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Key Facts: Iran Specialty Board - Obstetrics & Gynecology Exam

150

Total four-option multiple-choice questions on the national written specialty board examination

Council for Medical and Specialized Education

70%

Strict minimum passing threshold (105/150 written points) required to advance to the clinical OSCE stage

Sanjesh Pezeshki examination regulations

210 min

Total written examination duration, providing an average of 84 seconds per clinical scenario

Sanjesh Pezeshki official schedule

Negative marking score penalty: incorrect answers do not deduct points from correct scores

MOHME board examination guidelines

Annual

National examination administration frequency, held each late summer (Shahrivar) in Tehran

National Center for Health Assessment

The Iranian Specialty Board in Obstetrics & Gynecology is an annual high-stakes credentialing exam administered by Sanjesh Pezeshki. Candidates must achieve at least 70% (105/150) on a 152-question written multiple-choice test (no negative marking, 240 minutes) referenced to Williams Obstetrics and Berek & Novak's Gynecology to advance to the multi-station clinical OSCE and structured oral examination.

Sample Iran Specialty Board - Obstetrics & Gynecology Practice Questions

Try these sample questions to review concepts for the Iran Specialty Board - Obstetrics & Gynecology 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 primigravida at 11 weeks of gestation presents for aneuploidy screening. Cell-free DNA (cfDNA) screening is performed and returns a 'no-call' (low fetal fraction) result. Ultrasound confirms a viable singleton fetus with normal anatomy. Which of the following is the most appropriate next step in management?

A.Offer comprehensive clinical genetic counseling, repeat targeted ultrasound, and discuss diagnostic testing due to the increased risk of fetal triploidy or aneuploidy

B.Reassure the patient that a no-call result represents low clinical risk and resume routine prenatal care

C.Immediately perform maternal serum alpha-fetoprotein (MSAFP) to confirm fetal aneuploidy status

D.Administer low-dose aspirin and repeat cfDNA testing in 4 weeks

Explanation: A 'no-call' or test failure on cell-free DNA screening due to low fetal fraction is clinically significant because it carries an elevated risk of fetal aneuploidy, particularly trisomy 18, trisomy 13, and triploidy, as well as fetal growth restriction. The patient should receive detailed genetic counseling, a thorough anatomical ultrasound survey, and the option of diagnostic testing such as chorionic villus sampling or amniocentesis. Repeating cfDNA can fail again in up to 50% of cases and delays definitive diagnostic evaluation.

2A 32-year-old multigravida at 32 weeks of gestation with suspected fetal growth restriction undergoes umbilical artery Doppler velocimetry. The Doppler waveform demonstrates persistent absent end-diastolic velocity (AEDV). Fetal biophysical profile is 8/8, and fetal heart rate tracing is Category I. What is the most appropriate management plan?

A.Schedule routine delivery at 37 weeks of gestation after weekly nonstress tests

B.Admit for inpatient surveillance, administer antenatal corticosteroids for fetal lung maturity, and plan delivery at 33 to 34 weeks of gestation

C.Perform immediate emergency cesarean delivery without administering corticosteroids

D.Initiate maternal hyperoxygenation and outpatient Doppler assessment every 2 weeks

Explanation: Absent end-diastolic velocity in the umbilical artery signifies substantial placental vascular resistance and villous obliteration. In pregnancies with persistent AEDV, standard management includes hospitalization or intensive surveillance, administration of antenatal corticosteroids for fetal lung maturation, and planned delivery between 33 0/7 and 34 0/7 weeks of gestation, or sooner if fetal testing deteriorates. Immediate delivery without steroids is reserved for reversed end-diastolic velocity or non-reassuring fetal status.

3A 26-year-old RhD-negative primigravida at 28 weeks of gestation has a negative anti-D antibody screen. She receives 300 mcg of anti-D immune globulin. At 39 weeks of gestation, she delivers a vigorous 3500 g infant whose blood type is RhD-positive. What test should be performed immediately postpartum before dosing postnatal anti-D immune globulin?

