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Exam Review

Key Facts: Iraqi Board Emergency Medicine Exam

IBMS / MOHESR

Governing Body & Ministry

Iraqi Board for Medical Specializations

4 Years

Residency Program Length

IBMS Curriculum 2025

Not published

Published Pass Mark

Scientific Council of Emergency Medicine curriculum

100 MCQs

Practice Bank Study Items

OpenExamPrep

The Iraqi Board of Emergency Medicine (IBMS/MOHESR) credential entails a 4-year residency assessed by the Primary Written Exam (end of Year 1), Mid-Clinical Exam (Year 3), and Final Examination (end of Year 4; written papers, clinical OSCE, oral viva, and dissertation defense); the 100-MCQ and 150-MCQ/4.5-hour figures in the curriculum are attributed there to the Arab Board of Health Specializations. This independent 100-question MCQ practice bank supports preparation for the theoretical written papers of Part 1 and Part 2; it is not a clinical OSCE simulation or a substitute for accredited residency training.

Sample Iraqi Board Emergency Medicine Practice Questions

Try these sample questions to review concepts for the Iraqi Board Emergency Medicine exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 58-year-old man collapses in the emergency department waiting room. The monitor reveals ventricular fibrillation. A team member initiates chest compressions immediately while the biphasic defibrillator is charged. What is the MOST appropriate next action once the defibrillator is ready?
A.Deliver a 120-200 J shock and check the carotid pulse immediately
B.Deliver a 120-200 J shock and immediately resume chest compressions for 2 minutes
C.Administer epinephrine 1 mg IV push prior to delivering the defibrillation shock
D.Perform endotracheal intubation before delivering the first defibrillation shock
Explanation: Per ACLS resuscitation guidelines, once ventricular fibrillation is identified and the defibrillator is charged, deliver a single shock (120-200 J biphasic) and immediately resume CPR beginning with chest compressions for 2 minutes without pausing for a rhythm or pulse check. Minimizing interruptions in chest compressions is paramount for coronary and cerebral perfusion pressures.
2A 64-year-old woman remains in refractory ventricular fibrillation after three unsynchronized shocks, 4 minutes of high-quality CPR, and 1 mg of IV epinephrine. Which antiarrhythmic regimen is FIRST-LINE according to ACLS resuscitation algorithms?
A.Amiodarone 300 mg IV/IO bolus
B.Lidocaine 3.0 mg/kg IV/IO bolus
C.Magnesium sulfate 4 g IV bolus
D.Procainamide 50 mg/min IV infusion
Explanation: For shock-refractory ventricular fibrillation or pulseless ventricular tachycardia (VF/pVT) following at least three defibrillation attempts and epinephrine, amiodarone 300 mg IV/IO bolus is the first-line antiarrhythmic agent (with an optional second dose of 150 mg). Lidocaine is an acceptable alternative, but at an initial dose of 1.0 to 1.5 mg/kg.
3A 45-year-old man in pulseless electrical activity (PEA) arrest is undergoing active resuscitation. Point-of-care ultrasound (POCUS) during a pulse check demonstrates a severely dilated, hypokinetic right ventricle with left ventricular septal flattening ('D-sign') and absence of pericardial effusion. Which underlying reversible cause is MOST likely?
A.Cardiac tamponade
B.Tension pneumothorax
C.Massive pulmonary embolism
D.Severe hypovolemia
Explanation: A severely dilated right ventricle with bowing of the interventricular septum into the left ventricle (the classic D-shaped LV sign) in the setting of PEA cardiac arrest strongly suggests acute right ventricular strain due to massive pulmonary embolism. This echocardiographic finding should prompt immediate consideration of rescue systemic thrombolytic therapy during resuscitation.
4A 72-year-old woman is brought to the resuscitation bay with sudden out-of-hospital cardiac arrest. The cardiac monitor shows a flat baseline rhythm. What is the MOST appropriate initial sequence of actions?
A.Deliver a 200 J unsynchronized shock, then resume chest compressions
B.Administer atropine 1 mg IV push and begin transcutaneous pacing
C.Check rhythm in two leads, verify lead attachments, and continue high-quality CPR with epinephrine 1 mg IV every 3-5 minutes
D.Administer sodium bicarbonate 100 mEq IV push and initiate synchronized cardioversion
Explanation: When asystole is suspected, the resuscitation team must confirm true asystole by checking lead connections, power, and gain across at least two leads to rule out fine ventricular fibrillation. Asystole is a non-shockable rhythm managed by uninterrupted high-quality CPR and epinephrine 1 mg IV/IO every 3-5 minutes while actively investigating reversible causes (5 Hs and 5 Ts).
5A 52-year-old man achieves return of spontaneous circulation (ROSC) following 15 minutes of resuscitation for ventricular fibrillation. He remains comatose (GCS 3). According to current post-cardiac arrest care guidelines, what is the RECOMMENDED target temperature management (TTM) strategy?
A.Rapid active rewarming to 38.0°C to stimulate cerebral perfusion
