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2026 Statistics

Key Facts: Facharzt FMH Medizinische Onkologie Exam

ESMO + SGMO

Exam Format

SIWF / SGMO Examination Regulations

140–160

Written ESMO MCQs

ESMO Examination Committee

5–6 Years

Postgraduate Training

SIWF Weiterbildungsprogramm

300 min

Written Exam Duration

ESMO Examination Standard

Lifetime

FMH Title Validity

Swiss Medical Association (FMH)

100

Practice Questions

OpenExamPrep

The Facharzt FMH Medizinische Onkologie credential certifies specialist medical oncologists in Switzerland through SIWF and SGMO. Examination assessment comprises the written European ESMO Examination (140–160 MCQs) and the SGMO oral clinical board, covering solid tumors, systemic immuno-oncology, emergencies, hematology, and clinical trial design.

Sample Facharzt FMH Medizinische Onkologie Practice Questions

Try these sample questions to test your Facharzt FMH Medizinische Onkologie exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 56-year-old postmenopausal woman undergoes breast-conserving surgery and sentinel lymph node biopsy for an invasive ductal carcinoma of the breast. Pathology reveals a 2.2 cm, grade 2 tumor with 2 positive sentinel lymph nodes (pT2 pN1a M0). The tumor is estrogen receptor (ER) 95% positive, progesterone receptor (PR) 80% positive, and HER2-negative (IHC 1+). A 21-gene recurrence score (Oncotype DX) assay returns a recurrence score of 28. According to ESMO guidelines and landmark clinical trial data, what is the most appropriate systemic adjuvant treatment strategy?

A.Adjuvant chemotherapy (anthracycline/taxane-based) followed by an aromatase inhibitor plus 2 years of the CDK4/6 inhibitor abemaciclib

B.Aromatase inhibitor monotherapy for 5 years without chemotherapy, as postmenopausal node-positive luminal disease does not benefit from cytotoxic therapy

C.Adjuvant trastuzumab emtansine (T-DM1) for 14 cycles followed by tamoxifen monotherapy for 10 years

D.Ovarian function suppression with goserelin plus tamoxifen without chemotherapy or CDK4/6 inhibition

Explanation: In postmenopausal women with hormone receptor-positive, HER2-negative, node-positive (pN1) early breast cancer and a high 21-gene recurrence score (>25), landmark data from the RxPONDER and TAILORx trials confirm a significant benefit from adjuvant chemotherapy. Furthermore, the monarchE trial demonstrated that adding the CDK4/6 inhibitor abemaciclib for 2 years to adjuvant endocrine therapy significantly improves invasive disease-free survival in patients with high-risk clinicopathological features, including ≥4 positive nodes or 1–3 positive nodes with grade 3 histology or tumor size ≥5 cm.

2A 49-year-old woman with metastatic HER2-positive (IHC 3+) invasive ductal breast cancer experiences disease progression in the liver and lungs while receiving first-line maintenance trastuzumab and pertuzumab following induction docetaxel. She is asymptomatic with an ECOG performance status of 0 and normal baseline left ventricular ejection fraction (LVEF 60%). Based on ESMO guidelines and the DESTINY-Breast03 trial, what is the standard second-line systemic therapy of choice?

A.Trastuzumab emtansine (T-DM1) monotherapy

B.Trastuzumab deruxtecan (T-DXd)

C.Lapatinib plus capecitabine

D.Tucatinib plus trastuzumab and capecitabine

Explanation: Trastuzumab deruxtecan (T-DXd) is the standard second-line therapy for metastatic HER2-positive breast cancer following progression on a taxane and dual HER2 blockade. In the randomized Phase III DESTINY-Breast03 trial, T-DXd demonstrated dramatic superiority over T-DM1 in progression-free survival (HR 0.28) and overall survival, establishing it as the preferred second-line treatment.

3A 62-year-old woman with metastatic ER-positive, HER2-low (IHC 1+, ISH-negative) breast cancer develops symptomatic bone and visceral liver metastases after progressing through two prior lines of endocrine therapy plus CDK4/6 inhibition and one line of single-agent paclitaxel chemotherapy. Her ECOG performance status is 1. Which systemic therapy is supported by Phase III trial data (DESTINY-Breast04) to provide statistically significant progression-free and overall survival benefits in this setting?