A.Direct Coombs test on maternal blood

B.Amniotic fluid delta OD450 analysis

C.Qualitative rosette screening test on maternal blood, followed by Kleihauer-Betke testing if positive

D.Fetal middle cerebral artery peak systolic velocity Doppler

Explanation: Following the delivery of an RhD-positive infant to an unsensitized RhD-negative mother, maternal blood should be screened for excessive fetomaternal hemorrhage using a qualitative rosette test. If the rosette screen is positive, indicating fetomaternal hemorrhage greater than 30 mL of fetal whole blood (which exceeds the protection provided by a standard 300 mcg dose), a quantitative test such as the Kleihauer-Betke acid elution test or flow cytometry must be performed to determine the exact additional dose of anti-D immune globulin needed.

4A 24-year-old woman at 26 weeks of gestation with known RhD alloimmunization (anti-D titer 1:64) undergoes middle cerebral artery (MCA) Doppler assessment. The peak systolic velocity (PSV) is measured at 1.65 multiples of the median (MoM). What is the next most appropriate management step?

A.Repeat the MCA Doppler in 2 weeks

B.Schedule elective induction of labor at 34 weeks of gestation

C.Administer an additional 300 mcg dose of anti-D immune globulin

D.Perform cordocentesis (percutaneous umbilical blood sampling) with preparation for intrauterine red blood cell transfusion

Explanation: A middle cerebral artery peak systolic velocity exceeding 1.5 multiples of the median (MoM) has high sensitivity and specificity for moderate-to-severe fetal anemia. In an alloimmunized pregnancy at 26 weeks, this finding mandates immediate diagnostic cordocentesis to verify the fetal hematocrit and perform an intrauterine intravascular blood transfusion using crossmatched, irradiated, CMV-negative O-negative packed red cells. Waiting or administering RhIG is inappropriate in an already sensitized pregnancy.

5A 30-year-old woman at 18 weeks of gestation with a monochorionic diamniotic (MCDA) twin pregnancy presents for routine ultrasound. The examination reveals polyhydramnios in Twin A (maximum vertical pocket [MVP] 9.5 cm) with a distended bladder, and oligohydramnios in Twin B (MVP 1.2 cm) with an unvisualized bladder. Umbilical artery Doppler waveforms in both fetuses are normal. What is the diagnosis and Quintero stage?

A.Twin anemia-polycythemia sequence (TAPS), Stage 1

B.Twin-twin transfusion syndrome (TTTS), Stage I

C.Twin-twin transfusion syndrome (TTTS), Stage II

D.Twin-twin transfusion syndrome (TTTS), Stage III

Explanation: Twin-twin transfusion syndrome is diagnosed in monochorionic gestations by the presence of polyhydramnios (MVP > 8 cm before 20 weeks or > 8 cm after) in the recipient twin and oligohydramnios (MVP < 2 cm) in the donor twin. Quintero Stage I is defined by this fluid discordance while the donor bladder remains visible and Doppler findings are normal. In Quintero Stage II, the donor bladder is persistently empty/not visualized over the examination, but Doppler flows remain normal. Because Twin B's bladder is not visualized and Dopplers are normal, this represents TTTS Stage II.

6A 23-year-old primigravida at 12 weeks of gestation has a history of preeclampsia with severe features in a previous pregnancy ending in delivery at 30 weeks. Which of the following prophylactic interventions has the strongest evidence for reducing her recurrence risk?

A.Low-dose aspirin (81 to 150 mg daily) initiated between 12 and 16 weeks of gestation and continued until 36 weeks

B.Prophylactic low-molecular-weight heparin throughout pregnancy

C.High-dose vitamin C and vitamin E supplementation starting in the first trimester

D.Strict dietary sodium restriction and prophylactic oral furosemide

Explanation: Low-dose aspirin (81 to 150 mg/day), started between 12 and 16 weeks of gestation (and ideally before 16 weeks) and continued until delivery or 36 weeks, significantly decreases the risk of preeclampsia, preterm birth, and fetal growth restriction in high-risk women. Evidence-based guidelines from ACOG, FIGO, and national health protocols unanimously recommend low-dose aspirin for women with a history of early-onset preeclampsia. Antioxidants, heparin without antiphospholipid syndrome, and sodium restriction have proven ineffective or potentially harmful.

7A 31-year-old woman at 26 weeks of gestation undergoes a two-step gestational diabetes mellitus (GDM) screening. Her 50-g glucose challenge test is 158 mg/dL. She then undergoes a 100-g, 3-hour oral glucose tolerance test (OGTT) using Carpenter-Coustan thresholds. Which of the following result sets confirms the diagnosis of GDM?

