100+ Free HPCSA Medical Board Exam Practice Questions

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A 22-year-old requests contraception and is breastfeeding her 3-week-old baby. According to South African contraceptive guidelines and WHO medical eligibility criteria, which method is generally preferred at this stage?

No contraception is needed while breastfeeding

Progestogen-only method such as the injectable or progestogen-only pill

Combined oral contraceptive pill started immediately

Oestrogen patch

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Sample HPCSA Medical Board Exam Practice Questions

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

1A 9-month-old infant is brought to a South African district clinic with watery diarrhoea for 2 days. The child is restless and irritable, has sunken eyes, drinks eagerly when offered fluid, and a skin pinch goes back slowly. Using the IMCI classification, how is this child's dehydration classified?

A.Some dehydration

B.No dehydration

C.Severe dehydration

D.Persistent diarrhoea

Explanation: Under IMCI, two or more of: restless/irritable, sunken eyes, drinks eagerly/thirsty, and slow skin pinch classify the child as 'Some dehydration', managed with ORS using Treatment Plan B. This is the standard SA District Health System approach taught for the board exam.

2According to the South African expanded programme on immunisation (EPI-SA) schedule, at which age is the first dose of measles-containing vaccine routinely given?

A.At birth

B.9 months

C.6 weeks

D.6 months

Explanation: The current South African EPI-SA schedule gives the first measles-containing vaccine dose at 6 months and the second at 12 months. The first routine dose is therefore at 6 months.

3A newborn delivered at a district hospital is apnoeic and floppy at 30 seconds of life despite drying, warming and stimulation. According to neonatal resuscitation principles, what is the single most important first intervention?

A.Chest compressions at 90 per minute

B.Intravenous adrenaline

C.Effective positive-pressure ventilation

D.Endotracheal intubation

Explanation: In newborn resuscitation, effective ventilation is the cornerstone because most neonatal arrests are respiratory in origin. After initial steps fail, positive-pressure ventilation with a bag-valve-mask in air or oxygen is the priority within the first minute (the 'Golden Minute').

4A 2-year-old in a rural clinic has bilateral pitting oedema of the feet, a thin sparse hair pattern and is miserable. Mid-upper-arm circumference is 12.0 cm. According to IMCI and SA nutritional guidelines, how should this child be classified?

A.Moderate acute malnutrition, manage as outpatient

B.Normal nutritional status

C.Uncomplicated severe acute malnutrition for outpatient therapeutic feeding

D.Complicated severe acute malnutrition requiring inpatient care

Explanation: Bilateral pitting oedema indicates kwashiorkor, which is severe acute malnutrition. Oedematous (and any complicated) SAM requires admission for stabilisation, cautious feeding, treatment of infection and prevention of hypoglycaemia and hypothermia per the WHO/SA 10-step protocol.

5A 4-year-old presents to a district hospital with fever, neck stiffness, photophobia and a non-blanching petechial rash. While awaiting transfer and lumbar puncture, what is the most appropriate immediate management according to South African standard treatment guidelines?

A.Immediate intravenous or intramuscular ceftriaxone

B.Oral amoxicillin and discharge

C.Wait for lumbar puncture results before any antibiotic

D.Intravenous aciclovir alone

Explanation: A petechial/purpuric rash with meningism suggests meningococcal meningitis or septicaemia, a medical emergency. Parenteral third-generation cephalosporin (ceftriaxone) must be given immediately and must never be delayed for the lumbar puncture, as early antibiotics reduce mortality.

6A 6-month-old infant born to an HIV-positive mother had a negative HIV PCR at birth. According to the South African PMTCT guidelines, when must HIV PCR testing routinely be repeated for early infant diagnosis?

A.Only if the infant becomes symptomatic

B.At 10 weeks and again at 6 months and 18 months

C.Never, the birth test is sufficient

D.Only at 5 years of age

Explanation: SA PMTCT guidelines require HIV PCR at birth, at 10 weeks (6 weeks post the 6-week visit), at 6 months, and an antibody test at 18 months, with additional testing if breastfeeding continues. Repeated testing is essential because a negative birth test does not exclude later transmission, especially during breastfeeding.

7A 3-year-old child presents with fever, cough, fast breathing (respiratory rate 48/min) and lower chest wall indrawing but is alert and able to drink. Using the IMCI classification of cough or difficult breathing, this child has:

A.No pneumonia: cough or cold

B.Pneumonia

C.Severe pneumonia or very severe disease

D.Bronchiolitis only

Explanation: Lower chest-wall indrawing in a child with cough or difficult breathing classifies as 'severe pneumonia or very severe disease' under IMCI, requiring referral, oxygen if needed and parenteral antibiotics. Any danger sign or chest indrawing upgrades the severity classification.

8An 18-month-old child is brought to a clinic. The Road-to-Health booklet shows the weight curve flattening and then crossing downward across two centile lines over 3 months. This finding is best described as:

A.Normal catch-down growth

B.Obesity risk

C.An expected response to teething

D.Growth faltering requiring assessment

Explanation: A downward trend crossing centile lines signals growth faltering (failure to thrive) and mandates assessment for feeding problems, infection (including HIV and TB), and social factors. The Road-to-Health booklet is a key SA primary-care tool for early detection.

9A 5-year-old presents with a generalised tonic-clonic convulsion that has lasted 6 minutes on arrival at a district emergency unit. After securing the airway and giving oxygen, what is the most appropriate first-line anticonvulsant according to SA standard treatment guidelines?

