State of Kuwait Ministry of Health Kuwait Institute for Medical Specialization Kuwait Medical Licensing Examination (KMLE) Guide Table of contents Introduction Objectives Eligibility Validity of the examination Board of examiners Format and content of the examination Examination schedule Results Resit for the examination Registration fees Application procedure Recommended textbooks for KMLE Answer Sheet for Paper 1 Answer Sheet for Paper 2 Appendix Sample questions – Paper 1 Sample questions – Paper 2 Introduction Most countries have laws and regulations governing the practice of medicine. Although licensing provisions vary among industrialized countries, requirements commonly include successful completion of a licensing examination. To ensure minimal professional standards for those who wish to practice medicine in Kuwait, a licensing examination has been established and recognized by the Ministry of Health, State of Kuwait. Objectives The objectives of the Kuwait Medical Licensing Examination (KMLE) are to: Institute standardized methods of evaluating medical graduates from different medical schools for the practice of medicine in Kuwait. Ensure that doctors have the required medical knowledge, clinical judgement and skills to practice medicine consistent with contemporary standards of care. Assure the public that doctors intending to practice in Kuwait are professionally qualified. Eligibility The KMLE is a prerequisite for the practice of Medicine in Kuwait. All medical school graduates who do not currently hold a license to practice in Kuwait are required to successfully complete this examination in order to practice medicine in the public or private sectors. A doctor who holds a professional medical degree conferred by a medical school recognized by the Ministry of Higher Education, Kuwait (as listed in the most recent issue of the World Directory of Medical Schools, published by the World Health Organization) is eligible to apply for the KMLE. Validity of the examination The results of the KMLE are valid for five years subsequent to the date of passing the examination. If a doctor has not practiced medicine for more than five years after passing this examination, successful completion of a new examination, under its current format at the time of re-examination, will be required for licensure. Board of examiners The examination is set by the Board of Examiners who are members of the Faculty of Medicine of Kuwait University and the Ministry of Health. Format and content of the examination KMLE is a one day written examination in English, composed of two MCQ papers. The professional competencies of candidates are evaluated by means of the following examination tools: Paper 1 This is an MCQ paper of 100 questions. Twenty five questions are derived from each of the 4 major disciplines (Medicine, Paediatrics, Surgery and Obstetrics and Gynaecology). Questions on Psychiatry, Community Medicine and Primary Care are included in the major disciplines. Each question has 5 answers, of which ONE is correct. The candidate has to identify only the correct one on the special answer sheet provided. The total mark for this paper is 100. There is NO negative marking. The time allowed is 2.5 hours. Paper 2 This paper consists of 40 questions, 10 from each of the major disciplines, and deals with clinical problem-solving exercises. Each question has 5 answers, each of which may be true or false. Each has to be marked as true or false on the special answer sheet. The total mark for this paper is 200. There is no negative marking. The time allowed is 2.5 hours. Examination schedule The KMLE is administered three times annually, generally in October, February and June. The dates for the examination and deadlines for the application procedures are set by the Kuwait Institute for Medical Specialization (KIMS). Results The results will be announced within 2 weeks of sitting for the KMLE. The pass mark for the entire examination will be determined by the Board of Examiners. Resit for the examination There is no limit to the number of attempts at the KMLE. Registration fees The fee for the KMLE will be determined by the Ministry of Health. This fee must accompany the Application Form. Any candidate who fails to appear for the examination will forfeit the registration fee. The fee must be paid for each attempt at the examination. The fee may be revised based on the costs of the examination. Application procedures Candidates must submit: A completed application form The full fee for