A.Fasting: 90 mg/dL; 1-hour: 170 mg/dL; 2-hour: 145 mg/dL; 3-hour: 130 mg/dL

B.Fasting: 92 mg/dL; 1-hour: 190 mg/dL; 2-hour: 150 mg/dL; 3-hour: 135 mg/dL

C.Fasting: 98 mg/dL; 1-hour: 175 mg/dL; 2-hour: 150 mg/dL; 3-hour: 138 mg/dL

D.Fasting: 96 mg/dL; 1-hour: 185 mg/dL; 2-hour: 160 mg/dL; 3-hour: 130 mg/dL

Explanation: According to the Carpenter-Coustan criteria for the 100-g 3-hour OGTT, the diagnostic thresholds are: Fasting >= 95 mg/dL, 1-hour >= 180 mg/dL, 2-hour >= 155 mg/dL, and 3-hour >= 140 mg/dL. A diagnosis of gestational diabetes requires at least two abnormal values. In the result set with Fasting 96 mg/dL (elevated, >=95), 1-hour 185 mg/dL (elevated, >=180), and 2-hour 160 mg/dL (elevated, >=155), three values meet or exceed the thresholds, unequivocally establishing GDM.

8A 29-year-old primigravida with gestational diabetes mellitus has initiated medical nutrition therapy and lifestyle modifications. After 2 weeks of compliant diet and moderate exercise, her self-monitored blood glucose values show fasting readings averaging 106 mg/dL and 2-hour postprandial readings averaging 142 mg/dL. What is the recommended first-line pharmacotherapy according to standard board guidelines?

A.Metformin 500 mg orally twice daily

B.Subcutaneous insulin therapy

C.Glyburide (glibenclamide) 5 mg orally daily

D.Acarbose 50 mg orally with each meal

Explanation: Insulin is the standard first-line pharmacotherapy for gestational diabetes when medical nutrition therapy fails to achieve glycemic targets (fasting < 95 mg/dL, 1-hour postprandial < 140 mg/dL, or 2-hour postprandial < 120 mg/dL). Insulin does not cross the placenta in significant amounts and provides precise dose titration. Oral antihyperglycemic agents such as metformin and glyburide cross the placenta; metformin is associated with higher rates of treatment failure and preterm delivery, while glyburide is associated with increased neonatal hypoglycemia and macrosomia.

9A 27-year-old woman at 34 weeks of gestation presents with severe generalized pruritus, predominantly affecting the palms of her hands and soles of her feet, which worsens noticeably at night. Physical examination reveals excoriations without primary cutaneous lesions. Serum total bile acids are measured at 112 micromol/L. What is the diagnosis and the most critical management priority?

A.Pruritic urticarial papules and plaques of pregnancy (PUPPP); treat with topical corticosteroids and deliver at 39 weeks

B.Intrahepatic cholestasis of pregnancy with severe disease; initiate ursodeoxycholic acid and plan delivery at 36 0/7 weeks of gestation

C.Acute fatty liver of pregnancy; proceed with immediate emergency cesarean delivery within 2 hours

D.Pemphigoid gestationis; perform skin biopsy and initiate high-dose intravenous methylprednisolone

Explanation: Intrahepatic cholestasis of pregnancy (ICP) typically presents in the late second or third trimester with intense nocturnal pruritus of the palms and soles without primary dermatologic eruption. Serum total bile acids >= 100 micromol/L define severe ICP and are associated with a substantially increased risk of spontaneous stillbirth, meconium-stained amniotic fluid, and fetal asphyxia. Ursodeoxycholic acid (UDCA) is the first-line medication to alleviate maternal symptoms and improve biochemical parameters, and delivery is recommended at 36 0/7 weeks (or even at diagnosis if >= 36 weeks) to prevent sudden intrauterine demise.

10A 33-year-old pregnant woman with chronic hypertension at 16 weeks of gestation has blood pressure readings consistently around 152/96 mmHg on home and clinic logs. Baseline renal function and urine protein-to-creatinine ratio are normal. According to the landmark CHAP trial and modern international guidelines, what is the current recommended blood pressure threshold for initiating treatment and the target blood pressure?