A.Sacituzumab govitecan

B.Eribulin mesylate monotherapy

C.Trastuzumab deruxtecan (T-DXd)

D.Capecitabine combined with bevacizumab

Explanation: The pivotal Phase III DESTINY-Breast04 trial established Trastuzumab deruxtecan (T-DXd) as the standard of care for pretreated patients with HER2-low (IHC 1+ or IHC 2+/ISH-) metastatic breast cancer. T-DXd demonstrated a statistically significant and clinically meaningful improvement in both progression-free survival and overall survival compared with physician's choice of single-agent chemotherapy in hormone receptor-positive and hormone receptor-negative HER2-low cohorts.

4A 42-year-old premenopausal woman is diagnosed with clinical stage IIB (cT2 cN1 M0) triple-negative breast cancer (TNBC). Genetic testing is negative for germline BRCA1/2 mutations. In accordance with the KEYNOTE-522 trial and ESMO guidelines, what is the standard neoadjuvant and adjuvant treatment paradigm?

A.Neoadjuvant dose-dense AC followed by paclitaxel alone, followed by definitive surgery and adjuvant capecitabine for 8 cycles

B.Neoadjuvant carboplatin plus paclitaxel followed by surgery, omitting anthracyclines and adjuvant therapy if a pathologic complete response is attained

C.Neoadjuvant pembrolizumab monotherapy for 6 months followed by surgery and observation

D.Neoadjuvant pembrolizumab combined with carboplatin/paclitaxel followed by doxorubicin/cyclophosphamide, then definitive surgery, followed by adjuvant pembrolizumab to complete 1 year

Explanation: The KEYNOTE-522 regimen is the international standard of care for high-risk early triple-negative breast cancer (stage II/III). It consists of neoadjuvant pembrolizumab plus platinum-containing chemotherapy (carboplatin plus paclitaxel followed by doxorubicin or epirubicin plus cyclophosphamide), followed by definitive breast surgery and continued adjuvant pembrolizumab for up to 9 cycles (totaling approximately 1 year of immunotherapy), significantly improving pathologic complete response (pCR) and event-free survival regardless of pCR status.

5A 38-year-old woman with a documented deleterious germline BRCA1 mutation completes neoadjuvant anthracycline/taxane chemotherapy and bilateral mastectomy for triple-negative breast cancer. Final surgical pathology reveals residual invasive carcinoma measuring 1.8 cm with 1 positive axillary lymph node (ypT1c ypN1a, non-pCR). Which adjuvant targeted therapy is indicated based on the Phase III OlympiA trial to improve invasive disease-free and overall survival?

A.Adjuvant Olaparib orally for 1 year

B.Adjuvant Talazoparib orally for 6 months

C.Adjuvant Niraparib combined with bevacizumab for 2 years

D.Adjuvant Rucaparib monotherapy for 3 years

Explanation: The OlympiA Phase III trial demonstrated that 1 year of adjuvant olaparib (a PARP inhibitor) significantly improves invasive disease-free survival (IDFS) and overall survival (OS) in patients with high-risk, HER2-negative early breast cancer harboring germline BRCA1 or BRCA2 mutations who have residual disease after neoadjuvant chemotherapy (or high-risk features upfront).

6A 44-year-old premenopausal woman is diagnosed with de novo metastatic ER-positive (90%), PR-positive (70%), HER2-negative breast cancer with multiple non-visceral bone metastases. She has no visceral crisis. What constitutes the standard first-line systemic management according to SGMO and ESMO guidelines?

A.Tamoxifen monotherapy without ovarian ablation to avoid premature menopausal symptoms

B.Ovarian function suppression (GnRH agonist or bilateral oophorectomy) combined with an aromatase inhibitor (or fulvestrant) and a CDK4/6 inhibitor (e.g., ribociclib)

C.Single-agent capecitabine until disease progression followed by second-line endocrine therapy

D.Doxorubicin plus cyclophosphamide (AC) chemotherapy followed by maintenance fulvestrant

Explanation: Premenopausal women with ER+/HER2- metastatic breast cancer without visceral crisis should receive endocrine therapy plus a CDK4/6 inhibitor (such as ribociclib, which demonstrated an overall survival benefit in MONALEESA-7) combined with ovarian function suppression (OFS via GnRH agonists like goserelin/leuprolide or surgical oophorectomy) to render them postmenopausal, enabling effective aromatase inhibition or fulvestrant therapy.

7A 58-year-old non-smoking man undergoes complete surgical resection (lobectomy and systematic mediastinal lymphadenectomy) for stage IIA (pT2b pN0 M0) non-small cell lung cancer (adenocarcinoma). Molecular pathology confirms an EGFR exon 19 deletion. He completes 4 cycles of adjuvant cisplatin plus vinorelbine. Based on the Phase III ADAURA trial, what is the next standard step in his curative management?

