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Key Facts: Internat en Pharmacie Exam

60 QCMs

Paper 1 theoretical multiple-choice test (1 h 30 min, Coef 2)

Arrêté du 12 avril 2012 modifié

5 Exercises

Paper 2 quantitative and analytical exercises (2 h 00 min, Coef 2)

Arrêté du 12 avril 2012 modifié

5 Dossiers

Paper 3 clinical and biological case studies (3 h 00 min, Coef 3)

Arrêté du 12 avril 2012 modifié

4 Years

Full-time hospital residency training leading to DES specialist qualification

Code de la santé publique (CSP)

The Concours National de l'Internat en Pharmacie is the French competitive residency examination organized annually by the CNG for 5th-year pharmacy students. Consisting of 60 QCMs, 5 application exercises, and 5 clinical dossiers over two days in Rungis, it ranks candidates nationally to assign 4-year DES residency training posts in Medical Biology, Hospital Pharmacy, and Pharmaceutical Research.

Sample Internat en Pharmacie Practice Questions

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1According to the Beer-Lambert law (A = ε · l · c), which factor directly explains a non-linear deviation observed at high analyte concentrations during UV-Visible spectrophotometric assays?

A.Linear decrease in the path length of the quartz cuvette during measurement

B.Intermolecular electrostatic interactions and changes in the medium refractive index

C.Spontaneous radiative emission of photons by unexcited ground-state molecules

D.Complete photodecomposition of the chromophore into non-absorbing radical fragments

Explanation: The Beer-Lambert law assumes independent behavior of absorbing species in dilute solutions (typically ≤ 0.01 M). At high solute concentrations, electrostatic interactions between neighboring absorbing molecules alter their electronic charge distribution, modifying the molar absorption coefficient (ε). Additionally, high concentrations cause noticeable shifts in the solution refractive index (n), introducing real physical deviations from linearity.

2In reversed-phase high-performance liquid chromatography (RP-HPLC) utilizing an octadecylsilyl (C18) stationary phase, what is the expected elution order for three drug molecules with increasing lipophilicity (Log P values: A = 0.5, B = 2.1, C = 4.3) using an isocratic water/acetonitrile mobile phase?

A.Compound C elutes first, followed by Compound B, then Compound A

B.Compound B elutes first, followed by Compound C, then Compound A

C.Compound A elutes first, followed by Compound B, then Compound C

D.All three compounds co-elute simultaneously regardless of their lipophilicity

Explanation: In reversed-phase HPLC, the stationary phase is non-polar (hydrophobic C18 alkyl chains) and the mobile phase is polar (aqueous buffer with organic modifier). Solutes partition between the phases based on hydrophobicity: more hydrophilic molecules with low Log P interact weakly with the C18 chains and elute earliest, whereas highly lipophilic molecules with high Log P partition strongly into the stationary phase and elute last (retention order: A < B < C).

3During the volumetric titration of a 0.1 M weak monoprotic acid (acetic acid, pKa = 4.76) with 0.1 M sodium hydroxide (NaOH), which pH indicator is the most appropriate for detecting the equivalence point?

A.Phenolphthalein (transition zone pH 8.2 – 10.0)

B.Methyl orange (transition zone pH 3.1 – 4.4)

C.Bromocresol green (transition zone pH 3.8 – 5.4)

D.Methyl red (transition zone pH 4.4 – 6.2)

Explanation: At the equivalence point of the titration of a weak acid by a strong base, the acid is completely converted into its conjugate base (sodium acetate). Acetate ions undergo basic hydrolysis in aqueous solution (CH3COO- + H2O ⇌ CH3COOH + OH-), yielding an alkaline equivalence pH (typically ~8.7 for 0.05 M acetate). Phenolphthalein has a visual transition zone between pH 8.2 and 10.0, perfectly encompassing this equivalence pH.

4Which statement accurately describes the operational principle and selectivity of a flame ionization detector (FID) used in capillary gas chromatography?

A.It measures changes in thermal conductivity of the carrier gas relative to a reference filament

B.It selectively captures thermal electrons to detect electronegative halogenated compounds with high sensitivity

C.It quantifies optical absorbance of organic vapors in the far-ultraviolet region inside a heated quartz cell

D.It combusts organic analytes in a hydrogen/air flame to produce CHO+ ions and free electrons collected by an electrode

Explanation: A flame ionization detector (FID) burns organic compounds exiting the GC column in a micro-flame of hydrogen and air. Hydrocarbon radicals react with excited oxygen atoms via chemi-ionization (e.g., CH• + O• → CHO+ + e-), producing ions that migrate toward a polarized collector electrode. The resulting micro-current is directly proportional to the mass flow rate of carbon atoms, providing universal, robust, and sensitive detection for carbon-containing organic analytes while remaining non-responsive to permanent gases (CO2, H2O, N2).