A.Initiate antihypertensive therapy at >= 140/90 mmHg to achieve a target blood pressure < 140/90 mmHg

B.Initiate antihypertensive therapy only when systolic BP reaches >= 160 mmHg or diastolic reaches >= 110 mmHg

C.Initiate antihypertensive therapy at >= 130/80 mmHg to achieve an aggressive target blood pressure < 120/70 mmHg

D.Withhold all antihypertensive therapy until after 24 weeks of gestation to avoid impaired uteroplacental perfusion

Explanation: The Chronic Hypertension and Pregnancy (CHAP) trial demonstrated that treating mild chronic hypertension in pregnancy to a goal blood pressure of less than 140/90 mmHg (initiating treatment at BP >= 140/90 mmHg) significantly reduced the incidence of preeclampsia, preterm birth, placental abruption, and fetal/neonatal death without impairing fetal growth. Previously, therapy was withheld until severe thresholds (160/110 mmHg) were reached. Standard first-line agents include labetalol, extended-release nifedipine, and methyldopa.

About the Iran Specialty Board - Obstetrics & Gynecology Exam

The Iranian Specialty Board Examination in Obstetrics and Gynecology (آزمون دانشنامه تخصصی زنان و زایمان / بورد تخصصی زنان و مامایی) represents the ultimate postgraduate academic credential for obstetricians and gynecologists in the Islamic Republic of Iran. Administered annually by the National Center for Health Assessment (Sanjesh Pezeshki) under the supervision of the Council for Medical and Specialized Education, the examination certifies that a graduate of an accredited 4-year obstetrics and gynecology residency program has demonstrated expert clinical judgment, surgical decision-making, and deep scientific mastery across maternal-fetal medicine, operative obstetrics, general gynecology, urogynecology, gynecologic oncology, and reproductive endocrinology. Earning board certification (Daneshnameh Takhasosi) confers the prestigious title of Board Certified Specialist and is a statutory prerequisite for appointment to medical school faculties, fellowship subspecialty training, and high-level academic practice in Iran. The national written board examination consists of 152 four-option multiple-choice questions administered over 240 minutes without negative marking. Exam questions are referenced to the latest designated editions of the core international textbooks established by the MOHME Board Examination Committee: Williams Obstetrics (Cunningham, Leveno, Bloom, Das, Hoffman, Casey, Spong) and Berek & Novak's Gynecology (Berek), supplemented by authoritative national clinical guidelines and international consensus statements (ACOG, FIGO, RCOG). The curriculum encompasses six weighted domains: Antepartum Care, Fetal Assessment & Maternal Medical Complications (25%); Labor, Delivery, Operative Obstetrics & Obstetric Emergencies (20%); General Gynecology, Urogynecology & Pelvic Floor Disorders (18%); Gynecologic Oncology (15%); Reproductive Endocrinology, Infertility & Assisted Reproduction (12%); and Pediatric & Adolescent Gynecology, Family Planning & Menopause (10%). Candidates scoring at least 70% (105/150) advance to the multi-station clinical OSCE and structured oral examination, which assesses intraoperative crisis management, ultrasound image interpretation, patient management problems (PMP), and evidence-based clinical reasoning. This 100-question practice bank is an independent English-language adaptation developed by OpenExamPrep to provide postgraduate residents and international candidates with challenging, scenario-based practice questions featuring exhaustive clinical rationales and distractor analyses.

Exam sponsor: National Center for Health Assessment / Sanjesh Pezeshki (مرکز سنجش آموزش پزشکی) & Council for Medical and Specialized Education. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

The Iranian Specialty Board Examination in Obstetrics and Gynecology (آزمون دانشنامه تخصصی زنان و زایمان) is held annually in late summer (traditionally Shahrivar) by the National Center for Health Assessment (مرکز سنجش آموزش پزشکی - Sanjesh Pezeshki) under the auspices of the Secretariat of the Council for Medical and Specialized Education of the Ministry of Health and Medical Education (MOHME). The examination consists of two consecutive stages: a written examination (Azmoon-e Katbi) comprising 152 multiple-choice questions administered in a 240-minute session, and an objective structured clinical/oral examination (Azmoon-e Shafahi/Amali - OSCE / PMP / Clinical Stations). Candidates must achieve a minimum scaled score of 70% (105 points out of a written total of 150) on the written exam to qualify for and sit the clinical oral/practical board examination. The written exam features single-best-answer MCQs with four options and no negative marking.

