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Key Facts: Iran Pre-Internship Medical Exam Exam

200

Total clinical multiple-choice questions on the official national milestone examination

Sanjesh Pezeshki Pre-Internship Examination Regulations

Per sitting

Qualifying threshold is recalculated for each national sitting rather than fixed at a set percentage

Secretariat for Medical Education, Ministry of Health and Medical Education

200 min

Total examination time limit, providing an average of 60 seconds per clinical item

Sanjesh Pezeshki official exam administration rules

Negative marking penalty: incorrect answers receive zero points without penalty

Ministry of Health and Medical Education examination guidelines

2 times/yr

National testing administrations held annually across Iran (Shahrivar and Esfand)

Sanjesh Pezeshki National Medical Assessment Calendar

The Iranian Comprehensive Pre-Internship Medical Exam is a mandatory 200-question, 200-minute national milestone examination administered by Sanjesh Pezeshki with no negative marking. Reaching the qualifying score for that sitting, a threshold recalculated nationally each time rather than fixed, is required to transition from clinical clerkship (Stagiary) to hospital medical internship (Interni).

Sample Iran Pre-Internship Medical Exam Practice Questions

Try these sample questions to review concepts for the Iran Pre-Internship Medical Exam exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 56-year-old man presents to the emergency department with severe, crushing substernal chest pressure radiating to his left jaw that began 50 minutes ago. He is diaphoresis and nauseated. Blood pressure is 135/85 mm Hg, pulse is 88 beats/min, and oxygen saturation is 98% on room air. The 12-lead ECG demonstrates 3 mm of ST-segment elevation in leads V1 through V4 with reciprocal ST depression in leads III and aVF. Which intervention is the most appropriate immediate definitive management?

A.Emergent transfer for primary percutaneous coronary intervention

B.Oral beta-blocker administration followed by outpatient treadmill testing

C.Immediate intravenous unfractionated heparin with serial ECGs every 8 hours

D.Urgent computed tomography angiography of the chest to rule out aortic dissection

Explanation: This patient presents with an acute anterior ST-elevation myocardial infarction (STEMI) characterized by persistent ischemic symptoms and localized ST elevation in the anterior precordial leads. The primary goal of STEMI management is emergent coronary reperfusion, with primary percutaneous coronary intervention (PCI) preferred within 90 minutes of medical contact at a PCI-capable center (or fibrinolytic therapy within 30 minutes if PCI is unavailable within 120 minutes). Dual antiplatelet therapy, anticoagulation, and analgesia should be initiated concurrently without delaying coronary catheterization.

2A 62-year-old woman with ischemic cardiomyopathy presents for routine follow-up. Echocardiography reveals a left ventricular ejection fraction of 30%. She reports mild dyspnea when climbing more than one flight of stairs (NYHA Class II). Her current medications include lisinopril 20 mg daily, carvedilol 25 mg twice daily, and spironolactone 25 mg daily. Blood pressure is 122/76 mm Hg, pulse is 64 beats/min, serum potassium is 4.4 mEq/L, and serum creatinine is 1.0 mg/dL. Which medication should be added to complete guideline-directed medical therapy and reduce cardiovascular mortality?

A.Digoxin 0.25 mg orally daily

B.Empagliflozin 10 mg orally once daily

C.Isosorbide dinitrate 20 mg three times daily

D.Furosemide 40 mg orally twice daily

Explanation: Guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF, LVEF ≤ 40%) comprises four foundational pillars: a renin-angiotensin system inhibitor (preferably an ARNI like sacubitril-valsartan, or an ACEi/ARB), an evidence-based beta-blocker, a mineralocorticoid receptor antagonist, and an SGLT2 inhibitor (such as empagliflozin or dapagliflozin). Large clinical trials have demonstrated that adding an SGLT2 inhibitor provides substantial reductions in heart failure hospitalizations and cardiovascular mortality regardless of the presence or absence of type 2 diabetes mellitus.

3A 68-year-old man with a history of hypertension and type 2 diabetes mellitus is found to have an irregularly irregular pulse during an annual physical examination. He has no chest pain, palpitations, or shortness of breath. An ECG confirms atrial fibrillation with a ventricular rate of 86 beats/min. Echocardiogram shows normal left ventricular systolic function with mild left atrial enlargement. Blood pressure is 134/82 mm Hg. Which antithrombotic strategy is most appropriate for stroke prevention in this patient?