5Which atmospheric-pressure ionization technique in mass spectrometry is best suited for analyzing intact high-molecular-weight therapeutic proteins (e.g., monoclonal antibodies) because it readily forms multiply charged ions [M + nH]ⁿ⁺?

A.Electron ionization (EI)

B.Electrospray ionization (ESI)

C.Chemical ionization with methane (CI)

D.Fast atom bombardment (FAB)

Explanation: Electrospray ionization (ESI) is a soft, liquid-phase atmospheric pressure ionization method that transfers macromolecular solutes into the gas phase by nebulizing the solution into fine charged droplets under a high electric field. During solvent desolvation, large basic polypeptides and intact proteins acquire multiple protons at lysine, arginine, and histidine residues, forming multiply charged envelopes [M + nH]n+. Because the mass spectrometer measures the mass-to-charge ratio (m/z), multiple charging shifts large molecules (>100 kDa) into the standard detection range (m/z 1000–3000) of quadrupole or Orbitrap analyzers.

6According to the Nernst equation, what theoretical electrical potential change (slope factor) does a calibrated glass combination electrode produce for each variation of one pH unit at a standardized temperature of 25 °C (298.15 K)?

A.-29.58 mV per pH unit

B.-43.20 mV per pH unit

C.-59.16 mV per pH unit

D.-118.32 mV per pH unit

Explanation: The Nernst equation for a hydrogen ion indicator electrode is E = E0 - (2.3026 · R · T / F) · pH. At 25 °C (298.15 K), substituting the ideal gas constant R (8.314 J·mol-1·K-1), Faraday's constant F (96,485 C·mol-1), and absolute temperature T yields 2.3026 · (8.314 · 298.15) / 96,485 = 0.05916 V, or 59.16 mV. A one-unit change in pH therefore corresponds to a theoretical potential shift of approximately 59.16 mV.

7When a solution of an aromatic phenolic drug (such as paracetamol or salicylic acid) is adjusted from an acidic pH to a strongly alkaline pH (pH > 11), which spectroscopic modification is observed in its UV spectrum?

A.Bathochromic shift (red shift) to longer wavelengths accompanied by a hyperchromic effect

B.Hypsochromic shift (blue shift) to shorter wavelengths accompanied by complete loss of absorbance

C.Disappearance of all conjugated π → π* electronic transitions due to cleavage of the aromatic ring

D.Appearance of a sharp vibrational Rayleigh scattering peak without any wavelength shift

Explanation: Deprotonation of the phenolic hydroxyl group (-OH) in strongly alkaline solution converts it into a phenolate anion (-O-). The extra lone pair of electrons on the negatively charged oxygen conjugates more extensively with the aromatic π-system (+M mesomeric effect), narrowing the energy gap between the highest occupied molecular orbital (HOMO) and the lowest unoccupied molecular orbital (LUMO). This reduced transition energy causes a shift to longer wavelengths (bathochromic or red shift), typically accompanied by an increased molar absorptivity (hyperchromic effect).

8Which statement correctly distinguishes the international HbA1c diagnostic threshold from routine French diagnostic practice?

A.France diagnoses diabetes from any HbA1c above 5.7%, without confirmation.

B.HbA1c is never standardized and therefore has no diagnostic use anywhere.

C.France and every international body require HbA1c above 8.0% as the sole test.

D.Several international criteria use HbA1c at or above 6.5% (48 mmol/mol) when valid and confirmed, while routine French diagnosis remains based on venous plasma glucose.

Explanation: WHO and several international organizations recognize HbA1c at or above 6.5% (48 mmol/mol) as a diagnostic threshold when the assay is standardized and no condition invalidates it, with confirmation in an asymptomatic person. French routine diagnostic criteria continue to use venous plasma glucose; HbA1c is mainly used for follow-up. The former item incorrectly attributed the HbA1c diagnostic rule to HAS as if it were uniform French practice.

9Which fundamental physiological distinction explains why the CKD-EPI equation is preferred over the Cockcroft-Gault formula for staging chronic kidney disease in clinical laboratory practice?