the examination A certified true copy of the candidate's diploma for the basic medical degree Two passport size photos Recommended Text Books for KMLE Medicine Text Book of Medicine Ed. A.L. SouhaMi, J. Moxam Or equivalent text book. Supplementary Revision Guides: 1. The Cleveland Clinic Intensive Review of Internal Medicine Ed. J. K. Stoller, M. Ahmed, D. Longworth 2. Pretest medicine: Pretest Self-assessment and Review 3. Pretest Step 2 Simulated Exam. “Latest Edition” McGraw Hill Obstetrics and Gynaecology 1. Williams Obstetrics (19th Edition) - 1993 F. Gary Cunningham, Paul C. Macdonald, Norman F. Gant, kenneth J. Leveno, Larry C. Gilstrap III 2. Comprehensive Gynaecology Arthur L. Herbst et al Paediatrics 1. Illustrated textbooks of Paediatrics Tom Lissauer and Graham Clayden 2. Practical Paediatrics M.J. Robinson and D.M. Roberton Surgery 1. Principles of Surgery – Schwartz, 7th Edition, Edited by Shires Spencer and Daly Fisher Galloway 2. Bailey and Love’s Short Practice of Surgery, 23rd edition, Edited by RCG Russell, WS Williams & CJK Bulstrode Sample Questions – Paper 1 1. Guillain-Barre syndrome (acute inflammatory demyelinating polyradiculoneuropathy) is characterized by all the following EXCEPT a. Symmetrical weakness beginning in the feet. b. Bilateral lower motor neurone facial palsy c. Hyporeflexia or areflexia d. Severe sensory loss with sharp level of anesthesia e. Elevated protein with normal cell in CSF 2. The following are commonly associated with childhood asthma EXCEPT a. Raised serum IgE level b. Clubbing of fingers c. Positive skin test to house dust mite d. Previous history of infantile eczema e. Wheezing after exercise 3. Massive lower gastrointestinal hemorrhage a. Rarely stops after resuscitation b. Is caused by large bowel lesions only c. can be most accurately localized by colonoscopy d. Is frequently related to right colon lesions e. Is most commonly caused by adenocarcinoma of the large intestine 4. Which one of the following statements about nausea and vomiting of pregnancy is correct? a. It occurs in the morning b. It usually disappears by the 4th month c. The severity of vomiting correlates with the serum levels of chorionic gonadotrophins d. Therapeutic abortion is frequently the only successful therapy for severe nausea & vomiting e. Pregnancies with nausea & vomiting are less likely to have a favorable outcome Correct Answers 1. d 2. b 3. d 4. b Sample Questions - Paper 2 1. A 23 year old healthy female is being evaluated for explorative laporotomy for a possible unruptured ectopic pregnancy. She has no cardiac symptoms, a mid-systolic click over the mitral area is heard with no other extraneous sounds or murmurs. a. Surgery should be performed as scheduled b. Surgery should be postponed until cardiac work up can be done c. Prophylactic antibiotics for subacute bacterial endocarditis should be given before surgery d. A cardiac surgeon should stand by doing the explorative laparotomy e. None of the above 2. A 72 years old man comes to the urology clinic with symptoms of frequency, urgency, poor stream and post micturition dribbling. On examination, the bladder is not palpable and on rectal examination the prostate feels nodular and hard in areas. Plain X-ray abdomen reveals calcification in the prostate. Patient should have: a. An abdominal ultrasound b. A cystoscopy and transurethal resection of the prostate c. Serum prostate specific antigen (PSA) d. Uroflametry e. Transrectal ultrasound and simultaneous biopsies of any suspicious lesions 3. A 62 year old male is admitted with a history of sudden onset of retrosternal chest pain while sleeping associated with nausea & vomiting. There is no similar past history. A routine blood check 3 months back had shown a normal cholesterol level. Which of the following are true or false? a. Acute myocardial infarction is the most likely diagnosis b. The ECG will provide diagnostic information c. The diagnosis should be confirmed by an urgent stress exercise test d. The patient should be admitted to hospital e. A normal cholesterol level excludes the diagnosis of myocardial infraction 4. A female 1 year old child develops a one day history of vomiting followed by a brief generalized convulsion. Your action will be: a. Admit the child to ICU b. Do lumbar puncture c. Observe the baby in hospital d. Give the baby regular antipyretics e. Start the baby on antibiotics Correct Answers 1. True a, c 2. True c, d, e 3. True a, b, d 4. True b, c, d False b, d, e False a, b False c, e False a, e