B.Targeted temperature management maintaining a constant temperature between 32°C and 36°C for at least 24 hours, actively preventing fever
C.Induction of deep therapeutic hypothermia below 28°C for 48 hours
D.Targeted normothermia only if intracranial pressure monitoring demonstrates acute brain swelling
Explanation: For comatose adult patients after ROSC, targeted temperature management (TTM) maintaining a constant target temperature between 32°C and 36°C (or strictly preventing fever >37.7°C for at least 72 hours) is recommended to mitigate ischemic-reperfusion neuronal injury. Deep hypothermia below 30°C precipitates fatal dysrhythmias and coagulopathy.
6A 60-year-old woman achieves ROSC following an out-of-hospital cardiac arrest. Her post-resuscitation 12-lead ECG reveals 3 mm ST-segment elevation in leads V1 through V4. She remains comatose and intubated. What is the MOST appropriate next management step?
A.Emergent cardiac catheterization laboratory activation for primary percutaneous coronary intervention (PCI)
B.Wait 24 hours to observe neurological recovery before considering coronary angiography
C.Administer IV fibrinolysis in the resuscitation bay to avoid transport risks
D.Perform urgent non-contrast head CT and defer coronary angiography until brain edema is ruled out
Explanation: Emergency coronary angiography with intent for primary PCI is indicated in all hemodynamically stable or unstable post-cardiac arrest patients with ST-segment elevation on ECG, regardless of whether the patient is comatose or awake. Acute coronary occlusion is the predominant cause of adult out-of-hospital cardiac arrest.
7A 68-year-old man with septic shock requires emergency rapid sequence intubation (RSI) for respiratory failure. His BP is 78/42 mmHg and HR is 125 bpm. Which induction agent is MOST appropriate to minimize peri-intubation cardiovascular collapse?
A.Propofol 2.0 mg/kg IV
B.Midazolam 0.3 mg/kg IV
C.Etomidate 0.3 mg/kg IV (or Ketamine 1.5 mg/kg IV)
D.Thiopental 4.0 mg/kg IV
Explanation: Etomidate (0.2-0.3 mg/kg) and ketamine (1-2 mg/kg) are the preferred induction agents for RSI in hemodynamically unstable patients because they provide exceptional hemodynamic stability. Propofol and thiopental cause pronounced vasodilation and direct myocardial depression, which frequently precipitate lethal cardiovascular collapse in shock states.
8A 40-year-old male construction worker is brought to the ED after sustaining severe crush injuries to both lower extremities 72 hours ago. He requires urgent endotracheal intubation. His serum potassium is 6.2 mEq/L. Which neuromuscular blocking agent is STRICTLY CONTRAINDICATED?
A.Rocuronium
B.Vecuronium
C.Cisatracurium
D.Succinylcholine
Explanation: Succinylcholine is a depolarizing neuromuscular blocker that stimulates post-junctional extrajunctional acetylcholine receptors, typically causing a transient increase in serum potassium of 0.5-1.0 mEq/L in healthy individuals. In patients with crush injury >24-48 hours old, severe burns, extensive denervation, or baseline hyperkalemia, it can trigger life-threatening hyperkalemic cardiac arrest.
9During rapid sequence intubation of a 55-year-old trauma patient with cervical spine collar in place, direct laryngoscopy reveals only the soft palate with no visible epiglottis (Cormack-Lehane Grade 4). SpO2 is 96%. What is the MOST appropriate next action?
A.Switch to video laryngoscopy or use an articulating bougie guide while maintaining oxygenation
B.Perform immediate emergent surgical cricothyroidotomy
C.Administer an additional dose of succinylcholine to improve muscle relaxation
D.Remove the cervical collar and hyperextend the neck to improve the line of sight
Explanation: When direct laryngoscopy fails with adequate oxygenation preserved (non-CICO scenario), the operator should not repeatedly attempt the same blind technique. Transitioning to video laryngoscopy, optimizing external laryngeal manipulation, or using an airway adjunct/bougie is the recommended next step according to difficult airway algorithms.
10A 50-year-old man with severe Ludwig angina undergoes emergency induction in the ED. Endotracheal intubation fails across two attempts. Insertion of a second-generation laryngeal mask airway fails to seat, and two-person bag-valve-mask ventilation produces no chest rise with SpO2 dropping to 62% and heart rate falling to 38 bpm. What is the MANDATORY immediate action?
A.Administer intravenous sugammadex and wait for spontaneous respiratory effort
B.Perform immediate emergency scalpel-bougie-tube surgical cricothyroidotomy
C.Attempt fiberoptic bronchoscopic intubation via the oral route
D.Place a nasopharyngeal airway and attempt high-pressure jet ventilation
Explanation: This patient is in a catastrophic 'Cannot Intubate, Cannot Oxygenate' (CICO) situation with profound hypoxemia and bradycardia. The universal failed airway algorithm mandates immediate emergency front-of-neck access (FONA), specifically a scalpel-bougie-tube cricothyroidotomy, to restore oxygenation and prevent hypoxic cardiac arrest.