A.Aspirin 81 mg daily monotherapy

B.Aspirin 81 mg daily combined with clopidogrel 75 mg daily

C.Direct oral anticoagulant such as apixaban

D.Subcutaneous low-molecular-weight heparin bridge to therapeutic aspirin

Explanation: This patient's CHA2DS2-VASc score is 3 (1 point for age 65-74, 1 point for hypertension, and 1 point for diabetes mellitus). In men with non-valvular atrial fibrillation and a CHA2DS2-VASc score of 2 or greater (or women with a score of 3 or greater), oral anticoagulation is strongly indicated to reduce the risk of thromboembolic stroke. Direct oral anticoagulants (DOACs, such as apixaban, rivaroxaban, edoxaban, or dabigatran) are preferred over warfarin due to a lower risk of intracranial hemorrhage and non-inferior or superior efficacy without requiring routine INR monitoring.

4A 74-year-old man presents with progressive exertional dyspnea and two recent episodes of presyncope while walking uphill. Cardiac auscultation reveals a harsh, late-peaking systolic ejection murmur heard best at the right upper sternal border that radiates to the carotid arteries, along with a soft, delayed single second heart sound (S2) and a diminished, slow-rising carotid pulse (pulsus parvus et tardus). Transthoracic echocardiogram confirms a calcified aortic valve with an aortic valve area of 0.7 cm² and a mean transvalvular gradient of 48 mm Hg. Which intervention is indicated?

A.Initiation of high-dose beta-blocker therapy with six-month clinical follow-up

B.Long-term oral vasodilator therapy with nifedipine and watchful waiting

C.Routine annual serial echocardiography without physical activity restrictions

D.Prompt aortic valve replacement via surgical or transcatheter approach

Explanation: This patient has severe, symptomatic aortic stenosis defined by an aortic valve area < 1.0 cm², mean transvalvular gradient ≥ 40 mm Hg, and classic cardinal symptoms of angina, syncope/presyncope, and heart failure. Once symptoms develop in severe aortic stenosis, the average survival without intervention is only two to three years. The only definitive, life-prolonging therapy is aortic valve replacement (surgical AVR or transcatheter aortic valve implantation [TAVI]), which should be undertaken promptly.

5A 66-year-old man with a 40 pack-year history of cigarette smoking and known severe chronic obstructive pulmonary disease (COPD) presents with a three-day history of increased shortness of breath, increased sputum volume, and sputum purulence. Blood pressure is 140/85 mm Hg, pulse is 102 beats/min, respiratory rate is 26 breaths/min, and oxygen saturation is 87% on ambient room air. Arterial blood gas shows pH 7.34, PaCO2 52 mm Hg, and PaO2 55 mm Hg. What is the most appropriate initial oxygenation strategy?

A.Titrated controlled oxygen therapy targeting an oxygen saturation of 88% to 92%

B.Non-rebreather mask at 15 L/min targeting an oxygen saturation of 99% to 100%

C.Complete withholding of supplemental oxygen to preserve the patient's hypoxic drive

D.Immediate endotracheal intubation and mechanical ventilation prior to medical therapy

Explanation: In acute exacerbations of COPD, uncontrolled high-concentration oxygen therapy can lead to worsening hypercapnia, respiratory acidosis, and CO2 narcosis via ventilation-perfusion mismatching (loss of hypoxic pulmonary vasoconstriction) and the Haldane effect. Guidelines recommend titrated oxygen therapy utilizing a Venturi mask or low-flow nasal cannula to maintain a target SpO2 between 88% and 92%. Inhaled short-acting bronchodilators, systemic corticosteroids, and antibiotics should be administered simultaneously.

6A 24-year-old woman with persistent asthma presents to the emergency room in acute respiratory distress. She is sitting forward, speaking in short two-word phrases, and using accessory muscles of respiration. Heart rate is 128 beats/min, respiratory rate is 32 breaths/min, and oxygen saturation is 91% on room air. Auscultation reveals diffuse bilateral expiratory and inspiratory wheezing. Which combination of medications represents the most appropriate initial pharmacologic therapy?

