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2026 Statistics

Key Facts: Internat Médecine (Côte d'Ivoire) Exam

4 Years

Duration of the specialized hospital residency program for appointed interns

MSHPCMU / DEPPS Internat Regulations

11th Semester

Semester of medical study that must be validated before a candidate may register

Arrêté n°00095/MSHPCMU/CAB du 18 mars 2026, art. 3

50,000 FCFA

Candidacy fee payable to the DEPPS régie de recettes for the medicine internat competition

Arrêté n°00095/MSHPCMU/CAB du 18 mars 2026, art. 4

60 QCM

Items in the one-hour Épreuve Multidisciplinaire that opens the competition; below 15/30 is eliminatory

DEPPS communiqué, session 2025-2026

90 Posts

Internship posts opened for the 2025-2026 session: 81 for nationals and 9 for non-nationals

Arrêté n°00095/MSHPCMU/CAB du 18 mars 2026, art. 2

DEPPS / MSHPCMU

Official governmental administrative authority responsible for the competition

Ministère de la Santé de Côte d'Ivoire

Côte d'Ivoire's Concours National d'Internat en Médecine is the statutory national competition selecting top medical students (6th year / 11+ semesters) for 4-year hospital residency. Covering medical pathology, surgical pathology, anatomy, and clinical biology, this bank provides a comprehensive 100-question English study adaptation.

Sample Internat Médecine (Côte d'Ivoire) Practice Questions

Try these sample questions to test your Internat Médecine (Côte d'Ivoire) exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 28-year-old patient presents with high fever, impaired consciousness, severe pallor, and dark urine. The thick blood film confirms Plasmodium falciparum malaria with a parasite density of 180,000 trophozoites/μL. According to WHO and Côte d'Ivoire national malaria guidelines, what is the first-line emergency antimalarial treatment?

A.Intravenous artesunate at 2.4 mg/kg at 0, 12, and 24 hours, then once daily

B.Intramuscular artemether at 3.2 mg/kg once daily for 7 days

C.Intravenous quinine gluconate loading dose of 20 mg/kg infused over 4 hours in 5% dextrose

D.Oral artemether-lumefantrine 80/480 mg twice daily with fatty food

Explanation: Intravenous artesunate (2.4 mg/kg IV at 0, 12, and 24 hours, followed by once daily until oral intake is tolerated) is the WHO first-line treatment for severe malaria at every age. The mortality benefit over quinine was shown in adults by SEAQUAMAT (Southeast Asia) and in African children by AQUAMAT; a full oral ACT course must still follow once the patient can swallow, to clear residual parasitaemia.

2A 35-year-old HIV-positive patient on antiretroviral therapy presents with a 3-week history of productive cough, evening fever, night sweats, and a 5 kg weight loss. Chest radiography shows apical cavitary infiltrates. Which diagnostic test is recommended as the initial rapid molecular assay for tuberculosis and rifampicin resistance detection?

A.GeneXpert MTB/RIF automated real-time PCR assay on sputum

B.Ziehl-Neelsen microscopic smear examination for acid-fast bacilli

C.Lowenstein-Jensen solid egg-based culture of expectorated sputum

D.Tuberculin skin test (Mantoux reaction with 5 TU of PPD)

Explanation: GeneXpert MTB/RIF is the WHO-recommended rapid initial diagnostic test for pulmonary tuberculosis, providing automated detection of Mycobacterium tuberculosis complex DNA and rpoB gene mutations conferring rifampicin resistance within 2 hours with high sensitivity.

3A 22-year-old university student is admitted with sudden onset of severe headache, photophobia, fever (39.5°C), neck stiffness, and positive Kernig and Brudzinski signs. Lumbar puncture reveals cloudy cerebrospinal fluid (CSF) with 2,500 leukocytes/mm³ (88% neutrophils), protein of 2.8 g/L, and CSF/blood glucose ratio of 0.18. Gram stain demonstrates Gram-negative diplococci. What is the immediate empiric antibiotic and adjunctive management?

A.Intravenous ceftriaxone 2 g every 12 hours plus intravenous dexamethasone 10 mg started prior to or with the first antibiotic dose

B.Intravenous ampicillin 2 g every 4 hours plus gentamicin 5 mg/kg once daily

C.Intravenous vancomycin 15 mg/kg every 12 hours monotherapy

D.Oral ciprofloxacin 500 mg single dose plus oral rifampicin

Explanation: Acute purulent meningitis caused by Neisseria meningitidis (Gram-negative diplococci) or Streptococcus pneumoniae requires high-dose bactericidal third-generation cephalosporins (ceftriaxone 4 g/day) combined with early IV dexamethasone (10 mg every 6 hours) to reduce neurological sequelae, hearing loss, and cerebral edema.