About the Iraqi Board Emergency Medicine Exam

The Fellowship of the Iraqi Board for Medical Specializations in Emergency Medicine (F.I.B.M.S.) is the definitive national postgraduate medical qualification awarded by the Iraqi Board for Medical Specializations (IBMS), operating under the Ministry of Higher Education and Scientific Research (MOHESR). The four-year emergency medicine training program provides rigorous clinical and academic instruction across adult resuscitation, acute medical emergencies, major trauma systems, surgical emergencies, pediatric acute care, intensive care, toxicology, disaster management, and point-of-care ultrasound (POCUS). Important disclosure: Attaining the FIBMS credential requires four years of structured clinical residency training, ongoing workplace-based assessments (Mini-CEX, DOPS, CBD), resuscitation life support certifications, an approved scientific research dissertation, and formal clinical OSCE and oral viva examinations, none of which can be replicated by multiple-choice questions alone. This 100-question multiple-choice practice bank is an independent English-language educational study resource authored to reinforce theoretical medical knowledge, acute diagnostic reasoning, and evidence-based pharmacotherapy for the Part 1 (Primary) and Part 2 (Final Written) examinations. It is not an official IBMS examination, does not provide OSCE or simulation stations, and is not a substitute for formal accredited clinical residency training.

Exam sponsor: Scientific Council of Emergency Medicine, Iraqi Board for Medical Specializations (المجلس العراقي للاختصاصات الطبية — المجلس العلمي لاختصاص طب الطوارئ). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

The Iraqi Board of Emergency Medicine follows a structured four-year postgraduate residency program directed by the Scientific Council of Emergency Medicine under the Iraqi Board for Medical Specializations (IBMS) and Ministry of Higher Education and Scientific Research (MOHESR). The formal assessment structure includes three mandatory evaluation milestones: 1) The Primary Examination (taken at the conclusion of Year 1), consisting of a 100-question written multiple-choice examination focusing on applied basic sciences (anatomy, physiology, pathology, pharmacology) and fundamental principles of acute emergency resuscitation. Candidates must pass this examination to advance to the secondary stage of training. 2) The Mid-Clinical Examination (conducted in Year 3), assessing clinical reasoning, emergency presentations, and procedural safety. 3) The Final Examination (taken at the completion of Year 4), which comprises a comprehensive written MCQ paper (150 questions administered over 4.5 hours) covering advanced resuscitation, trauma, toxicology, environmental medicine, and subspecialty emergencies; an Objective Structured Clinical Examination (OSCE) with dynamic clinical and simulation stations; a visual assay slide examination; a structured oral examination (viva voce) on short and long clinical cases; and defense of an approved scientific research dissertation.

Time Limit

Not published for the Iraqi Board examinations. The curriculum's assessment section cites 4.5 hours for the 150-MCQ Arab Board of Health Specializations final written examination.

Passing Score

Not published. The Scientific Council of Emergency Medicine's curriculum does not state pass marks, percentage thresholds, or attempt limits for its examinations; it requires only that candidates pass all examinations of the Iraqi Board for Emergency Medicine.