A.Subcutaneous epinephrine and intravenous theophylline

B.Inhaled short-acting beta-2 agonist, inhaled ipratropium, and systemic corticosteroids

C.Inhaled long-acting beta-2 agonist and intravenous magnesium sulfate monotherapy

D.Oral montelukast and broad-spectrum intravenous cephalosporin

Explanation: The initial pharmacotherapy for acute severe asthma exacerbations consists of high-dose, repetitive or continuous inhaled short-acting beta-2 agonists (such as albuterol) combined with an inhaled short-acting anticholinergic (ipratropium bromide), along with early administration of systemic corticosteroids (oral prednisone or intravenous methylprednisolone). Systemic corticosteroids reduce airway inflammation, decrease relapse rates, and restore beta-receptor sensitivity, taking effect within 4 to 6 hours.

7A 58-year-old man who underwent total left knee arthroplasty 10 days ago suddenly develops severe dyspnea, pleuritic chest pain, and lightheadedness. On examination, he is pale and markedly tachypneic. Blood pressure is 78/50 mm Hg, pulse is 126 beats/min, and oxygen saturation is 85% on room air. Jugular venous distension is present, and lung fields are clear. Bedside echocardiography demonstrates severe right ventricular enlargement with flattening of the interventricular septum and right ventricular hypokinesis. There are no active bleeding sites. What is the most appropriate immediate definitive management?

A.Therapeutic subcutaneous low-molecular-weight heparin only

B.Urgent inferior vena cava filter placement

C.Systemic intravenous thrombolysis

D.Oral dabigatran 150 mg twice daily

Explanation: This patient presents with a massive (high-risk) pulmonary embolism defined by acute pulmonary arterial occlusion accompanied by sustained systemic hypotension (systolic BP < 90 mm Hg) or cardiogenic shock and right ventricular dysfunction. In the absence of absolute contraindications (such as active internal bleeding or recent hemorrhagic stroke), emergent systemic fibrinolytic therapy (e.g., intravenous recombinant tissue plasminogen activator [alteplase]) is indicated to rapidly lyse the thrombus, reduce pulmonary vascular resistance, and restore systemic perfusion.

8A 64-year-old man with osteoarthritis who regularly takes high-dose ibuprofen presents with two episodes of coffee-ground emesis and several dark, tarry stools over the past 24 hours. On physical examination, he appears pale and anxious. Blood pressure is 98/62 mm Hg, heart rate is 114 beats/min, and abdomen is soft and non-distended with mild epigastric tenderness. Digital rectal examination reveals black, sticky stool that is positive for occult blood. After securing two large-bore intravenous lines and initiating isotonic fluid resuscitation, what is the best next pharmacologic and diagnostic management?

A.Oral sucralfate slurry and urgent barium swallow study

B.Intravenous octreotide infusion and emergent colonoscopy within 48 hours

C.Intravenous vasopressin and emergency surgical wedge resection

D.Intravenous proton pump inhibitor infusion and upper endoscopy within 24 hours

Explanation: This patient presents with non-variceal upper gastrointestinal bleeding secondary to NSAID-induced peptic ulcer disease. Following hemodynamic resuscitation and airway protection, high-dose intravenous proton pump inhibitor therapy (e.g., bolus followed by infusion of pantoprazole or esomeprazole) should be initiated. Intravenous PPI therapy maintains intragastric pH > 6.0, stabilizing clot formation over bleeding vessels. Early upper gastrointestinal endoscopy (esophagogastroduodenoscopy [EGD]) within 24 hours is diagnostic and therapeutic, permitting targeted hemostasis of active bleeding or high-risk stigmata.

9A 54-year-old man with decompensated hepatitis B cirrhosis is brought to the hospital by his family due to progressive confusion, daytime sleepiness, and inverted sleep patterns over the last four days. Physical examination reveals scleral icterus, palmar erythema, moderate ascites, and a prominent flapping tremor when his wrists are dorsiflexed with arms outstretched (asterixis). Vital signs are stable. Serum electrolytes are normal, but serum ammonia is elevated at 112 mcg/dL. The patient had severe constipation for the past week. What is the initial drug of choice for this condition?

A.Lactulose orally or via nasogastric tube

B.Neomycin oral monotherapy

C.Intravenous flumazenil infusion

D.Intravenous high-protein hyperalimentation

Explanation: This patient presents with hepatic encephalopathy triggered by constipation, a common precipitating factor that increases intestinal ammonia production and transit time. Lactulose, a non-absorbable synthetic disaccharide, is the first-line pharmacologic therapy. Colonic bacteria metabolize lactulose into lactic acid and acetic acid, acidifying the colonic lumen. This converts diffusible ammonia (NH3) into non-absorbable ammonium ions (NH4+) that are trapped and excreted in stool ('ammonia trapping'), while its osmotic laxative effect promotes evacuation. Rifaximin is typically added if encephalopathy is refractory or for secondary prevention.