Time Limit

240 minutes

Passing Score

70% of the written total (105 of 150 points)

Exam / Certification Fees

Nominal administrative registration fee set annually by the Ministry of Health and Medical Education, payable online via the Sanjesh Pezeshki portal during registration

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%

Obstetrics: Antepartum Care, Fetal Assessment & Maternal Medical Complications

Cell-free DNA and first-/second-trimester aneuploidy screening algorithms; ultrasound evaluation of fetal anatomical malformations; antenatal surveillance modalities including nonstress test (reactive vs. nonreactive criteria), contraction stress test, biophysical profile (BPP) scoring, and modified BPP; Doppler velocimetry of the umbilical artery (absent/reversed end-diastolic velocity), middle cerebral artery (peak systolic velocity in fetal anemia), and ductus venosus; early-onset versus late-onset fetal growth restriction (FGR); RhD alloimmunization titers, middle cerebral artery Doppler surveillance, and intrauterine transfusion criteria; twin gestation chorionicity and amnionicity diagnosis, twin-twin transfusion syndrome (TTTS Quintero staging) and laser photocoagulation; diagnostic criteria and glycemic targets for gestational diabetes mellitus (GDM) and overt pregestational diabetes; management of chronic hypertension, superimposed preeclampsia, systemic lupus erythematosus (antiphospholipid syndrome, lupus flare vs. preeclampsia), chronic kidney disease, cardiovascular disease in pregnancy (NYHA classifications, maternal mortality risks, peripartum cardiomyopathy), deep vein thrombosis and pulmonary embolism (low-molecular-weight heparin dosing, anticoagulation delivery protocols), and maternal TORCH and viral infections (cytomegalovirus, toxoplasmosis, parvovirus B19, hepatitis B and C, influenza, and COVID-19).

20%

Obstetrics: Labor, Delivery, Operative Obstetrics & Obstetric Emergencies

Physiology and active phase labor progression curves (Zhang criteria versus Friedman); cervical ripening agents (dinoprostone, misoprostol contraindications with prior hysterotomy, mechanical Foley bulb); high-dose versus low-dose oxytocin protocols; electronic fetal heart rate monitoring interpretation using NICHD Categories I, II, and III, intrauterine resuscitation measures (maternal repositioning, IV fluid bolus, oxygen, amnioinfusion, tocolysis with terbutaline); operative vaginal delivery prerequisites, indications, instrument selection (Simpson, Tucker-McLane, vacuum extractor cup placement), and maternal-fetal complications; shoulder dystocia emergency protocol (HELPERR mnemonic: McRoberts maneuver, suprapubic pressure, rotational maneuvers [Rubin, Woods screw], posterior arm delivery, Zavanelli maneuver); postpartum hemorrhage (PPH) definition, quantitative blood loss, etiology (4 Ts: Tone, Trauma, Tissue, Thrombin), stepped medical management (oxytocin, methylergonovine, carboprost/15-methyl PGF2a, misoprostol, tranexamic acid), Bakri intrauterine balloon tamponade, uterine compression sutures (B-Lynch, Hayman), bilateral uterine and internal iliac artery ligation, and emergency peripartum hysterectomy; severe preeclampsia diagnostic criteria and management (intravenous magnesium sulfate seizure prophylaxis, labetalol and hydralazine protocols for severe hypertension, delivery timing); management of eclamptic convulsions; placental abruption diagnosis and delivery urgency; placenta previa localization and delivery planning; and placenta accreta spectrum (PAS) antenatal imaging, preoperative multidisciplinary planning, and cesarean hysterectomy protocols.

