Free Practice Questions for MDCG Pre-Registration Assessment
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Sample MDCG Pre-Registration Assessment Practice Questions
Try these sample questions to review concepts for the MDCG Pre-Registration Assessment exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A 28-year-old male farmer in Brikama presents to the outpatient clinic with a 3-day history of high intermittent fevers, chills, profuse sweating, headache, and generalized body aches. Physical examination reveals a temperature of 38.8°C, mild pallor, and no signs of altered mental state, respiratory distress, or severe jaundice. A rapid diagnostic test (RDT) and Giemsa-stained thick blood smear confirm Plasmodium falciparum malaria with a parasite density of 1.2%. According to national clinical guidelines in The Gambia, which of the following is the recommended first-line therapy for this patient?
2A 34-year-old female is brought to the emergency department of Edward Francis Small Teaching Hospital (EFSTH) in Banjul with a 4-day history of deteriorating febrile illness, confusion, and generalized tonic-clonic seizures. On examination, she is comatose (Glasgow Coma Scale score 7/15), deeply jaundiced, tachypneic (respiratory rate 32 breaths/min), and anuric for the past 12 hours. A thick blood film reveals Plasmodium falciparum trophozoites with a 9% parasitemia. What is the immediate drug of choice for parenteral antimalarial therapy?
3A 42-year-old male carpenter presents to a divisional health centre in Basse with a 4-week history of productive cough, evening fevers, drenching night sweats, anorexia, and involuntary weight loss of 6 kg. Physical examination reveals bronchial breathing in the right upper zone and apical crepitations. Sputum GeneXpert MTB/RIF assay demonstrates Mycobacterium tuberculosis with no rifampicin resistance detected. What is the standard national regimen for this patient's newly diagnosed drug-susceptible pulmonary tuberculosis?
4A 36-year-old male with known advanced HIV disease (baseline CD4 count 38 cells/μL) who defaulted on antiretroviral therapy presents with a 2-week history of progressively worsening headache, low-grade fever, neck stiffness, and photophobia. Neurological examination reveals neck rigidity and positive Kernig's sign without focal neurological deficits. Lumbar puncture reveals clear cerebrospinal fluid (CSF) with an opening pressure of 280 mm H₂O, lymphocytic pleocytosis (45 cells/μL), elevated protein (1.2 g/L), low glucose (1.6 mmol/L), and India ink preparation demonstrating numerous encapsulated budding yeast cells. Which of the following represents the preferred first-line induction antifungal regimen?
5A 48-year-old male teacher undergoes pre-employment health screening in Serekunda. Serology reveals that he is hepatitis B surface antigen (HBsAg) positive, hepatitis B e-antigen (HBeAg) positive, and antibody to hepatitis C virus (anti-HCV) negative. Quantitative real-time PCR reveals a serum HBV DNA level of 85,000 IU/mL. Serum alanine aminotransferase (ALT) is 98 U/L (more than twice the upper limit of normal), and transient elastography demonstrates significant liver fibrosis (stage F2). Which of the following is the most appropriate first-line antiviral monotherapy for this patient?
6A 16-year-old boy living in a village bordering the River Gambia in the Central River Region presents with a 2-month history of recurrent, painless terminal hematuria and mild dysuria. He frequently swims and fishes in local freshwater streams. Physical examination is unremarkable. Microscopic examination of centrifuged urine sediment reveals characteristic elongated eggs with a prominent terminal spine. What is the definitive treatment of choice for this parasitic infection?
7A 24-year-old university student in Kanifing presents to the emergency department with acute-onset high fever, severe throbbing headache, neck stiffness, photophobia, and a petechial/purpuric skin rash on the lower extremities. Vital signs include blood pressure 100/60 mmHg, heart rate 116 bpm, and temperature 39.5°C. Lumbar puncture yields turbid CSF with an opening pressure of 260 mm H₂O, white blood cell count of 3,200/μL (92% neutrophils), protein of 2.8 g/L, and CSF glucose of 1.1 mmol/L (simultaneous blood glucose 5.8 mmol/L). Gram stain demonstrates Gram-negative bean-shaped diplococci. Which empirical antimicrobial therapy is most appropriate?
8A 30-year-old female presents with a 10-day history of step-ladder pattern fever, persistent frontal headache, anorexia, dry cough, and constipation followed by watery greenish ('pea-soup') diarrhea. Physical examination reveals a toxic-appearing woman with a temperature of 39.8°C and a pulse rate of 74 bpm (relative bradycardia). Faint, blanching erythematous macules ('rose spots') are noted on her upper abdomen, and palpation reveals mild splenomegaly. Which diagnostic investigation provides the highest sensitivity for confirming enteric (typhoid) fever during this second week of illness?