10A 28-year-old woman with a three-year history of ulcerative colitis presents with an acute flare consisting of 8 to 10 bloody bowel movements per day, nocturnal defecation, crampy lower abdominal pain, and subjective fever for the past five days. She is taking oral mesalamine 4.8 g daily. Physical examination demonstrates mild abdominal distension and generalized lower quadrant tenderness without rebound or involuntary guarding. Hemoglobin is 9.8 g/dL, ESR is 58 mm/h, and stool testing for Clostridioides difficile toxin is negative. Plain abdominal radiograph shows no colonic dilation. What is the most appropriate next step in management?

A.Switch oral mesalamine to topical 5-ASA enemas as monotherapy

B.Initiate systemic intravenous corticosteroids and hospitalize for close monitoring

C.Perform an immediate total proctocolectomy with end ileostomy

D.Start long-term loperamide and prescribe broad-spectrum oral metronidazole

Explanation: This patient has a severe acute flare of ulcerative colitis (defined by Truelove and Witts criteria: ≥ 6 bloody stools daily plus systemic toxicity signs such as tachycardia, fever, elevated ESR/CRP, or anemia). Severe flares require hospital admission, fluid and electrolyte resuscitation, and prompt initiation of intensive intravenous corticosteroid therapy (such as methylprednisolone 60 mg daily). Patients must be evaluated daily for clinical response, and non-responders after 3 to 5 days should be transitioned to salvage medical therapy (infliximab or cyclosporine) or surgical resection.

About the Iran Pre-Internship Medical Exam Exam

The Comprehensive Pre-Internship Medical Examination (آزمون جامع پیش‌کارورزی پزشکی - colloquially known as 'Pish-karvarzi' or 'Peh-e Interni') is the definitive clinical milestone examination that medical students in the Islamic Republic of Iran must pass upon completing their two-year clinical clerkship stage (کارآموزی بالینی / Stagiary). Administered nationwide by the National Center for Health Assessment (مرکز سنجش آموزش پزشکی - Sanjesh Pezeshki) under the Secretariat for Medical Education of the Ministry of Health and Medical Education (MOHME), successfully passing this examination is mandatory to earn the rank of Medical Intern (کارورز پزشکی / Intern) and enter the culminating 18-month hospital-based internship phase of the Doctor of Medicine (MD) curriculum. The official examination tests clinical decision-making, diagnostic synthesis, acute emergency stabilization, and therapeutics across eight core domains based on nationally designated medical textbooks: Internal Medicine (~22%), General Surgery & Acute Trauma (~12%), Pediatrics & Neonatology (~12%), Obstetrics & Gynecology (~10%), Infectious Diseases & Antimicrobial Therapy (~8%), Neurology, Psychiatry & Behavioral Medicine (~10%), Minor Clinical Specialties (Orthopedics, Ophthalmology, ENT, Dermatology, Urology, Radiology; ~20%), and Medical Ethics, Forensic Medicine & Epidemiology (~6%). The qualifying benchmark floats from sitting to sitting rather than sitting at a fixed percentage, and there is no negative penalty for incorrect guesses. This question bank is an independent English-language multiple-choice study adaptation authored by OpenExamPrep. It provides 100 high-yield clinical practice vignettes accompanied by in-depth diagnostic rationales and distractor explanations to help medical students master essential clinical knowledge. The official Iranian examination is delivered in Persian; this resource is an educational supplement and is neither an official translation nor sponsored by Sanjesh Pezeshki.

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

Assessment

The examination is administered nationwide twice per academic year (traditionally in late summer / Shahrivar and late winter / Esfand) across designated regional university testing centers under the central administration of the National Center for Health Assessment (مرکز سنجش آموزش پزشکی - Sanjesh Pezeshki). The test comprises exactly 200 four-option multiple-choice questions administered in a single continuous session of 200 minutes (1 minute per question). There is NO negative marking: incorrect answers receive zero points without penalty, so examinees are advised to attempt all questions. The qualifying score (hadd-e nesab) is not a fixed percentage: it is recalculated for each sitting from national performance, and recent sittings have settled in the mid-80s to low-90s out of 200.