18%

General Gynecology, Urogynecology & Pelvic Floor Disorders

Etiologic workup and modern management of abnormal uterine bleeding according to the FIGO PALM-COEIN classification system; medical and surgical management of uterine leiomyomas (GnRH agonists/antagonists, tranexamic acid, ulipristal, myomectomy techniques, uterine artery embolization); adenomyosis clinical presentation, transvaginal ultrasound markers (asymmetric myometrial thickening, subendometrial cysts), MRI findings, and therapy; endometriosis staging, pathogenesis, medical suppression (dienogest, combined oral contraceptives, GnRH analogs with add-back), and laparoscopic excision of deep infiltrating endometriosis and endometriomas; acute pelvic inflammatory disease (PID) outpatient and inpatient parenteral antibiotic regimens, surgical drainage and timing for tubo-ovarian abscess; ectopic pregnancy diagnosis (hCG discriminative zone, progesterone levels), strict criteria for systemic methotrexate administration (mass size <3.5 cm, absent fetal cardiac activity, hCG <5000 mIU/mL), contraindications, and laparoscopic salpingectomy versus salpingostomy; differential diagnosis and algorithmic management of adnexal masses in premenopausal versus postmenopausal women (IOTA ultrasound rules, RMI, ROMA score); pelvic organ prolapse quantification (POP-Q system stages and anatomical landmarks Aa, Ba, C, D, Ap, Bp, gh, pb, tvl), pessary selection, and surgical repair (sacrocolpopexy, uterosacral ligament suspension, sacrospinous ligament fixation); stress urinary incontinence evaluation (cough stress test, multichannel urodynamic testing, urethral hypermobility) and management (pelvic floor muscle therapy, retropubic vs. transobturator midurethral slings, bulking agents); overactive bladder and urgency urinary incontinence (lifestyle, behavioral therapy, anticholinergic medications, mirabegron, intravesical onabotulinumtoxinA); and recognition and repair of intraoperative surgical injuries (bladder, ureteral transection/kinking, bowel perforation, retroperitoneal hemorrhage).

15%

Gynecologic Oncology

Cervical cancer primary screening paradigms (hrHPV testing, cytology cotesting), risk-based management of abnormal cervical cancer screening tests per ASCCP consensus guidelines, colposcopic hallmarks (acetowhite changes, coarse punctation, atypical vessels), excisional procedures (LEEP, cold-knife conization, margins); 2018 FIGO staging of cervical carcinoma, fertility-sparing radical trachelectomy, radical hysterectomy (Piver-Rutledge/Querleu-Morrow classification) with pelvic lymphadenectomy, and definitive concurrent chemoradiation with cisplatin and brachytherapy for locally advanced disease; endometrial hyperplasia classification (benign vs. atypical hyperplasia/EIN), conservative progestin therapy for fertility preservation, FIGO 2023 staging of endometrial adenocarcinoma, molecular classification (POLE ultramutated, MMR-deficient, p53-abnormal, NSMP), sentinel lymph node biopsy with indocyanine green (ICG), adjuvant radiation, and systemic therapy; epithelial ovarian cancer histological subtypes (high-grade serous, clear cell, endometrioid, mucinous), origin in fallopian tube fimbriae (STIC lesions), primary cytoreductive surgery to no gross residual disease (R0), neoadjuvant chemotherapy with interval debulking, platinum-taxane regimens, PARP inhibitor maintenance in BRCA-mutated and HRD-positive tumors, and malignant germ cell (dysgerminoma, endodermal sinus tumor) and sex cord-stromal tumors (granulosa cell tumor, inhibin monitoring); vulvar intraepithelial neoplasia (uVIN vs. dVIN), staging and surgical resection of vulvar squamous cell carcinoma with groin sentinel node or inguinofemoral lymphadenectomy; and gestational trophoblastic disease including complete versus partial hydatidiform mole, post-molar gestational trophoblastic neoplasia (GTN), FIGO/WHO prognostic scoring system for low-risk (single-agent methotrexate/actinomycin-D) and high-risk GTN (EMA-CO multiagent chemotherapy).

12%

Reproductive Endocrinology, Infertility & Assisted Reproduction

Physiology of follicular development, two-cell two-gonadotropin theory, dominant follicle selection, positive feedback estrogen surge, and corpus luteum function; diagnostic algorithms for primary amenorrhea (karyotype analysis, pelvic ultrasound for müllerian structures, FSH/LH levels) and secondary amenorrhea (pregnancy test, TSH, prolactin, progestin challenge, estrogen-progestin withdrawal, gonadotropin levels); polycystic ovary syndrome (PCOS) pathophysiology, insulin resistance, hyperandrogenism, Rotterdam diagnostic criteria, long-term cardiometabolic risks, first-line ovulation induction with letrozole versus clomiphene citrate, and laparoscopic ovarian drilling; hyperprolactinemia causes, prolactinoma evaluation with pituitary MRI, and medical therapy with cabergoline; late-onset 21-hydroxylase deficiency congenital adrenal hyperplasia (morning 17-hydroxyprogesterone screening, ACTH stimulation test); comprehensive infertility evaluation of the couple (semen analysis interpretation per WHO 2021 criteria, tubal patency evaluation with HSG or laparoscopy, ovulation confirmation with mid-luteal progesterone); ovarian reserve assessment (anti-müllerian hormone [AMH], antral follicle count [AFC], day-3 FSH and estradiol); controlled ovarian stimulation protocols (GnRH antagonist vs. agonist long protocol, rFSH, trigger with hCG vs. GnRH agonist); intracytoplasmic sperm injection (ICSI) indications, preimplantation genetic testing (PGT-A, PGT-M); and pathophysiology, risk factors, classification, prevention (cabergoline, freeze-all strategy, GnRH agonist trigger), and clinical management of severe ovarian hyperstimulation syndrome (OHSS).