A.Intravenous or rectal benzodiazepine such as diazepam or lorazepam

B.Oral phenytoin

C.Intramuscular adrenaline

D.Intravenous magnesium sulphate

Explanation: A benzodiazepine (IV lorazepam, or IV/rectal diazepam if no IV access) is first-line for terminating an active seizure lasting more than 5 minutes. If seizures continue, a loading dose of phenytoin or phenobarbital follows per the status epilepticus protocol.

10A health worker notices that a 4-year-old has multiple bruises of differing ages, a torn frenulum and a fearful demeanour, with a history inconsistent with the injuries. According to South African law and HPCSA guidance, what is the practitioner's obligation?

A.Keep the suspicion confidential to preserve the family relationship

B.Report the suspected child abuse to the relevant authorities

C.Discharge the child and review only if injuries recur

D.Confront the parent and refuse to treat until they confess

Explanation: Under the Children's Act, suspected child abuse must be reported to a designated child protection organisation, the provincial department, or the police. Reporting is a mandatory legal and ethical duty, and the child must be examined, documented and kept safe.

About the HPCSA Medical Board Exam Exam

The HPCSA board examination assesses whether foreign-qualified doctors meet the South African standard to register as a Medical Practitioner (Public Service). It tests clinical knowledge and skills relevant to the SA District Health System plus South African ethics, legislation and scope of practice, and requires ECFMG credential verification before sitting.

Assessment

A single board examination in two parts: a 100-item written MCQ paper (75 clinical + 25 ethical/legal, 3 hours, no negative marking), followed by a practical OSCE/OSPE of at least 13 stations (manned and unmanned, including one English-language station).

Time Limit

Written: 3 hours. Practical OSCE: minimum 13 stations of at least 5 minutes each, held about 10-14 days after the written paper.

Passing Score

At least 50% on each written component separately to be admitted to the practical; results are reported as deciles, not specific marks.

Exam Fee

R7283 written/theory component and R7283 practical (OSCE) component (2026 HPCSA fees); a re-administration fee applies if a confirmed candidate does not attend. (Health Professions Council of South Africa (HPCSA), Medical and Dental Professions Board)

HPCSA Medical Board Exam Exam Content Outline

75%

Clinical Knowledge and Skills

SA District Health System conditions across child health, maternal and reproductive health, infectious diseases (TB, HIV, malaria, STIs), emergency and trauma, chronic illness, mental health, surgery/acute abdomen, ENT, eyes, dermatology and primary health care.

25%

Ethical and Medico-Legal Knowledge

HPCSA ethical guidelines, Health Professions Act 56 of 1974, Mental Health Care Act, Choice on Termination of Pregnancy Act, National Health Act, Children's Act, COIDA, consent, confidentiality, record keeping and scope of practice.

How to Pass the HPCSA Medical Board Exam Exam

What You Need to Know

Passing score: At least 50% on each written component separately to be admitted to the practical; results are reported as deciles, not specific marks.
Assessment: A single board examination in two parts: a 100-item written MCQ paper (75 clinical + 25 ethical/legal, 3 hours, no negative marking), followed by a practical OSCE/OSPE of at least 13 stations (manned and unmanned, including one English-language station).
Time limit: Written: 3 hours. Practical OSCE: minimum 13 stations of at least 5 minutes each, held about 10-14 days after the written paper.
Exam fee: R7283 written/theory component and R7283 practical (OSCE) component (2026 HPCSA fees); a re-administration fee applies if a confirmed candidate does not attend.

Keys to Passing

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

HPCSA Medical Board Exam Study Tips from Top Performers

1Anchor your clinical revision in South African sources: the Standard Treatment Guidelines and Essential Medicines List, the SA Family Practice Manual, IMCI, BANC Plus maternity guidelines, and the national TB and HIV/PMTCT guidelines.

2Master the ethics and law list explicitly examined: the HPCSA booklets on good practice, the Health Professions Act, Mental Health Care Act, Choice on Termination of Pregnancy Act, National Health Act, Children's Act and COIDA, since 25 of the 100 written items test these.

3Practise OSCE-style tasks for both manned stations (consultations, counselling, CPR, examinations) and unmanned stations (writing prescriptions, reading X-rays, assessing Road-to-Health charts), and rehearse clear English communication.

Frequently Asked Questions

How many questions are on the HPCSA written board exam and what is the pass mark?

The written paper is a 100-item multiple-choice examination with no negative marking: 75 items on clinical knowledge and 25 on ethical and legal knowledge, completed in 3 hours. Candidates must score at least 50% on each component separately to be admitted to the practical OSCE.

Who administers the HPCSA board exam and how often is it held?

It is conducted on behalf of the HPCSA Medical and Dental Professions Board by the University of KwaZulu-Natal (UKZN). It is held three times a year; the 2026 theory dates are 10 February, 23 June and 15 September, each followed by an OSCE about six weeks later.

How many attempts do foreign-qualified doctors get at the HPCSA board exam?

Candidates are allowed a maximum of three attempts within two years to complete the board examination. Each attempt comprises one theory paper plus the practical, and after three unsuccessful attempts within two years they may no longer sit the exam.

What verification is required before sitting the HPCSA board exam?

Applicants must submit credential verification through the Education Commission for Foreign Medical Graduates (ECFMG/EPIC), a certificate of good standing, a letter of endorsement from the National Department of Health, and (if qualified in a non-English language) IELTS at overall band 6 before being permitted to write.