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100+ Free HKMLE Part I Practice Questions

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2025 Part I: 16% in first sitting and 16% in second sitting Pass Rate
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A child has recurrent chest infections, failure to thrive and bulky greasy stools. Which test is most appropriate to support the likely diagnosis?

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2026 Statistics

Key Facts: HKMLE Part I Exam

240 MCQs

Official Part I question count

MCHK Part I format

2 papers

Paper I and Paper II

MCHK Part I format

3h 30m each

Time per paper

MCHK Part I format

60% total

Overall passing criterion

MCHK Part I passing criteria

50% each

Minimum per-paper mark

MCHK Part I passing criteria

HK$3,220

Part I examination fee

MCHK 2026 guidance notes

16%

Latest published Part I pass rate in each 2025 sitting

MCHK examination statistics

HKMLE Part I is a 240-question professional knowledge exam administered by the Medical Council of Hong Kong. Paper I covers Basic Sciences, Medicine, Psychiatry and Paediatrics; Paper II covers Basic Sciences, Medical Ethics/Community Medicine, Surgery, Orthopaedic Surgery and Obstetrics & Gynaecology. Candidates receive 3 hours 30 minutes per paper, and passing requires at least 50% in each paper plus 60% overall.

Sample HKMLE Part I Practice Questions

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

1A patient presents 10 hours after ingesting a large amount of paracetamol. Which mechanism best explains why N-acetylcysteine is given?
A.It replenishes glutathione to detoxify NAPQI
B.It blocks cyclooxygenase-mediated renal vasoconstriction
C.It chelates salicylate and increases urinary excretion
D.It reverses opioid receptor agonism in the brainstem
Explanation: Paracetamol overdose generates the toxic metabolite NAPQI when normal conjugation pathways are saturated. N-acetylcysteine replenishes glutathione stores so NAPQI can be detoxified and hepatic injury reduced, especially when started early.
2A man has shoulder trauma with weakness abducting the arm from 15 to 90 degrees and numbness over the lateral deltoid area. Which nerve is most likely injured?
A.Axillary nerve
B.Radial nerve
C.Suprascapular nerve
D.Long thoracic nerve
Explanation: The axillary nerve supplies the deltoid and teres minor and carries sensation from the regimental badge area. It is vulnerable in surgical neck of humerus fractures and anterior shoulder dislocation.
3Spirometry in a wheezy patient shows reduced FEV1/FVC that improves significantly after salbutamol. Which interpretation is most appropriate?
A.Reversible obstructive ventilatory defect
B.Fixed restrictive ventilatory defect
C.Normal spirometry with poor effort only
D.Isolated diffusion impairment
Explanation: A low FEV1/FVC indicates airflow obstruction. Significant bronchodilator reversibility supports asthma or another reversible obstructive process rather than restriction.
4A man with known G6PD deficiency develops jaundice and dark urine after taking an oxidant drug. Blood film shows bite cells. What is the main pathophysiology?
A.Impaired NADPH production causing oxidative red-cell damage
B.Defective alpha-globin chain synthesis
C.Autoantibody-mediated warm haemolysis
D.Mechanical shearing across a prosthetic valve
Explanation: G6PD generates NADPH, which keeps glutathione reduced inside red cells. Without adequate NADPH, oxidant stress denatures haemoglobin into Heinz bodies, which are removed by splenic macrophages to create bite cells.
5Which antimicrobial mechanism is correctly matched with the drug?
A.Vancomycin binds D-Ala-D-Ala and inhibits cell-wall synthesis
B.Aminoglycosides inhibit folate synthesis
C.Macrolides block bacterial DNA gyrase
D.Beta-lactams inhibit the 50S ribosomal subunit
Explanation: Vancomycin binds the D-Ala-D-Ala terminus of peptidoglycan precursors, blocking cell-wall polymerisation. This is clinically important for many Gram-positive infections including MRSA when susceptible.
6A patient with nephrotic syndrome has ankle oedema, heavy proteinuria, low serum albumin and hyperlipidaemia. Which mechanism best explains the oedema?
A.Loss of plasma oncotic pressure from urinary albumin loss
B.Increased albumin production by the liver
C.Reduced capillary hydrostatic pressure
D.Primary lymphatic obstruction of both legs
Explanation: Heavy urinary protein loss lowers plasma albumin and oncotic pressure, allowing fluid to shift into the interstitial space. Renal sodium retention can further worsen oedema.
7An elderly patient with chronic kidney disease is prescribed gentamicin for severe Gram-negative sepsis. Which prescribing principle is most important?
A.Adjust dosing and monitor levels because aminoglycosides are renally cleared
B.Avoid all drug-level monitoring because peak levels are unreliable
C.Give a fixed adult dose because aminoglycosides are hepatically metabolised
D.Combine with another nephrotoxin to prevent resistance
Explanation: Aminoglycosides are primarily renally cleared and can cause nephrotoxicity and ototoxicity. In older patients and renal impairment, dosing interval and drug levels must be monitored carefully.
8A patient develops fever, flank pain, hypotension and haemoglobinuria shortly after a blood transfusion is started. What is the immediate action?
A.Stop the transfusion and maintain IV access with normal saline
B.Slow the transfusion and prescribe an antihistamine
C.Continue the transfusion with furosemide cover
D.Restart the same unit after symptoms settle
Explanation: This is an acute haemolytic transfusion reaction until proven otherwise. Stop the transfusion immediately, maintain venous access with normal saline, support circulation, and notify the blood bank for investigation.
9A 58-year-old man presents 45 minutes after crushing central chest pain. ECG shows ST elevation in II, III and aVF. What is the best immediate reperfusion strategy if available promptly?
A.Primary percutaneous coronary intervention
B.Outpatient treadmill testing
C.Elective coronary CT in 6 weeks
D.High-dose oral nitrate therapy alone
Explanation: Inferior STEMI requires immediate reperfusion, and primary PCI is preferred where it can be delivered promptly. Aspirin and antithrombotic therapy are given, but definitive reperfusion should not be delayed.
10A 76-year-old woman with hypertension and diabetes has persistent non-valvular atrial fibrillation. What is the main reason to offer long-term oral anticoagulation if there is no contraindication?
A.To reduce cardioembolic stroke risk
B.To convert atrial fibrillation to sinus rhythm
C.To prevent infective endocarditis
D.To treat symptomatic bradycardia
Explanation: Older age, hypertension and diabetes give this patient a high CHA2DS2-VASc score, so anticoagulation reduces embolic stroke risk. Anticoagulation does not itself restore sinus rhythm.