Exam / Certification Fees

Prescribed by Iraqi Board for Medical Specializations / MOHESR regulatory bylaws

Exam sponsor website

Reported exam pass rate: Not published. The Scientific Council of Emergency Medicine's curriculum does not state pass marks, percentage thresholds or attempt limits; it requires only that candidates pass all examinations of the Iraqi Board for Emergency Medicine. The 100-MCQ primary and 150-MCQ, 4.5-hour final written examinations that appear in the curriculum's assessment section are attributed there to the Arab Board of Health Specializations rather than to the Iraqi Board. Exam sponsor website

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

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%

Resuscitation, Shock & Critical Care

ACLS and APLS cardiac arrest algorithms, post-cardiac arrest care (TTM, coronary angiography), airway evaluation, rapid sequence intubation (RSI) pharmacodynamics, failed airway management and surgical cricothyroidotomy, hemodynamic shock classification and invasive monitoring, Surviving Sepsis Campaign resuscitation bundles, vasopressor and inotropic support, and ED mechanical ventilation strategies.

25%

Major Trauma & Surgical Emergencies

ATLS primary and secondary survey sequences, severe traumatic brain injury (TBI) and intracranial pressure optimization, immediate life-threatening thoracic trauma (tension pneumothorax, massive hemothorax, cardiac tamponade, tracheobronchial rupture), tube thoracostomy, massive transfusion protocol (MTP), damage control resuscitation and tranexamic acid, pelvic ring disruption, FAST examination, and acute surgical abdomen evaluation.

20%

Cardiovascular & Pulmonary Emergencies

Acute coronary syndromes (STEMI reperfusion criteria, NSTE-ACS risk stratification), acute decompensated heart failure and cardiogenic shock, thoracic aortic dissection classification and blood pressure control, emergent cardiac dysrhythmias (tachyarrhythmias, bradyarrhythmias, transcutaneous pacing), pulmonary embolism hemodynamics and thrombolysis, near-fatal asthma, and COPD exacerbations with non-invasive ventilation.

15%

Toxicology & Environmental Emergencies

Recognition of acute toxidromes, paracetamol toxicity and Rumack-Matthew nomogram N-acetylcysteine protocols, organophosphate cholinergic crisis and pralidoxime/atropine dosing, carbon monoxide poisoning and hyperbaric oxygen indications, regional snake and scorpion envenomation protocols, exertional vs non-exertional heat stroke, accidental hypothermia rewarming, electrical injuries, and drowning.

15%

Pediatric, Obstetric & Neurologic Emergencies

Pediatric resuscitation (PALS algorithms, fluid bolus guidelines, intraosseous access), neonatal resuscitation, pediatric respiratory emergencies (stridor, croup, foreign body aspiration), status epilepticus stepped medical therapy, acute ischemic stroke thrombolysis (alteplase/tenecteplase) and mechanical thrombectomy eligibility, aneurysmal subarachnoid hemorrhage, severe pre-eclampsia/eclampsia magnesium sulfate therapy, and postpartum hemorrhage.

Preparing for the Iraqi Board Emergency Medicine Exam

What You Need to Know

  • Passing score: Not published. The Scientific Council of Emergency Medicine's curriculum does not state pass marks, percentage thresholds, or attempt limits for its examinations; it requires only that candidates pass all examinations of the Iraqi Board for Emergency Medicine.
  • Assessment: The Iraqi Board of Emergency Medicine follows a structured four-year postgraduate residency program directed by the Scientific Council of Emergency Medicine under the Iraqi Board for Medical Specializations (IBMS) and Ministry of Higher Education and Scientific Research (MOHESR). The formal assessment structure includes three mandatory evaluation milestones: 1) The Primary Examination (taken at the conclusion of Year 1), consisting of a 100-question written multiple-choice examination focusing on applied basic sciences (anatomy, physiology, pathology, pharmacology) and fundamental principles of acute emergency resuscitation. Candidates must pass this examination to advance to the secondary stage of training. 2) The Mid-Clinical Examination (conducted in Year 3), assessing clinical reasoning, emergency presentations, and procedural safety. 3) The Final Examination (taken at the completion of Year 4), which comprises a comprehensive written MCQ paper (150 questions administered over 4.5 hours) covering advanced resuscitation, trauma, toxicology, environmental medicine, and subspecialty emergencies; an Objective Structured Clinical Examination (OSCE) with dynamic clinical and simulation stations; a visual assay slide examination; a structured oral examination (viva voce) on short and long clinical cases; and defense of an approved scientific research dissertation.
  • Time limit: Not published for the Iraqi Board examinations. The curriculum's assessment section cites 4.5 hours for the 150-MCQ Arab Board of Health Specializations final written examination.
  • Exam / certification fees: Prescribed by Iraqi Board for Medical Specializations / MOHESR regulatory bylaws 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

