared exam format, the oral exam can seem a bit pot luck at times.

It usually works by having you draw a topic (usually from the syllabus) and then tasking you to write an essay on said topic.

Once this part is over, you’ll then be asked to present this topic to an examiner who’ll ask you direct questions about it designed to test your understanding.

Sometimes it can feel like they’re being deliberately harsh but most of the time they’re fair and trying to “guide” you toward the correct answers.

It helps to be really prepared for this type of medical school exam. Namely as sometimes you’ll be asked to do it in front of other students too!

Tips for Oral Exams

  • Dress respectfully (no baseball cap, shorts etc.)
  • Be patient with an examiner (especially if they’re speaking in a language that’s non-native to your own)
  • Ask for clarification on anything you don’t understand
  • Be precise and specific (avoid fluff answers)
  • Be honest with the limitations of your knowledge (don’t waste the professors time)
  • Keep eye contact and try be friendly as possible

Another good idea here is to practice answering topics with the help of colleagues. Get them to play the role of examiner (and vice versa).

Practical Exams

Practicals are where you’ll have to demonstrate your clinical skills and assessment of patients. These are usually referred to as OCSE’s.

Sometimes you might be given real patients or “actors” that you’ll be observed interacting with.

Practical Exam Tips

  • Practice with your colleagues
  • Be polite, empathetic and professional
  • Take a video of yourself and critique your skills
  • Take opportunities during study to present patients

Final Exams

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!

They happen at the end of finishing each subject/course.

Depending on where you go to school, the grades from these exams (assuming they’re not always “pass/fail”) can end up on your transcript (the certification you’ll recieve on completion of your degree).

How important they may be is entirely dependent on your country of study and your aims as a doctor.

Final Exam Tips

  • Try to be well-rested. Get enough sleep the night before
  • Eat and drink well enough to help your stamina
  • Take healthy snacks to keep your energy levels up during the waiting periods
  • Focus on your test (forget everyone else)
  • Have confidence in your own preparation

Board Exams

Just like the USMLE STEP exams previously mentioned, board exams are the ones you’ll need to do to get licencing specific to whatever country it is you plan on working in.

Although these aren’t really integrated into medical school (and done independently of them), a lot of the material you’ll cover during your mid-terms and all the above exams will be applicable.

Examples include COMLEX (the board exams doctors of osteopathy complete) and PLAB (UK board exams for international medical graduates).

Board Exam Tips

  • Prioritize these above all “internal” exams (they largely dictate your future career)
  • Use official learning materials and practice tests (where available)
  • Come up with a detailed study plan – and stick to it!

General Medical School Exam Tips

As for general tips that can help you face any type of exam and come out fighting, here’s what you can do at the start of a course to best prepare…

  1. Study the syllabus and outline at the start of each course. You’ll know what’s at stake, how many points you’ll need etc.
  2. Ask your professors/teachers what the best resources are to use to score high. Make sure you prep with all the possible questions from the examples in these recommendations.
  3. Take individual responsibility for your own education. Never copy your friends or put your medical degree standing at risk. It’s better just to fail and try harder the next time.
  4. Get really good at rote-memorisation. Do multiple passes of the content and run through all the relevant questions you can find.

Final Thoughts

And that’s it for our rough guide. We’ve covered a fair bit of content and given you lots of tips along the way.

Hopefully you know better what to expect and what you’ll have to face when you’re in med school (and beyond).

Just remember it’s all do-able as long as you put in the work.

Good luck now fellow medic!