A.Cockcroft-Gault requires a mandatory 24-hour urine collection, whereas CKD-EPI is calculated from a capillary blood drop

B.CKD-EPI provides an estimated glomerular filtration rate standardized to body surface area (mL/min/1.73 m²), whereas Cockcroft-Gault estimates unindexed creatinine clearance (mL/min)

C.Cockcroft-Gault uses serum cystatin C concentrations, whereas CKD-EPI uses serum beta-2 microglobulin

D.CKD-EPI is unaffected by extreme body surface area and amputations because it ignores age and biological sex

Explanation: The CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation was developed using standardized IDMS serum creatinine measurements and expresses glomerular filtration rate indexed to a standard body surface area of 1.73 m² (mL/min/1.73 m²), making it the gold standard for CKD staging across diverse populations. In contrast, the historical Cockcroft-Gault formula estimates creatinine clearance in absolute volumetric flow (mL/min) and incorporates actual patient body weight without surface area indexing, making it useful primarily for legacy pharmacokinetics drug dosing rather than disease staging.

10A patient presents to the emergency department with deep, rapid respirations (Kussmaul breathing). Blood gas reveals: pH 7.22, HCO3⁻ 10 mmol/L, PaCO2 25 mmHg, Na⁺ 140 mmol/L, Cl⁻ 98 mmol/L. What is the calculated plasma anion gap, and which etiology is most consistent with this presentation?

A.Anion gap 14 mmol/L; hyperchloremic acidosis secondary to severe secretory diarrhea

B.Anion gap 22 mmol/L; renal tubular acidosis type 2 (proximal bicarbonate wasting)

C.Anion gap 32 mmol/L; high anion gap metabolic acidosis secondary to diabetic ketoacidosis or lactic acidosis

D.Anion gap 42 mmol/L; respiratory acidosis with incomplete renal metabolic compensation

Explanation: The plasma anion gap is calculated as [Na+] - ([Cl-] + [HCO3-]). Here, 140 - (98 + 10) = 32 mmol/L, which is markedly elevated above the reference physiological range (8–16 mmol/L). An elevated anion gap metabolic acidosis reflects the accumulation of unmeasured fixed organic or inorganic anions, such as acetoacetate/beta-hydroxybutyrate in diabetic ketoacidosis, lactate in tissue hypoperfusion, or exogenous toxic acids (methanol, ethylene glycol). The patient's Kussmaul breathing represents respiratory compensation (hyperventilation lowering PaCO2 to 25 mmHg).

About the Internat en Pharmacie Exam

The Concours National de l'Internat en Pharmacie is the national competitive examination selecting eligible pharmacy students for postgraduate DES positions. Governed by the Arrêté du 12 avril 2012 modifié and the annual CNG opening order, it comprises 60 multiple-choice questions, five application exercises, and five therapeutic and biological dossiers.

Exam sponsor: Centre National de Gestion (CNG) des praticiens hospitaliers et des personnels de direction du service public hospitalier. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Written competitive examination sat over two consecutive days in Rungis: Paper 1 (1 h 30 min, coef 2) features 60 QCMs covering the entire national syllabus; Paper 2 (2 h 00 min, coef 2) features 5 application exercises covering analytical chemistry, pharmacokinetics, biostatistics, and biochemistry; Paper 3 (3 h 00 min, coef 3) features 5 clinical dossiers integrating pharmacology, therapeutics, and medical biology.

Time Limit

Three written papers over 2 days: Épreuve 1 (1 h 30 min), Épreuve 2 (2 h 00 min), Épreuve 3 (3 h 00 min)

Passing Score

Competitive rank-based merit list (concours classant); candidates choose their specialty (DES de Biologie Médicale, DES de Pharmacie Hospitalière, or DES IPR) and regional training subdivison in strict order of national merit rank

Exam / Certification Fees

No separate examination fee is stated in the current national rules or opening order

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

25%

Chimie, Biochimie et Biologie Cellulaire / Moléculaire

Analytical chemistry (spectroscopy, chromatographic separations, volumetric titrations), clinical enzymology, dyslipidemias, diabetes mellitus monitoring, renal and liver function panels, acid-base homeostasis, molecular genetics, and cellular signaling.

25%

Microbiologie, Immunologie et Hématologie

Medical bacteriology, resistance mechanisms (ESBL, carbapenemases, MRSA), viral infections (hepatitis B/C, HIV, CMV, EBV), fungal and parasitic pathogens (malaria, toxoplasmosis, candidiasis), clinical immunology, anemias, acute and chronic leukemias, and hemostasis.