A.Observation with routine chest CT surveillance every 6 months

B.Adjuvant erlotinib for 1 year

C.Adjuvant osimertinib (80 mg orally daily) for up to 3 years

D.Adjuvant thoracic radiotherapy followed by durvalumab

Explanation: In the Phase III ADAURA trial, adjuvant osimertinib (80 mg daily for up to 3 years) demonstrated a profound disease-free survival benefit and a statistically significant overall survival benefit (HR 0.49) in patients with completely resected stage IB–IIIA EGFR-mutated (exon 19 deletion or L858R) NSCLC following standard adjuvant chemotherapy.

8A 64-year-old woman is newly diagnosed with metastatic lung adenocarcinoma with extensive bone and pleural metastases. Next-generation sequencing (NGS) reveals an EGFR exon 21 L858R point mutation. She has no neurologic symptoms and an ECOG performance status of 1. According to the FLAURA and FLAURA2 trials and ESMO guidelines, what represents standard first-line systemic management?

A.Afatinib monotherapy until progression followed by osimertinib

B.Cisplatin plus pemetrexed doublet chemotherapy alone

C.Pembrolizumab plus carboplatin and pemetrexed

D.Osimertinib monotherapy (or osimertinib combined with platinum-pemetrexed chemotherapy)

Explanation: Third-generation EGFR TKI osimertinib is the standard first-line treatment for EGFR-mutated (exon 19 del / L858R) advanced NSCLC based on the FLAURA trial, which showed superior progression-free survival, overall survival, and central nervous system (CNS) efficacy compared to first-generation TKIs. Furthermore, FLAURA2 demonstrated that adding platinum-pemetrexed chemotherapy to osimertinib further extends progression-free survival.

9A 48-year-old non-smoker presents with stage IV lung adenocarcinoma with asymptomatic brain metastases. Molecular profiling confirms an EML4-ALK fusion rearrangement (ALK-positive). PD-L1 expression is 85%. Which first-line systemic therapy provides the highest central nervous system penetration and superior progression-free survival according to ESMO guidelines?

A.Second- or third-generation ALK TKI (such as Alectinib, Brigatinib, or Lorlatinib)

B.Pembrolizumab monotherapy based on high PD-L1 expression (TPS ≥ 50%)

C.Crizotinib monotherapy with whole-brain radiotherapy

D.Carboplatin plus paclitaxel and bevacizumab

Explanation: Next-generation ALK tyrosine kinase inhibitors (such as alectinib, brigatinib, or lorlatinib) are the preferred first-line standard of care for ALK-rearranged NSCLC. The Phase III ALEX and CROWN trials demonstrated marked superiority of next-generation TKIs over crizotinib, achieving median progression-free survivals exceeding 30–38+ months and exceptional intracranial activity, effectively controlling and preventing brain metastases without upfront whole-brain radiation.

10A 66-year-old man with a 40 pack-year smoking history is diagnosed with metastatic non-squamous non-small cell lung cancer (cT3 cN2 cM1c with adrenal and contralateral lung lesions). Comprehensive genomic profiling reveals no actionable mutations in EGFR, ALK, ROS1, BRAF, RET, MET, or KRAS. Immunohistochemistry for PD-L1 shows a Tumor Proportion Score (TPS) of 0%. His ECOG performance status is 1 and renal function is normal. What is the standard first-line treatment regimen?

A.Docetaxel monotherapy

B.Platinum doublet chemotherapy (cisplatin or carboplatin plus pemetrexed) combined with Pembrolizumab (or Nivolumab plus Ipilimumab plus 2 cycles of chemotherapy)

C.Pembrolizumab monotherapy

D.Osimertinib combined with bevacizumab

Explanation: For patients with metastatic non-squamous NSCLC without actionable genomic alterations and PD-L1 TPS < 1% (or 0%), standard first-line therapy is platinum-pemetrexed chemotherapy combined with pembrolizumab (KEYNOTE-189) or dual checkpoint inhibition with nivolumab plus ipilimumab and 2 cycles of platinum doublet chemotherapy (CheckMate 9LA). Both strategies demonstrate significant overall survival superiority over platinum doublet chemotherapy alone.