Time Limit

200 minutes

Passing Score

Per-sitting floating threshold (out of 200)

Exam / Certification Fees

Set annually by the Ministry of Health and Medical Education, payable online via sanjeshp.ir during official exam 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.

22%

Internal Medicine (بیماری‌های داخلی)

Cardiology (acute coronary syndromes, heart failure, arrhythmias, hypertension), Pulmonology (COPD, asthma, hemoptysis, interstitial lung diseases), Gastroenterology & Hepatology (cirrhosis, acute liver failure, GI bleeding, IBD), Nephrology & Acid-Base (AKI, CKD, glomerulopathies, electrolyte disorders), Endocrinology (diabetes, ketoacidosis, thyroid, adrenal, calcium disorders), Rheumatology (SLE, RA, spondyloarthropathies, vasculitides), and Hematology/Oncology (anemias, leukemias, coagulopathies, transfusion medicine).

12%

General Surgery & Acute Trauma/Emergency (جراحی عمومی و تروما)

Acute abdomen, acute appendicitis, cholecystitis, bowel obstruction, perforated viscus, mesenteric ischemia, abdominal aortic aneurysm rupture, ATLS trauma resuscitation (tension pneumothorax, hemothorax, cardiac tamponade, pelvic fracture), hemorrhagic shock, burns, and surgical soft tissue infections.

12%

Pediatrics & Neonatology (کودکان و نوزادان)

Normal infant and child growth and developmental milestones, neonatal resuscitation and common neonatal disorders (respiratory distress syndrome, hyperbilirubinemia, sepsis), pediatric infectious diseases (croup, bronchiolitis, Kawasaki disease, exanthems), dehydration and rehydration protocols, pediatric nephrology, and common pediatric surgical conditions (pyloric stenosis, intussusception).

10%

Obstetrics & Gynecology (زنان و مامایی)

Routine antenatal surveillance and high-risk pregnancy management (preeclampsia, gestational diabetes, placenta previa, placental abruption), active labor management, dysfunctional labor, postpartum hemorrhage, ectopic pregnancy, abnormal uterine bleeding, pelvic inflammatory disease, gynecologic oncology, and contraception.

Infectious Diseases & Antimicrobial Therapy (بیماری‌های عفونی)

Community-acquired and hospital-acquired bacterial infections, bacterial meningitis, infective endocarditis, tuberculosis management, viral hepatitis and HIV/AIDS, regional and endemic infectious diseases in Iran (brucellosis, anthrax, hydatid disease, cutaneous and visceral leishmaniasis, Crimean-Congo hemorrhagic fever), and rational antibiotic selection.

10%

Neurology, Psychiatry & Behavioral Medicine (بیماری‌های مغز و اعصاب و روانپزشکی)

Acute stroke syndromes and thrombolytic therapy, status epilepticus, headache syndromes (migraine, cluster, temporal arteritis), neurodegenerative and demyelinating diseases (multiple sclerosis, myasthenia gravis, Guillain-Barré syndrome), major depressive disorder, bipolar disorder, acute psychosis, panic disorder, delirium vs. dementia, and psychiatric emergencies.

20%

Minor Clinical Specialties (بخش‌های ماینور)

Orthopedics and fracture management (compartment syndrome, open fractures, septic arthritis, pediatric fractures), Ophthalmology (acute angle-closure glaucoma, central retinal artery occlusion, red eye algorithms), Otolaryngology-Head and Neck (epistaxis, peritonsillar abscess, stridor, sudden sensorineural hearing loss), Dermatology (psoriasis, eczema, pemphigus vulgaris vs. bullous pemphigoid, drug eruptions, melanoma), Urology (acute urinary retention, testicular torsion, nephrolithiasis, BPH, prostate cancer), and Emergency Diagnostic Radiology.

Medical Ethics, Forensic Medicine & Epidemiology (اخلاق پزشکی، پزشکی قانونی و اپیدمیولوژی)

Medical ethics principles in the Iranian clinical context, patient autonomy, truth-telling, confidentiality, medical malpractice liability, forensic identification of injuries, determination and certification of brain death, clinical toxicology (carbon monoxide, organophosphates, methanol, opioids), and epidemiological measures (prevalence, incidence, relative risk, odds ratio, screening sensitivity/specificity).