10%

Pediatric & Adolescent Gynecology, Family Planning & Menopause

Pubertal development staging (Tanner stages 1-5), evaluation of precocious puberty (central GnRH-dependent vs. peripheral GnRH-independent, bone age, GnRH agonist stimulation test, pelvic ultrasound for ovarian cysts/tumors) and delayed puberty (hypergonadotropic vs. hypogonadotropic hypogonadism); congenital reproductive tract anomalies including Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome (46,XX, normal ovaries, absent vagina and uterus), complete androgen insensitivity syndrome (CAIS: 46,XY, female phenotype, absent uterus, testes, elevated testosterone), transverse vaginal septum, and imperforate hymen; prepubertal vulvovaginitis etiologies (nonspecific poor hygiene, group A Streptococcus, pinworms, foreign bodies); contraception mechanism of action, efficacy (Pearl Index), and contraindications according to WHO and CDC Medical Eligibility Criteria (MEC categories 1-4) for combined hormonal contraceptives (thromboembolism risk, migraine with aura, smoking over age 35, uncontrolled hypertension), progestin-only pills, depot medroxyprogesterone acetate (bone mineral density considerations), subdermal etonogestrel implants, and intrauterine devices (copper vs. levonorgestrel 52mg/19.5mg); emergency contraception options (ulipristal acetate, levonorgestrel, copper IUD insertion within 5 days); endocrinology of the perimenopause and postmenopausal transition (elevated FSH, depleted follicular pool); menopausal hormone therapy (MHT) indications (vasomotor symptoms, genitourinary syndrome of menopause [GSM]), contraindications (unexplained vaginal bleeding, history of breast cancer, active venous thromboembolism, severe liver disease), unopposed estrogen risks and progestogen endometrial protection; and postmenopausal osteoporosis risk assessment (FRAX tool), bone mineral density DEXA T-scores, and pharmacotherapy (bisphosphonates, denosumab, SERMs, teriparatide).

Preparing for the Iran Specialty Board - Obstetrics & Gynecology Exam

What You Need to Know

Passing score: 70% of the written total (105 of 150 points)
Assessment: The Iranian Specialty Board Examination in Obstetrics and Gynecology (آزمون دانشنامه تخصصی زنان و زایمان) is held annually in late summer (traditionally Shahrivar) by the National Center for Health Assessment (مرکز سنجش آموزش پزشکی - Sanjesh Pezeshki) under the auspices of the Secretariat of the Council for Medical and Specialized Education of the Ministry of Health and Medical Education (MOHME). The examination consists of two consecutive stages: a written examination (Azmoon-e Katbi) comprising 152 multiple-choice questions administered in a 240-minute session, and an objective structured clinical/oral examination (Azmoon-e Shafahi/Amali - OSCE / PMP / Clinical Stations). Candidates must achieve a minimum scaled score of 70% (105 points out of a written total of 150) on the written exam to qualify for and sit the clinical oral/practical board examination. The written exam features single-best-answer MCQs with four options and no negative marking.
Time limit: 240 minutes
Exam / certification fees: Nominal administrative registration fee set annually by the Ministry of Health and Medical Education, payable online via the Sanjesh Pezeshki portal during registration Official sources

Using Our Practice Resources

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Iran Specialty Board - Obstetrics & Gynecology: Suggested Study Strategy

1Master Williams Obstetrics high-yield tables and management algorithms: dedicate substantial study time to the chapters on hypertensive disorders of pregnancy, postpartum hemorrhage, fetal growth restriction, abnormal labor progress, and operative vaginal delivery.