About the Facharzt FMH Medizinische Onkologie Exam

The Facharzt FMH für Medizinische Onkologie (Specialist in Medical Oncology FMH) is the Swiss Federal specialist title granting full independent practice rights in medical oncology across Switzerland. Governed by the SIWF (Swiss Institute for Postgraduate and Continuous Medical Training) and the SGMO (Swiss Society of Medical Oncology), board qualification requires passing the international ESMO (European Society for Medical Oncology) Examination as the official written component, followed by the SGMO oral-practical board examination. The syllabus covers solid tumors, systemic cancer therapies, immuno-oncology, targeted agents and antibody-drug conjugates (ADCs), hematologic malignancies, oncologic emergencies, palliative medicine, and clinical trial biostatistics. Note on format and language: While the official written ESMO examination is administered in English and the SGMO oral examination is conducted in Swiss national languages (German/French) or English, this question bank is an English-language multiple-choice study adaptation created by OpenExamPrep—not an official ESMO/SGMO examination release—specifically designed to train high-yield clinical decision-making, pharmacological mechanisms, and guideline-based management.

Assessment

Two-part qualifying examination: 1) The written ESMO Examination consisting of two 2.5-hour multiple-choice papers (140–160 MCQs in English), and 2) The SGMO oral-practical board examination consisting of multiple standardized clinical vignette stations evaluated by senior medical oncologists.

Time Limit

300 minutes written examination (two 150-minute sessions) plus approximately 60–90 minutes structured oral examination

Passing Score

Criterion-referenced standard passing score on the ESMO MCQ examination (typically ~60–65% raw score) and a structured passing evaluation across all clinical stations assessed by the SGMO examination committee

Exam Fee

ESMO Examination fee ~EUR 100–300; SGMO Oral Examination fee CHF 1,000–1,500; SIWF FMH Title Application fee CHF 1,000–2,500 (Schweizerisches Institut für ärztliche Weiter- und Fortbildung (SIWF / FMH) and Schweizerische Gesellschaft für Medizinische Onkologie (SGMO), utilizing the ESMO Examination)

Facharzt FMH Medizinische Onkologie Exam Content Outline

35%

Solid Tumors: Breast, Lung, GI & Genitourinary Cancers

Evidence-based management, staging, biomarker testing (ER/PR/HER2, EGFR/ALK/ROS1/KRAS/PD-L1, RAS/BRAF/MSI, BRCA, HRD), and multidisciplinary treatment of breast, non-small cell lung, small cell lung, colorectal, upper GI, pancreaticobiliary, prostate, renal, urothelial, melanoma, and sarcoma malignancies.

25%

Systemic Cancer Therapies & Immuno-Oncology

Mechanisms of action, pharmacokinetics, and resistance pathways of immune checkpoint inhibitors (anti-PD-1, anti-PD-L1, anti-CTLA-4, anti-LAG-3), antibody-drug conjugates (ADCs: T-DXd, T-DM1, sacituzumab govitecan, enfortumab vedotin), PARP inhibitors, targeted small molecules (TKIs, KRAS inhibitors), and classic cytotoxic agents.

18%

Oncologic Emergencies & Treatment Toxicities

Emergency recognition and protocol-driven management of febrile neutropenia (MASCC risk index), malignant spinal cord compression (MSCC), superior vena cava syndrome, tumor lysis syndrome (rasburicase), hypercalcemia of malignancy, immune-related adverse events (irAE colitis, pneumonitis, myocarditis, endocrinopathies), and chemotherapy extravasation.

10%

Hematologic Malignancies & Lymphomas

Diagnosis, risk stratification, and frontline/relapsed systemic therapy for diffuse large B-cell lymphoma (DLBCL), classical Hodgkin lymphoma, multiple myeloma (CRAB/SLiM criteria, quadruplets, autologous SCT, bispecifics/CAR-T), chronic lymphocytic leukemia (CLL/SLL with TP53/del(17p)), and indolent lymphomas.

12%

Palliative Care, Symptom Management & Clinical Trial Methodology

WHO 3-step cancer pain ladder, equianalgesic opioid conversions and rotation, chemotherapy-induced nausea and vomiting (CINV: MASCC/ESMO 4-drug regimens), malignant bowel obstruction, clinical trial designs, primary endpoints (OS, PFS, DFS, ORR), hazard ratios, Kaplan-Meier biostatistics, and medical ethics/advance care directives.