Preparing for the Iran Pre-Internship Medical Exam Exam

What You Need to Know

Passing score: Per-sitting floating threshold (out of 200)
Assessment: The examination is administered nationwide twice per academic year (traditionally in late summer / Shahrivar and late winter / Esfand) across designated regional university testing centers under the central administration of the National Center for Health Assessment (مرکز سنجش آموزش پزشکی - Sanjesh Pezeshki). The test comprises exactly 200 four-option multiple-choice questions administered in a single continuous session of 200 minutes (1 minute per question). There is NO negative marking: incorrect answers receive zero points without penalty, so examinees are advised to attempt all questions. The qualifying score (hadd-e nesab) is not a fixed percentage: it is recalculated for each sitting from national performance, and recent sittings have settled in the mid-80s to low-90s out of 200.
Time limit: 200 minutes
Exam / certification fees: Set annually by the Ministry of Health and Medical Education, payable online via sanjeshp.ir during official exam registration Official sources

Using Our Practice Resources

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Iran Pre-Internship Medical Exam: Suggested Study Strategy

1Master the high-weight core disciplines first: Internal Medicine (22%), Surgery (12%), Pediatrics (12%), and OB/GYN (10%) collectively account for 56% of the exam, providing the foundational passing margin when mastered thoroughly.

2Do not overlook the Minor Specialties: With Orthopedics, Ophthalmology, ENT, Dermatology, Urology, and Radiology constituting 20% of the blueprint, these questions are often straightforward, pattern-recognition clinical scenarios that offer quick, high-yield scoring opportunities.

3Focus on Iranian regional and endemic diseases: Pre-internship exams frequently test management of zoonotic and regional conditions common in Iran, such as brucellosis (Malta fever), hydatid cyst (Echinococcus), cutaneous and visceral leishmaniasis, Crimean-Congo hemorrhagic fever (CCHF), and scorpion/snake envenomation.

4Practice rapid 60-second clinical vignette pacing: Because the official exam allows exactly 200 minutes for 200 questions, hone your ability to identify chief complaints, key laboratory clues, and immediate next steps of management within 45 to 60 seconds per case.

5Leverage zero negative marking: Because incorrect answers carry no score penalties, develop a deliberate strategy to eliminate definitively incorrect distractors and select the most plausible clinical option on every single item.

Frequently Asked Questions

What is the Pre-Internship Comprehensive Medical Exam (Azmoon Jame Pish-karvarzi)?

The Pre-Internship Comprehensive Medical Exam (آزمون جامع پیش‌کارورزی پزشکی) is a nationwide milestone examination conducted by Sanjesh Pezeshki under the Iranian Ministry of Health and Medical Education. Medical students must pass this examination upon completing their two-year clinical clerkship (Stagiary / کارآموزی) before they are legally permitted to enter the clinical internship (Interni / کارورزی) phase and assume direct patient care duties in teaching hospitals.

How many questions are on the official exam, and what is the passing threshold?

The official exam comprises exactly 200 four-option multiple-choice questions administered over 200 minutes (1 minute per question). The national qualifying score (hadd-e nesab) is set separately for each sitting from that cohort's performance rather than fixed in advance; recent thresholds have fallen in the mid-80s to low-90s out of 200. Candidates who reach the announced threshold pass and matriculate into medical internship.

Is there any negative marking on the Pre-Internship Exam?

No. Unlike the national university entrance exam (Konkur) or general civil service tests, there is absolutely no negative marking on the Pre-Internship Medical Exam. Incorrect answers receive 0 points without deducting marks from correct responses, so candidates should ensure no question is left unanswered.

When and how often is the Pre-Internship Exam held?

The examination is held nationwide twice each academic year, typically in late summer (Shahrivar - August/September) and late winter (Esfand - February/March), synchronized with academic semester completions across all medical schools in Iran.

What happens if a medical student does not pass the exam?

A student who fails to attain the qualifying score announced for that sitting cannot commence their internship rotations and must retake the exam in the subsequent national administration (e.g., in Esfand if failed in Shahrivar, or vice versa), subject to maximum allowable academic extension regulations governed by the Ministry of Health.

Is this OpenExamPrep question bank an official Sanjesh Pezeshki resource?

No. This question bank is an independent English-language clinical MCQ study adaptation authored by OpenExamPrep for conceptual practice and revision. The official national exam is administered in Persian by the National Center for Health Assessment (Sanjesh Pezeshki), and this platform is not affiliated with or endorsed by Sanjesh Pezeshki or the Iranian Ministry of Health and Medical Education.