4A 62-year-old hypertensive patient presents to the emergency department with acute respiratory distress, orthopnea, bilateral basal crackles extending to mid-lung fields, jugular venous distension, blood pressure 195/110 mmHg, and oxygen saturation 84% on ambient air. What is the most appropriate initial pharmacological combination?

A.High-flow oxygen, intravenous furosemide bolus (40–80 mg), and sublingual/intravenous isosorbide dinitrate or nitroglycerin infusion

B.Intravenous digoxin 0.5 mg bolus and oral spironolactone 50 mg

C.Intravenous beta-blocker (labetalol) bolus and aggressive volume loading with normal saline

D.Subcutaneous low-molecular-weight heparin and oral amlodipine 10 mg

Explanation: Acute hypertensive cardiogenic pulmonary edema is managed urgently with oxygenation (including CPAP/BiPAP if needed), rapid IV loop diuretics (furosemide) to decrease preload, and IV vasodilators (nitroglycerin/nitrates) to rapidly reduce systemic vascular resistance (afterload) and left ventricular filling pressure.

5A 54-year-old male with a history of smoking and dyslipidemia presents with crushing substernal chest pain of 90 minutes duration radiating to the left jaw and arm. The 12-lead ECG reveals 3 mm ST-segment elevation in leads V1–V4 with reciprocal ST depression in leads II, III, and aVF. The nearest percutaneous coronary intervention (PCI) center is 4 hours away. What is the correct immediate reperfusion strategy?

A.Immediate intravenous fibrinolytic therapy (e.g., tenecteplase) within 10 minutes of diagnosis, accompanied by aspirin, clopidogrel, and enoxaparin

B.Transfer for primary PCI regardless of the 4-hour transport delay

C.Conservative medical management with nitrates, beta-blockers, and delayed elective coronary angiography at 48 hours

D.Intravenous unfractionated heparin bolus alone without antiplatelet or fibrinolytic agents

Explanation: In ST-elevation myocardial infarction (STEMI), if primary PCI cannot be performed within 120 minutes from STEMI diagnosis, intravenous fibrinolytic therapy (e.g., tenecteplase weight-adjusted bolus) must be administered within 10 minutes (door-to-needle), provided there are no contraindications, followed by transfer to a PCI center (pharmacoinvasive strategy).

6According to international (ISH/WHO) and regional African cardiology guidelines, what is the recommended first-line pharmacological treatment for uncomplicated essential hypertension in Black African patients?

A.A calcium channel blocker (e.g., amlodipine) combined with a thiazide/thiazide-like diuretic (e.g., indapamide/hydrochlorothiazide) or an ARB

B.An ACE inhibitor (e.g., captopril) as initial monotherapy

C.A non-selective beta-blocker (e.g., propranolol) monotherapy

D.A centrally acting alpha-2 agonist (e.g., clonidine) monotherapy

Explanation: Black African hypertensive patients characteristically have low-renin, volume-dependent hypertension. Clinical trials (such as CREOLE) demonstrate that dual combination therapy with a dihydropyridine calcium channel blocker (CCB) plus a thiazide-like diuretic, or CCB plus an angiotensin receptor blocker (ARB), is significantly more effective at lowering blood pressure than ACE inhibitor or beta-blocker monotherapy.

7A 68-year-old female presents with acute fever (39.0°C), right pleuritic chest pain, rust-colored sputum, confusion (disoriented to time and place), respiratory rate of 34 breaths/min, blood pressure 85/55 mmHg, and blood urea nitrogen (BUN) of 9.2 mmol/L (CURB-65 score = 4). Chest radiograph confirms right lower lobe consolidation. What is the most appropriate management setting and initial empiric antibiotic regimen?

A.Immediate hospital admission (intensive care / high-dependency unit) and intravenous amoxicillin-clavulanate plus a macrolide (clarithromycin/azithromycin) or respiratory fluoroquinolone

B.Outpatient treatment with oral amoxicillin 1 g three times daily

C.Outpatient treatment with oral doxycycline 100 mg twice daily for 5 days

D.General ward admission with oral erythromycin 500 mg monotherapy

Explanation: A CURB-65 score of 4 indicates severe community-acquired pneumonia with high 30-day mortality risk (~27%), mandating urgent inpatient admission (often ICU) and dual intravenous antimicrobial therapy covering typical pathogens (Streptococcus pneumoniae) and atypicals (Legionella, Mycoplasma) using a beta-lactam/beta-lactamase inhibitor plus a macrolide or fluoroquinolone.

8A 24-year-old asthmatic patient is brought to the emergency room with acute severe dyspnea, inability to complete sentences in one breath, respiratory rate of 32/min, pulse 124 bpm, peak expiratory flow (PEF) 42% of predicted, and widespread expiratory wheezing. What is the cornerstone emergency medical therapy?

