100+ Free Ishi Kokka Shiken Practice Questions
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A patient has medullary thyroid carcinoma and episodic headaches, palpitations, and sweating. Genetic testing shows a RET mutation. Before thyroid surgery, what associated tumor must be excluded or treated?
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Key Facts: Ishi Kokka Shiken Exam
400
Official Question Count Since 112th Format
MHLW Medical Council materials
15,300 yen
120th Exam Fee
MHLW administration notice
91.6%
120th Overall Pass Rate
MHLW results page
94.7%
120th New-Graduate Pass Rate
MHLW results page
2 days
120th Exam Duration
MHLW candidate instructions
For the 120th Ishi Kokka Shiken, MHLW scheduled a two-day paper examination on February 7-8, 2026, charged a 15,300 yen fee, published the A-F past-question PDFs and answer key, and reported an overall pass rate of 91.6%. The passing standard required at least 160/200 on required items, at least 224/300 on non-required items, and no more than 3 contraindicated choices.
Sample Ishi Kokka Shiken Practice Questions
Try these sample questions to test your Ishi Kokka Shiken exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A 64-year-old man has 40 minutes of crushing chest pain and ST elevations in leads II, III, and aVF. Blood pressure is stable. What is the most appropriate next management?
2A 22-year-old woman with known asthma has wheezing and dyspnea after cleaning a dusty room. She can speak in full sentences and oxygen saturation is 97% on room air. Which medication provides the fastest symptom relief?
3A 17-year-old with type 1 diabetes has abdominal pain, Kussmaul respirations, glucose 520 mg/dL, pH 7.12, bicarbonate 8 mEq/L, and positive serum ketones. What acid-base disorder is present?
4A 72-year-old man develops right arm weakness and aphasia 70 minutes ago. Finger-stick glucose is normal. What should be obtained before deciding on thrombolytic therapy?
5A man has chronic cough, weight loss, upper-lobe cavitation, and sputum acid-fast bacilli on smear. Which infection-control measure is most appropriate while evaluating him in hospital?
6A child has fever, cough, conjunctivitis, coryza, Koplik spots, and a descending maculopapular rash. Which transmission route best explains the need for strict isolation?
7A 4-year-old has 6 days of fever, bilateral conjunctival injection, cracked lips, cervical lymphadenopathy, rash, and swollen hands. Which treatment reduces coronary artery aneurysm risk?
8A 30-year-old pregnant woman at 32 weeks has blood pressure 162/104 mm Hg and new proteinuria. She reports headache and visual flashing lights. What diagnosis is most likely?
9Immediately after vaginal delivery, a woman has heavy bleeding and a soft, enlarged uterus. What is the most appropriate first treatment?
10A 35-year-old has depressed mood, anhedonia, insomnia, poor concentration, and guilt nearly every day for 3 weeks. There is no mania or psychosis. What is an appropriate initial treatment option?
About the Ishi Kokka Shiken Exam
The Ishi Kokka Shiken is Japan's national physician licensing examination administered by MHLW under the Medical Practitioners Act. The official scope is clinical medicine and public health knowledge and skills needed by physicians. Current official materials show a two-day, paper-based, 400-question examination with required/basic items, medical general content, and organ-system clinical disease content. The Reiwa 6 MHLW blueprint emphasizes professionalism, medical safety, interviewing, common symptoms, physical examination, tests, emergency initial care, public health, prevention, treatment principles, and clinical disease management across internal medicine, surgery, pediatrics, obstetrics and gynecology, psychiatry, emergency medicine, infectious disease, and environmental or occupational disease.
Assessment
Paper-based two-day national physician examination with required/basic items, medical general items, and medical specific clinical items. The 120th administration used six scheduled testing blocks over two days.
Time Limit
Two days; about 13 hours 40 minutes of scheduled testing time on the 120th candidate timetable
Passing Score
120th exam: required section at least 160/200, non-required total at least 224/300, and contraindicated choices no more than 3
Exam Fee
15,300 yen (Ministry of Health, Labour and Welfare Japan)
Ishi Kokka Shiken Exam Content Outline
Required Basic Medical Competencies
Professionalism, society and medicine, medical records, quality and safety, interviewing, symptoms, physical examination, basic tests, clinical judgment, emergency initial care, basic diseases, treatment, procedures, end-of-life care, team medicine, lifestyle risk, and general knowledge.
Medical General and Public Health
Health care systems, prevention and health promotion, normal structure and function, life-course medicine, pathophysiology, symptoms, examination, investigations, and treatment principles.
Organ-System Clinical Medicine
Perinatal and pediatric disorders, psychiatry, skin/head-neck disease, respiratory, cardiovascular, gastrointestinal, hematologic, renal and urogenital, neurologic and musculoskeletal, endocrine and metabolic, allergy/rheumatology/immunology, infectious, environmental, and occupational disease.
How to Pass the Ishi Kokka Shiken Exam
What You Need to Know
- Passing score: 120th exam: required section at least 160/200, non-required total at least 224/300, and contraindicated choices no more than 3
- Assessment: Paper-based two-day national physician examination with required/basic items, medical general items, and medical specific clinical items. The 120th administration used six scheduled testing blocks over two days.
- Time limit: Two days; about 13 hours 40 minutes of scheduled testing time on the 120th candidate timetable
- Exam fee: 15,300 yen
Keys to Passing
- Complete 500+ practice questions
- Score 80%+ consistently before scheduling
- Focus on highest-weighted sections
- Use our AI tutor for tough concepts
Ishi Kokka Shiken Study Tips from Top Performers
Frequently Asked Questions
Who administers the Ishi Kokka Shiken?
Japan's Ministry of Health, Labour and Welfare administers the national physician examination and publishes the administration notice, candidate instructions, past-question PDFs, answer keys, and passing standards.
How many questions are on the exam?
MHLW Medical Council materials describe the post-112th format as 400 questions. The 120th exam materials were published as A through F question booklets with a separate answer key.
What was the 120th exam passing standard?
MHLW reported three thresholds for the 120th exam: at least 160/200 on required items, at least 224/300 on non-required general and clinical items, and no more than 3 contraindicated choices.
Can foreign medical graduates take the exam?
Foreign medical graduates or foreign-licensed physicians need MHLW eligibility recognition before taking the Japanese physician national examination. MHLW publishes the current recognition system and procedures separately.
Are these official MHLW questions?
No. These are original practice questions created from official MHLW blueprints and public materials. They do not reproduce official copyrighted question stems.