Iraqi Board Emergency Medicine: Suggested Study Strategy

1Master core resuscitation algorithms early: thoroughly memorize ACLS, PALS, and ATLS flowcharts, including drug dosages (epinephrine, amiodarone, adenosine, atropine) and electrical cardioversion/defibrillation joule settings.
2Integrate point-of-care ultrasound (POCUS) findings into clinical vignettes: focus on bedside echocardiography in shock, FAST in blunt abdominal trauma, and lung ultrasound patterns for pneumothorax and pulmonary edema.
3Understand trauma resuscitation pathophysiology: study massive transfusion protocols (1:1:1 balanced blood component resuscitation), indications for tranexamic acid within 3 hours, and target parameters for severe traumatic brain injury (avoiding hypotension SBP <100 mmHg and hypoxia SpO2 <90%).
4Develop structured approaches to toxicology: memorize classic toxidromes (cholinergic, anticholinergic, sympathomimetic, opioid, sedative-hypnotic) and their specific antidotes (atropine/pralidoxime, physostigmine, naloxone, flumazenil, N-acetylcysteine, fomepizole, glucagon, high-dose insulin euglycemia).
5Review high-stakes medical and obstetric emergencies: master the narrow therapeutic windows for acute ischemic stroke thrombolysis (<=4.5 hours), acute coronary syndrome antiplatelet/anticoagulation regimens, eclampsia magnesium sulfate protocols, and postpartum hemorrhage uterotonics.

Frequently Asked Questions

What is the governing authority and credential awarded by the Iraqi Board in Emergency Medicine?

The emergency medicine residency program is governed by the Scientific Council of Emergency Medicine under the Iraqi Board for Medical Specializations (IBMS / المجلس العراقي للاختصاصات الطبية), which operates under the authority of the Ministry of Higher Education and Scientific Research (MOHESR). Successful graduates who satisfy all clinical, academic, and examination requirements are awarded the Fellowship of the Iraqi Board for Medical Specializations (F.I.B.M.S.) in Emergency Medicine.

What is the assessment architecture of the Iraqi Board of Emergency Medicine?

The curriculum establishes three major examination milestones over the 4-year residency: 1) The Primary Examination at the end of Year 1, consisting of a 100-question written MCQ examination covering applied basic sciences and emergency resuscitation principles. 2) The Mid-Clinical Examination in Year 3, evaluating bedside clinical judgment and emergency problem management. 3) The Final Examination at the end of Year 4, which includes a comprehensive 150-question written MCQ examination (duration 4.5 hours), clinical OSCE stations, visual assay slide examinations, structured oral viva voce examinations, and defense of a research thesis.

What are the passing scores and retake policies for the written papers?

The Scientific Council of Emergency Medicine's curriculum does not publish a pass mark, any percentage threshold, or attempt limits for its examinations; it states only that candidates must pass all examinations of the Iraqi Board for Emergency Medicine. The assessment section does list a 100-MCQ primary written examination and a 150-MCQ, 4.5-hour final written examination, but attributes both to the Arab Board of Health Specializations. The curriculum does require the Primary Examination to be passed before progressing to the secondary stage of training. Candidates should confirm the current Iraqi Board pass marks and retake rules with the Scientific Council.

In what language are the Iraqi Board Emergency Medicine examinations conducted?

The Iraqi Board for Medical Specializations publishes this council's curriculum, syllabus and reference list in English, and English-language proficiency appears among the admission requirements set by the Ministry. The council's published curriculum does not, however, contain any statement of the language in which the examination papers themselves are set, so no language of assessment is asserted here. This site is an independent English-language study resource and is not affiliated with, endorsed by, or connected to the Iraqi Board for Medical Specializations; candidates should confirm the language of their sitting directly with their Scientific Council.

Does this 100-question practice bank simulate the clinical OSCE or replace emergency medicine residency?

No. The Iraqi Board in Emergency Medicine is a demanding 4-year clinical residency requiring continuous workplace-based assessments (Mini-CEX, DOPS, CBD), supervised resuscitation shifts, life support certifications, research dissertation completion, and comprehensive clinical OSCE and oral viva examinations. This independent 100-question multiple-choice practice bank is strictly an educational tool designed to test theoretical knowledge, pharmacological calculations, and clinical triage decision-making for the Part 1 and Part 2 written papers; it is not an OSCE simulation or a substitute for formal clinical residency training.