How to Pass the Facharzt FMH Medizinische Onkologie Exam

What You Need to Know

Passing score: Criterion-referenced standard passing score on the ESMO MCQ examination (typically ~60–65% raw score) and a structured passing evaluation across all clinical stations assessed by the SGMO examination committee
Assessment: Two-part qualifying examination: 1) The written ESMO Examination consisting of two 2.5-hour multiple-choice papers (140–160 MCQs in English), and 2) The SGMO oral-practical board examination consisting of multiple standardized clinical vignette stations evaluated by senior medical oncologists.
Time limit: 300 minutes written examination (two 150-minute sessions) plus approximately 60–90 minutes structured oral examination
Exam fee: ESMO Examination fee ~EUR 100–300; SGMO Oral Examination fee CHF 1,000–1,500; SIWF FMH Title Application fee CHF 1,000–2,500

Keys to Passing

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

Facharzt FMH Medizinische Onkologie Study Tips from Top Performers

1Master Biomarker-Driven Solid Tumor Algorithms: Be fluent in genomic alterations that dictate first-line therapy, such as EGFR exon 19/21 vs exon 20 insertions, ALK/ROS1/RET fusions, KRAS G12C, HER2-low vs HER2-positive status, and mismatch repair deficiency (dMMR/MSI-H).

2Understand ADC Pharmacology & Toxicities: Know the specific payloads and target antigens for modern ADCs (trastuzumab deruxtecan with topoisomerase I inhibitor DXd; sacituzumab govitecan with SN-38; enfortumab vedotin with MMAE) and monitor for drug-specific adverse effects such as interstitial lung disease (ILD/pneumonitis) and peripheral neuropathy.

3Memorize Protocolized Management for irAEs: Know the exact step-up management for immune-related adverse events from Grade 1 (continue/hold) to Grade 2 (oral prednisone 0.5–1 mg/kg) to Grade 3–4 (IV methylprednisolone 1–2 mg/kg/day, infliximab for colitis, and withholding infliximab in favor of mycophenolate for hepatitis).

4Review Chemotherapy Dosing Modifications & Pharmacogenomics: Understand organ-specific dose adjustments (renal adjustments for cisplatin, carboplatin Calvert formula, methotrexate; hepatic adjustments for anthracyclines, taxanes, irinotecan) and genetic screenings like DPYD deficiency before 5-FU/capecitabine and UGT1A1*28 before irinotecan.

5Interpret Survival Curves & Trial Biostatistics: Understand hazard ratios (HR), 95% confidence intervals, alpha error spending, power, crossover dilution, surrogate endpoints (PFS vs OS), and non-inferiority margins.

Frequently Asked Questions

What is the Facharzt FMH für Medizinische Onkologie title?

The Facharzt FMH für Medizinische Onkologie is the federally recognized specialist medical title awarded by the SIWF / FMH (Swiss Medical Association) upon completion of at least 5–6 years of accredited postgraduate medical oncology and internal medicine training, passing both the written ESMO examination and the SGMO oral board examination, and meeting all logbook requirements.

How is the Swiss Medical Oncology specialist examination structured?

The qualification requires two distinct examinations: 1) The written European Society for Medical Oncology (ESMO) Examination, consisting of 140–160 MCQs administered in English, and 2) The SGMO oral board examination, which tests clinical reasoning, multidisciplinary care, toxicities, and real-world case management across clinical stations before a panel of Swiss oncology experts.

When can Swiss oncology trainees sit the ESMO and SGMO examinations?

Trainees typically register for the ESMO examination during their senior residency or clinical fellowship years (usually year 4 or 5 of training). The SGMO oral board examination is usually taken in the final year of residency or upon completing clinical training requirements.

What clinical guidelines form the primary basis of the examination?

The written ESMO examination and SGMO board are fundamentally based on the ESMO Clinical Practice Guidelines, ASCO guidelines, NCCN guidelines, and consensus recommendations from the Swiss Group for Clinical Cancer Research (SAKK) and SGMO.

Why is this practice bank presented in English?

The official written ESMO Examination is written and administered entirely in English across Europe, including in Switzerland. Medical oncology scientific literature, clinical trial protocols, and oncology drug monographs are universally published in English. This practice bank adapts Swiss and ESMO curriculum standards into 100 high-yield English-language questions.

What are the common oncologic emergencies tested on the board?

Key high-yield emergencies include febrile neutropenia (MASCC stratification and antipseudomonal monotherapy), malignant spinal cord compression (high-dose dexamethasone and urgent neurosurgical/radiation evaluation), tumor lysis syndrome (Cairo-Bishop criteria and rasburicase), hypercalcemia of malignancy (saline hydration, zoledronic acid, denosumab), and severe immune-related adverse events (irAE pneumonitis, myocarditis, and steroid-refractory colitis).

100+ Free Facharzt FMH Medizinische Onkologie Practice Questions

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