9A 55-year-old Gambian male with no past medical history attends an outpatient clinic for routine assessment. His blood pressure measurements on three separate occasions over 4 weeks average 154/96 mmHg. Physical examination, fundoscopy, ECG, serum creatinine (78 μmol/L), and urinalysis are completely normal, and he has no history of diabetes mellitus. According to standard WHO and international hypertension guidelines for individuals of African descent, which of the following is the preferred first-line pharmacological monotherapy?
10A 62-year-old male with a history of anterior myocardial infarction 2 years ago presents with progressively worsening exertional dyspnea, orthopnea requiring three pillows, and paroxysmal nocturnal dyspnea. On physical examination, his jugular venous pressure (JVP) is elevated to 6 cm above the sternal angle, bibasilar lung crackles are audible, and there is 2+ pitting bilateral pedal edema. Transthoracic echocardiography reveals a dilated left ventricle with an ejection fraction of 28% (HFrEF). He is started on oral furosemide 40 mg daily for symptom relief. Which of the following combinations represents the core evidence-based disease-modifying therapy proven to reduce long-term cardiovascular mortality in HFrEF?
About the MDCG Pre-Registration Assessment Exam
The Medical and Dental Council of The Gambia (MDCG) Pre-Registration Assessment is the Council's Assessment of Medical and Dental Competence, run under the mandate the Medical and Dental Practitioners Act 1988 gives the MDCG to regulate medical and dental practice in The Gambia. It applies to applicants whose primary medical or dental qualification comes from a country where the Council has no prior experience of assessing graduates' competence, and the Council reserves the discretion to select which countries and facilities are covered. The assessment ensures that practitioners entering the health system demonstrate the diagnostic competence, clinical judgment, procedural safety, and ethical conduct required to deliver safe patient care across Gambian hospitals and health centres.
Exam sponsor: Medical and Dental Council of The Gambia (MDCG). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.
Assessment
The assessment is organised into three parts. Part 1 is a single 3-hour written paper of 200 multiple-choice questions on basic and clinical sciences; the MDCG names the clinical sciences as internal medicine, obstetrics and gynaecology, paediatrics, general surgery, therapeutics, and dentistry for candidates who will practise dentistry. An applicant is invited to Parts 2 and 3 only after scoring 50% or more on the written paper. Part 2 is a 2-hour clinical skills assessment in which the applicant reviews 10 clinical cases, demonstrating specific clinical skills and answering questions on each. Part 3 is an oral assessment in which a Panel of Assessors interviews the applicant on managing different clinical scenarios. A pass mark of 50% in each of the three parts is required for the MDCG Certificate of Competence. The MDCG does not publish percentage weightings for any written-paper subject.
Time Limit
3 hours for the Part 1 written paper; 2 hours for the Part 2 clinical skills assessment
Passing Score
50% in each part (50% on written paper required to advance to clinical and oral parts)
Exam / Certification Fees
Published by the MDCG as a scanned fee schedule on its Fees and Charges page; paid into the Council's Standard Chartered Bank Gambia Limited account (GMD or USD) with the pay-in slip uploaded to the application
Exam sponsor websiteFees, 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.
Internal Medicine
An MDCG-named written-paper subject. Covers infectious diseases prevalent in West Africa (malaria, tuberculosis, HIV, viral hepatitis, schistosomiasis, meningitis, typhoid), cardiovascular disorders (hypertension, heart failure, acute coronary syndromes), respiratory illnesses, nephrology, and endocrinology.
Obstetrics and Gynaecology
An MDCG-named written-paper subject. Covers antenatal care protocols, pre-eclampsia and eclampsia management, postpartum haemorrhage, obstructed labour, maternal sepsis, neonatal transition, contraception, and common gynaecological pathology.
Paediatrics and Child Health
An MDCG-named written-paper subject. Covers neonatal resuscitation, the Gambian EPI vaccination schedule, severe acute malnutrition (kwashiorkor, marasmus), childhood dehydration and ORS/zinc management, acute respiratory infections, paediatric malaria, and sickle cell disease.
General Surgery and Emergency Care
An MDCG-named written-paper subject. Covers acute abdomen diagnosis (appendicitis, peritonitis, bowel obstruction), initial trauma assessment (ATLS ABCDE approach), burn resuscitation using the Parkland formula, surgical asepsis, and wound care.