A.Supplemental oxygen to maintain SaO2 93–95%, repetitive nebulized short-acting beta-2 agonist (salbutamol) combined with ipratropium bromide, and early systemic corticosteroids (oral prednisolone or IV hydrocortisone)

B.Immediate intravenous theophylline infusion and subcutaneous adrenaline

C.Inhaled fluticasone monotherapy and oral montelukast

D.Immediate endotracheal intubation and mechanical ventilation without pharmacotherapy trial

Explanation: Acute severe asthma exacerbations require high-dose inhaled SABA (salbutamol 2.5–5 mg nebulized every 20 min) combined with an inhaled anticholinergic (ipratropium bromide 0.5 mg) and early administration of systemic corticosteroids (prednisolone 40–50 mg orally or hydrocortisone 100–200 mg IV) to resolve airway inflammation and bronchospasm.

9A 48-year-old male with known post-hepatitic B cirrhosis presents with massive hematemesis and melena. On examination: heart rate 118 bpm, blood pressure 85/50 mmHg, splenomegaly, and spider angiomas. After initiating hemodynamic resuscitation with packed red blood cells to maintain hemoglobin around 7–8 g/dL, which pharmacotherapy and endoscopic procedure must be promptly performed?

A.Intravenous vasoactive agent (terlipressin or octreotide) infusion, prophylactic IV ceftriaxone, and urgent upper gastrointestinal endoscopy for endoscopic variceal band ligation

B.Intravenous high-dose tranexamic acid, oral propranolol 40 mg, and barium swallow radiography

C.Immediate transjugular intrahepatic portosystemic shunt (TIPS) placement without diagnostic endoscopy

D.Sengstaken-Blakemore balloon tamponade as sole primary therapy for all cases

Explanation: Acute esophageal variceal hemorrhage requires immediate vasoactive therapy (terlipressin, somatostatin, or octreotide) to reduce splanchnic blood flow and portal pressure, short-term antibiotic prophylaxis (ceftriaxone 1 g/day) to prevent spontaneous bacterial peritonitis and rebleeding, and urgent diagnostic/therapeutic endoscopy within 12 hours for endoscopic band ligation (EBL).

10A 32-year-old healthcare worker presents with 10 days of fatigue, nausea, dark urine, and jaundice. Serum AST is 1,450 IU/L and ALT is 1,820 IU/L. Serological panel reveals: HBsAg positive, anti-HBc IgM positive, HBeAg positive, and anti-HBs negative. What is the precise diagnostic interpretation?

A.Acute hepatitis B virus infection with high viral replication

B.Chronic active hepatitis B virus infection with low infectivity

C.Resolved past hepatitis B infection with developed immunity

D.Successful hepatitis B vaccination response

Explanation: The presence of hepatitis B surface antigen (HBsAg) and hepatitis B core IgM antibody (anti-HBc IgM) is the diagnostic hallmark of acute hepatitis B infection. The presence of HBeAg reflects active viral replication and high infectivity.

About the Internat Médecine (Côte d'Ivoire) Exam

The Concours National d'Internat des Hôpitaux en Médecine is the prestigious national competitive examination in Côte d'Ivoire organized by the DEPPS/MSHPCMU to recruit hospital resident physicians for tertiary healthcare institutions and academic hospital careers.

Assessment

Two-phase written competition over 4 days under Arrêté n°00136 MSHP/CAB du 12 avril 2021 as modified by Arrêté n°00656/MSHPCMU/CAB du 26 avril 2024. Phase 1 (admissibilité): Épreuve Multidisciplinaire, 1 hour, 60 QCM/QCD, eliminatory below 15/30. Phase 2 (admission): Pathologie médicale, Pathologie chirurgicale, Biologie and Anatomie. Admission is by rank order against the posts opened by decree.

Time Limit

4 days of written examination sessions; the day-1 admissibility paper lasts 1 hour

Passing Score

Eliminatory 15/30 on the admissibility paper, then rank-order merit selection against the posts opened by decree (90 for 2025-2026: 81 nationals, 9 non-nationals). Officials have cited a working admission average of at least 12/20.

Exam Fee

50,000 FCFA candidacy fee (Arrêté n°00095/MSHPCMU/CAB du 18 mars 2026, art. 4) (Ministère de la Santé / DEPPS & MESRS (Côte d'Ivoire))

Internat Médecine (Côte d'Ivoire) Exam Content Outline

Phase 1

Épreuve Multidisciplinaire (eliminatory)

Day-1 filter: 1 hour, 60 QCM and QCD items spanning the whole syllabus. Below 15/30 the candidate is eliminated and never reaches the admission papers. No subject breakdown is published for this paper.

Phase 2

Pathologie Médicale

Infectious diseases (malaria, TB, HIV, meningitis), cardiology (STEMI, heart failure, hypertension), pulmonology, gastroenterology, nephrology, endocrinology, neurology, and pediatrics.