25%

Pharmacologie, Toxicologie et Pharmacocinétique

Cardiovascular pharmacotherapy, psychotropics, antineoplastic agents, anti-infectives, endocrine pharmacology, fundamental and clinical pharmacokinetics (ADME, clearance, half-life, therapeutic drug monitoring), cytochrome P450 interactions, toxicological mechanisms, and acute poisoning management.

25%

Pharmacie Clinique, Pharmacie Hospitalière et Santé Publique

Hospital pharmacy organization (PUI), sterile preparation and isolators, sterilization technology, medical devices (DMs) and biocompatibility, pharmacovigilance, addictovigilance, clinical trial phases and Good Clinical Practice (GCP), health technology assessment, and epidemiological indicators.

Preparing for the Internat en Pharmacie Exam

What You Need to Know

Passing score: Competitive rank-based merit list (concours classant); candidates choose their specialty (DES de Biologie Médicale, DES de Pharmacie Hospitalière, or DES IPR) and regional training subdivison in strict order of national merit rank
Assessment: Written competitive examination sat over two consecutive days in Rungis: Paper 1 (1 h 30 min, coef 2) features 60 QCMs covering the entire national syllabus; Paper 2 (2 h 00 min, coef 2) features 5 application exercises covering analytical chemistry, pharmacokinetics, biostatistics, and biochemistry; Paper 3 (3 h 00 min, coef 3) features 5 clinical dossiers integrating pharmacology, therapeutics, and medical biology.
Time limit: Three written papers over 2 days: Épreuve 1 (1 h 30 min), Épreuve 2 (2 h 00 min), Épreuve 3 (3 h 00 min)
Exam / certification fees: No separate examination fee is stated in the current national rules or opening order Official sources

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Internat en Pharmacie: Suggested Study Strategy

1Master high-yield calculation algorithms for Paper 2: practice one-compartment and two-compartment pharmacokinetics (Css, Vd, Cl, Ke, t1/2, loading dose), analytical spectroscopy (Beer-Lambert, standard additions), stoichiometry, and dilution formulas until they become second nature.

2Thoroughly memorize French clinical practice guidelines (HAS, ANSM, SFPC) for first-line therapies, contraindications, and monitoring parameters across cardiology, diabetes, oncology, and anti-infectives.

3Integrate biological and clinical reasoning for Paper 3: practice analyzing laboratory panels (hemogram, hemostasis, ionogram, liver enzymes, CSF analysis, blood cultures) in conjunction with patient co-morbidities and drug regimens.

4Pay meticulous attention to antimicrobial resistance mechanisms (ESBL, OXA-48, KPC, VanA, mecA) and French therapeutic guidelines for sepsis, pyelonephritis, endocarditis, and meningitis.

5Review hospital pharmacy regulations: requirements for pharmacy preparation units (PUI), Good Preparation Practices (BPF / Bonnes Pratiques de Préparation), medical device classes (MDR 2017/745), and pharmacovigilance notification timelines.

Frequently Asked Questions

What is the Concours National de l'Internat en Pharmacie?

It is the national competitive postgraduate examination organized in France by the Centre National de Gestion (CNG) that enables pharmacy students at the end of their 5th year (DFASP2) to access 4-year hospital residency training programs (DES) leading to careers in hospital pharmacy, clinical biology, and pharmaceutical research.

Which specialties (DES) are accessible through the Internat en Pharmacie?

Laureates can choose among three Diplômes d'Études Spécialisées (DES): DES de Biologie Médicale (medical biology, polyvalent or specialized, shared with medicine), DES de Pharmacie Hospitalière (hospital pharmacy, clinical pharmacy, sterile compounding, radiopharmacy), and DES IPR (Innovations Pharmaceutiques et Recherche).

How is the competition structured and scored?

The examination takes place over 2 days in December at Espace Jean Monnet in Rungis and comprises three papers: Épreuve 1 (60 QCMs, 1 h 30 min, coef 2), Épreuve 2 (5 application exercises, 2 h 00 min, coef 2), and Épreuve 3 (5 therapeutic and biological dossiers, 3 h 00 min, coef 3). All marks are totaled without qualifying cutoffs, producing a national rank-order list.

Are there registration fees for the competition?

The current national rules and opening order do not state a separate examination fee. Candidates should rely on the current CNG registration notice rather than assume a universal charge or exemption.

Which official regulation defines the syllabus and examination rules?

The competition programme and examination framework are governed by the Arrêté du 12 avril 2012 modifié, together with the current annual opening order published for the session.