Therapeutics and Clinical Pharmacology
An MDCG-named written-paper subject. Covers rational prescribing, essential medicines usage, antimicrobial selection and stewardship, paediatric dosing calculations, adverse drug reactions, and critical drug interactions.
Medical Ethics, Jurisprudence, and Public Health
Supporting study rather than an MDCG-listed written-paper subject; aimed at the Part 3 oral assessment and at practising under Gambian registration. Covers the Medical and Dental Practitioners Act 1988, the WAHO-ECOWAS Harmonised Codes of Ethics and Practice issued by the MDCG, patient confidentiality, informed consent, medical negligence, notifiable infectious diseases, and epidemic disease surveillance.
Preparing for the MDCG Pre-Registration Assessment Exam
What You Need to Know
- Passing score: 50% in each part (50% on written paper required to advance to clinical and oral parts)
- Assessment: The assessment is organised into three parts. Part 1 is a single 3-hour written paper of 200 multiple-choice questions on basic and clinical sciences; the MDCG names the clinical sciences as internal medicine, obstetrics and gynaecology, paediatrics, general surgery, therapeutics, and dentistry for candidates who will practise dentistry. An applicant is invited to Parts 2 and 3 only after scoring 50% or more on the written paper. Part 2 is a 2-hour clinical skills assessment in which the applicant reviews 10 clinical cases, demonstrating specific clinical skills and answering questions on each. Part 3 is an oral assessment in which a Panel of Assessors interviews the applicant on managing different clinical scenarios. A pass mark of 50% in each of the three parts is required for the MDCG Certificate of Competence. The MDCG does not publish percentage weightings for any written-paper subject.
- Time limit: 3 hours for the Part 1 written paper; 2 hours for the Part 2 clinical skills assessment
- Exam / certification fees: Published by the MDCG as a scanned fee schedule on its Fees and Charges page; paid into the Council's Standard Chartered Bank Gambia Limited account (GMD or USD) with the pay-in slip uploaded to the application Official sources
Using Our Practice Resources
- Work through all 100 available questions
- Review every answer and explanation
- Track weak areas and revisit them
- Use our AI tutor for tough concepts
MDCG Pre-Registration Assessment: Suggested Study Strategy
Frequently Asked Questions
What is the MDCG Pre-Registration Assessment?
It is the Assessment of Medical and Dental Competence conducted by the Medical and Dental Council of The Gambia for doctors and dentists holding a primary qualification from a country where the Council has no prior experience of assessing the competence of graduates from its training institutions. The Council selects which countries and facilities are subject to it, so it is not required of every internationally trained applicant.
What is the format and structure of the MDCG assessment?
The assessment comprises three parts: Part 1 is a single 3-hour written paper of 200 multiple-choice questions on basic and clinical sciences (internal medicine, obstetrics and gynaecology, paediatrics, general surgery, therapeutics, and dentistry for dental candidates); Part 2 is a 2-hour clinical skills assessment across 10 clinical cases; and Part 3 is an oral assessment in which a Panel of Assessors interviews the applicant on managing clinical scenarios.
Is this practice test an official MDCG paper?
No. This free 100-question bank is an independent English-language study aid written from the MDCG's published assessment policy and the clinical guidelines that policy's subjects rest on. It is not produced or endorsed by the Council and does not reproduce the official 200-item paper. It can rehearse the knowledge and judgement that Parts 2 and 3 draw on, but no MCQ set can simulate a bedside clinical skills assessment or an oral panel interview.
What is the passing score required to obtain registration?
Candidates must achieve at least 50% on the Part 1 written examination to be invited to participate in the clinical skills assessment and oral interview. Candidates must score at least 50% in each of the three individual parts to be awarded the Certificate of Competence.
What is the retake policy if a candidate fails?
The MDCG policy states that an applicant who fails will only be allowed to re-sit the assessment after six months, and that an applicant may have unlimited attempts at the assessment.
What language is the assessment conducted in?
English. It is the official language of The Gambia and the language of medical training and clinical practice there, and the MDCG publishes its assessment policy, registration guidance, and application forms in English. This practice bank is likewise in English.
How are fees paid for the assessment?
Payment is made into the Medical and Dental Council of The Gambia accounts at Standard Chartered Bank Gambia Limited (GMD account 0100130242800 or USD account 8700130242800, SWIFT SCBLGMGM), and the bank pay-in slip is uploaded with the online application. The Council publishes its fee schedule as scanned tables on its Fees and Charges page; confirm the current amount with the MDCG before paying.