Phase 2

Pathologie Chirurgicale

Emergency abdominal surgery, peritonitis, bowel obstruction, trauma management, orthopedics, urology (torsion, retention), and obstetrics-gynecology (ectopic pregnancy, postpartum hemorrhage, eclampsia).

Phase 2

Anatomie

Cardiovascular, digestive, pelvic, and nervous system anatomy; vascular territories, celiac trunk, portal system, inguinal canal, brachial plexus, and surgical landmarks.

Phase 2

Biologie

Hematology, sickle cell disease, coagulopathies, acid-base and electrolyte disturbances, antimicrobial therapies, antimalarial protocols, analgesics, cardiovascular pharmacotherapy, and toxicities. The ministry names the four admission papers but publishes no coefficients, so the split of this bank across them is our editorial choice, not an official weighting.

How to Pass the Internat Médecine (Côte d'Ivoire) Exam

What You Need to Know

Passing score: Eliminatory 15/30 on the admissibility paper, then rank-order merit selection against the posts opened by decree (90 for 2025-2026: 81 nationals, 9 non-nationals). Officials have cited a working admission average of at least 12/20.
Assessment: Two-phase written competition over 4 days under Arrêté n°00136 MSHP/CAB du 12 avril 2021 as modified by Arrêté n°00656/MSHPCMU/CAB du 26 avril 2024. Phase 1 (admissibilité): Épreuve Multidisciplinaire, 1 hour, 60 QCM/QCD, eliminatory below 15/30. Phase 2 (admission): Pathologie médicale, Pathologie chirurgicale, Biologie and Anatomie. Admission is by rank order against the posts opened by decree.
Time limit: 4 days of written examination sessions; the day-1 admissibility paper lasts 1 hour
Exam fee: 50,000 FCFA candidacy fee (Arrêté n°00095/MSHPCMU/CAB du 18 mars 2026, art. 4)

Keys to Passing

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Internat Médecine (Côte d'Ivoire) Study Tips from Top Performers

1Master the national and WHO therapeutic protocols for high-prevalence tropical pathologies in Côte d'Ivoire, particularly severe malaria (IV artesunate protocol) and tuberculosis (GeneXpert-based diagnosis and 2RHZE/4RH regimens).

2Thoroughly review emergency surgical decision trees for acute peritonitis, strangulated hernia, mechanical bowel obstruction, and testicular torsion where surgical timing directly impacts survival.

3Memorize critical surgical anatomy landmarks including Calot's triangle, the inguinal canal layers, Scarpa's triangle neurovascular sequence (NAVEL), and the arterial circle of Willis.

4Practice interpreting laboratory abnormalities in emergency settings, including high anion gap metabolic acidosis, acute dyskalemias, and coagulation profiles in DIC.

5Review obstetric emergencies rigorously: management of postpartum hemorrhage (uterotonics, bimanual compression, balloon tamponade) and severe pre-eclampsia/eclampsia (IV magnesium sulfate loading and maintenance).

Frequently Asked Questions

What is the Concours National d'Internat de Médecine in Côte d'Ivoire?

The Concours National d'Internat de Médecine is the official state competitive examination organized by the Direction des Établissements Privés et des Professions Sanitaires (DEPPS) under the Ministère de la Santé, de l'Hygiène Publique et de la Couverture Maladie Universelle (MSHPCMU). It selects elite medical students to become hospital interns (Internes des Hôpitaux) in public university hospital centers (CHU) and specialized health institutes across Côte d'Ivoire.

Who is eligible to sit the medical internat competition?

Eligible candidates are medical students from accredited faculties (such as UFHB Abidjan, UAO Bouaké, San Pedro, and Korhogo) who have validated at least 11 semesters of medical studies (6th year / Doctorat 1) and who have not yet defended their state doctoral thesis in medicine.

What disciplines are tested during the competition?

Day 1 is a one-hour Épreuve Multidisciplinaire of 60 QCM and QCD items covering the whole syllabus; scoring below 15/30 eliminates the candidate. Those who pass sit four admission papers: Pathologie médicale, Pathologie chirurgicale, Biologie and Anatomie. The MSHPCMU names these papers but does not publish coefficients or percentage weightings for them.

What career opportunities follow success in the Internat?

Successful candidates are appointed as Internes des Hôpitaux for a four-year residency program, receiving specialized clinical immersion, a public hospital salary, and direct eligibility for academic hospital careers (Clinicat / Assistanat) and Diplôme d'Études Spécialisées (DES) specialty certifications.

Why is this question bank presented in English?

While the official examination in Côte d'Ivoire is sat in French, this question bank provides an English-language MCQ study adaptation aligned with the official national syllabus. It is designed to reinforce core diagnostic, pathophysiological, anatomical, and therapeutic concepts for candidates preparing for clinical assessments and international medical licensing standards.