About the HKMLE Part I Exam

HKMLE Part I is the Medical Council of Hong Kong Licensing Examination in Professional Knowledge for eligible non-local medical graduates and other eligible applicants under the Medical Registration Ordinance. It tests basic sciences, medicine, surgery, orthopaedic surgery, psychiatry, paediatrics, obstetrics and gynaecology, and medical ethics/community medicine through two 120-MCQ papers.

Assessment

Paper I: Basic Sciences 10, Medicine 60, Psychiatry 15, Paediatrics 35. Paper II: Basic Sciences 10, Surgery 45, Orthopaedic Surgery 15, Obstetrics and Gynaecology 35, Medical Ethics/Community Medicine 15. Official items have five options; this practice bank uses four options to match the site format.

Time Limit

3 hours 30 minutes per paper; two papers for Part I

Passing Score

50% in each paper and 60% total across both papers

Exam Fee

HK$1,590 application fee plus HK$3,220 Part I examination fee, subject to prevailing rates on date of payment (Licentiate Committee of the Medical Council of Hong Kong)

HKMLE Part I Exam Content Outline

25%

Medicine

60 of 240 official MCQs across cardiology, endocrinology, gastroenterology, haematology, nephrology, neurology, respiratory medicine, rheumatology, infectious diseases, geriatrics, dermatology and clinical pharmacology.

