Ishi Kokka Shiken study guide
Ishi Kokka Shiken · Work through your exam, one topic at a time.
The Ishi Kokka Shiken (医師国家試験, Physician National Examination) is Japan's licensing examination for physicians. Passing it, together with completion of the required clinical training, allows registration as a physician in Japan and is the final step for graduates of Japanese medical schools as well as for candidates who qualify through other recognised routes. The Ishi Kokka Shiken study guide has 9 sections and about 2,828 words.
01Basic Medical Sciences (Anatomy, Physiology, Biochemistry, Pathology, Pharmacology, Microbiology, Immunology)
The basic-science block of the 医師国家試験 (基礎医学) rarely asks isolated facts; it asks which molecule, transporter, enzyme, organism, or inheritance pattern explains a described phenotype. Anatomy is tested spatially without images: the recurrent laryngeal nerve's relation to the inferior thyroid artery, the facial nerve's course through the parotid, colonic blood supply at the splenic flexure, and dermatomes.
336 words, about 2 min02Internal Medicine (Subspecialties and Geriatrics)
Internal medicine (内科) is the largest block of the exam. Questions reward guideline-consistent initial management and recognition of presentations that must not be missed, especially in older adults where classic signs are blunted.
323 words, about 2 min03Surgery (General and Subspecialties)
Surgery (外科) spans general, gastroenterological, cardiovascular, thoracic, paediatric surgery, orthopaedics, neurosurgery, and urology, plus perioperative care. Questions favour decisions: operate or observe, which operation, and in what order, rather than operative technique.
311 words, about 2 min04Pediatrics and Obstetrics/Gynecology
Paediatric questions test normal development and what deviates from it; obstetric questions test the timeline (gestational age, antenatal screening, intrapartum monitoring); gynaecology adds oncology and reproductive endocrinology. Development: social smile at 2 months, head control 3–4 months, sitting 6–8 months, walking 12–15 months, two-word phrases 18–24 months.
304 words, about 2 min05Psychiatry and Neurology
Psychiatry and neurology are examined together and reward two skills: localisation in neurology and the time course in psychiatry. Ask always: acute or chronic, focal or diffuse, fluctuating or stable.
309 words, about 2 min06Emergency Medicine, Critical Care, and Anesthesiology
This domain tests the first ten minutes: prioritisation, immediate action, and recognition of physiologically lethal states before a definitive diagnosis is available. ABCDE with simultaneous resuscitation.
310 words, about 2 min07Public Health, Social Medicine, and Medical Law/Ethics
This domain combines epidemiology and biostatistics with the Japanese health system and the legal duties of a physician. Calculations appear every year, so practise them to the point of automaticity.
328 words, about 2 min08Clinical Skills and Communication (Interview and Physical Examination)
This domain tests interview structure, examination technique, and communication behaviour, usually through written vignettes or observed encounters. Marks are lost by skipping steps, not by lacking knowledge.
308 words, about 2 min09General Clinical Reasoning and Integrated Case-Based Problems
Integrated cases test whether you can move from a presenting complaint to a prioritised differential, choose tests that change management, and act safely when the diagnosis is still uncertain. Build illness scripts: age, onset, character, associated symptoms, risk factors.
299 words, about 1 min