2Memorize exact diagnostic thresholds and pharmacologic protocols: know the precise blood pressure criteria for severe preeclampsia (>=160/110 mmHg on two occasions 15 minutes apart), magnesium sulfate dosing regimens (4-6 g IV loading over 15-20 min followed by 1-2 g/h maintenance), severe hypertension first-line intravenous drugs (labetalol and hydralazine), and uterotonic contraindications (avoid methylergonovine in hypertension; avoid carboprost in asthma).

3Internalize FIGO staging and ASCCP guidelines: learn the 2018 FIGO cervical cancer staging, 2023 FIGO endometrial cancer staging (including molecular subgroups), and 2019 ASCCP risk-based management thresholds for abnormal cervical cancer screening tests.

4Understand the NICHD three-tier fetal heart rate monitoring classification: be fluent in recognizing Category I (normal), Category II (indeterminate, requiring intrauterine resuscitation), and Category III (abnormal, sinusoidal or absent baseline variability with recurrent late/variable decelerations or bradycardia, requiring prompt delivery).

5Capitalize on the zero-penalty scoring system: because there is no negative marking on the Iranian board examination, answer every single question on the paper. For challenging clinical vignettes, systematically eliminate physiologically implausible distractors to optimize your probability of selecting the correct answer.

Frequently Asked Questions

What is the Iranian Specialty Board Examination in Obstetrics and Gynecology?

It is the national exit and specialty credentialing examination administered annually by the National Center for Health Assessment (Sanjesh Pezeshki) and the Council for Medical and Specialized Education for graduates of accredited 4-year obstetrics and gynecology residency programs in Iran. Passing both the written examination (Azmoon-e Katbi) and the practical/oral clinical examination (Azmoon-e Shafahi/Amali) confers the prestigious Board Certification (Daneshnameh Takhasosi), which is legally required to hold academic university faculty appointments, supervise residents, and enter clinical subspecialty fellowship training programs.

What is the passing score and format for the written examination?

The written board examination consists of 152 single-best-answer multiple-choice questions with four options administered over a single 240-minute session. There is no negative marking for incorrect answers. Candidates must achieve a minimum score of 70% (105 points out of a written total of 150) on the written exam to qualify for and be admitted to the clinical oral/OSCE examination stage.

What are the primary reference textbooks designated by the Iranian Board Examination Committee?

The official national references specified in the curriculum published by the Secretariat of the Council for Medical and Specialized Education are Williams Obstetrics (latest edition by F. Gary Cunningham et al.) and Berek & Novak's Gynecology (latest edition by Jonathan S. Berek), supplemented by official national clinical protocols published by the Ministry of Health and Medical Education (MOHME) and standard international consensus guidelines (ACOG, FIGO, RCOG).

What is the difference between the Specialty Certificate (Govahi-nameh) and Specialty Board (Daneshnameh)?

The Specialty Exit Certificate (Govahi-nameh Takhasosi) qualifies an OB/GYN graduate to practice independently as a specialist physician in Iran and fulfill compulsory regional service obligations. The Specialty Board (Daneshnameh Takhasosi) is a higher-tier academic credential obtained by candidates who score 70% or higher on both the national written and clinical oral/OSCE board examinations, which is mandatory for university faculty tenure, academic promotions, and subspecialty fellowship entrance.

How is the clinical oral/OSCE examination structured?

Candidates who pass the written exam (>=70%) sit the multi-station clinical practical examination (Azmoon-e Shafahi/Amali). This consists of Objective Structured Clinical Examinations (OSCE), structured oral interviews with academic board examiners, patient management problems (PMP), computer-based clinical scenarios, intraoperative video and surgical decision-making stations, and ultrasound/pathology image interpretation stations.

Is this OpenExamPrep question bank an official Sanjesh Pezeshki resource?

No. This question bank is an independent English-language MCQ study adaptation developed by OpenExamPrep for conceptual review and mastery. The official Iranian specialty board examination is administered in Persian by Sanjesh Pezeshki. This resource is not an official translation, not an official-format simulation, and is neither affiliated with nor endorsed by Sanjesh Pezeshki or the Ministry of Health and Medical Education.

Free Practice Questions for Iran Specialty Board - Obstetrics & Gynecology

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