18.75%

Surgery

45 of 240 official MCQs across emergency and elective surgical topics including breast, colorectal, hepatobiliary, endocrine, upper GI, neurosurgery, urology, vascular and trauma care.

14.6%

Paediatrics

35 of 240 official MCQs covering neonatal jaundice, respiratory illness, infection, renal disease, development, safeguarding, vaccination and paediatric emergencies.

14.6%

Obstetrics and Gynaecology

35 of 240 official MCQs covering antenatal complications, labour emergencies, postpartum problems, gynaecological infection, acute pelvic pain and malignancy.

8.3%

Basic Sciences

20 of 240 official MCQs across pre-clinical disciplines such as anatomy, pharmacology, physiology, pathology and microbiology.

6.25%

Psychiatry

15 of 240 official MCQs covering mood disorders, psychosis, substance withdrawal, anxiety/OCD, emergencies and psychopharmacology.

6.25%

Orthopaedic Surgery

15 of 240 official MCQs covering fractures, septic arthritis, spinal emergencies, paediatric orthopaedics, open fractures and compartment syndrome.

6.25%

Medical Ethics and Community Medicine

15 of 240 official MCQs covering epidemiology, screening, Hong Kong public health, confidentiality, consent, medical records and relevant Hong Kong medical legislation.

How to Pass the HKMLE Part I Exam

What You Need to Know

  • Passing score: 50% in each paper and 60% total across both papers
  • Assessment: Paper I: Basic Sciences 10, Medicine 60, Psychiatry 15, Paediatrics 35. Paper II: Basic Sciences 10, Surgery 45, Orthopaedic Surgery 15, Obstetrics and Gynaecology 35, Medical Ethics/Community Medicine 15. Official items have five options; this practice bank uses four options to match the site format.
  • Time limit: 3 hours 30 minutes per paper; two papers for Part I
  • Exam fee: HK$1,590 application fee plus HK$3,220 Part I examination fee, subject to prevailing rates on date of payment

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

HKMLE Part I Study Tips from Top Performers

1Use the official MCHK topic list as your checklist; it is broad and explicitly says topics may appear across disciplines.
2Prioritise Medicine first because it is 60 of 240 questions, then Surgery, Paediatrics and Obstetrics & Gynaecology.
3Practise emergency recognition: STEMI, sepsis, cholangitis, ectopic pregnancy, shoulder dystocia, paediatric airway emergencies, cauda equina and compartment syndrome.
4Review Hong Kong-specific professional duties including notifiable infectious disease reporting, MCHK confidentiality standards, consent and medical record keeping.
5For pharmacology, focus on safe prescribing in pregnancy, renal impairment, older adults, antimicrobials, anticoagulation and antidotes.
6Use explanations actively: for each missed question, identify the clinical clue that separates the correct option from plausible distractors.

Frequently Asked Questions

Does HKMLE Part I exist?

Yes. MCHK and the Licensing Examination Information Portal describe Part I as the Examination in Professional Knowledge, one of three parts of the Licensing Examination.

How many questions are on HKMLE Part I?

The official Part I exam has two papers, each with 120 multiple-choice questions, for 240 MCQs total.

How long is HKMLE Part I?

Candidates are given 3 hours 30 minutes for Paper I and 3 hours 30 minutes for Paper II.

What is the passing score for HKMLE Part I?

MCHK states that candidates pass Part I with a total mark of 60% or above across the two papers, provided each paper is at least 50%.

How much does HKMLE Part I cost?

The 2026 MCHK guidance lists a HK$1,590 application fee and HK$3,220 Part I examination fee, subject to prevailing rates on date of payment.

What subjects are tested?

The Part I syllabus covers basic sciences, medicine, surgery, orthopaedic surgery, psychiatry, paediatrics, obstetrics and gynaecology, medical ethics/community medicine, and related areas including emergency medicine, radiology, ENT and ophthalmology.

Are official HKMLE Part I questions in this bank?

No. These are original practice questions. Official sample questions were consulted only to understand format style and were not copied.