MIR Exam Preparation Tips for International Medical Graduates

The MIR (Médico Interno Residente) exam is the gateway to residency training in Spain. If you’re a medical graduate—whether Spanish or foreign—and want to specialize in any field of medicine within Spain’s public health system, the MIR is your one shot to make it happen.

Each year, over 15,000 medical graduates compete for around 8,000–9,000 residency positions, making it an incredibly competitive national exam. But it’s more than just a hurdle—your MIR rank determines your specialty and location. Want dermatology in Madrid? Or cardiology in Barcelona? You’ll need a top-tier score.

This guide will give you the full picture: how the MIR works, what it tests, how to prepare effectively, what resources to use, and how to structure your study plan. Whether you’re a Spanish student or an international graduate dreaming of doing your residency in Spain, this is the deep-dive guide you’ve been searching for.

1. Understanding the MIR Exam Structure

The MIR exam is a national multiple-choice test held once a year—usually in late January or early February. It serves as the primary tool for assigning medical graduates to residency positions.

Key Facts:

• 200 multiple-choice questions (+10 "pilot" questions that don’t count)
• Each question has 4 options, only one correct
• Duration: 4 hours
• Questions are typically clinical case-based, testing applied medical knowledge and decision-making
• Negative marking: 1/3 of a point is deducted for each wrong answer

Scoring System:

• 90% of your final score is based on your exam result
• 10% comes from your academic record (Expediente Académico)

This means you could have top grades in med school, but if you bomb the MIR, you won’t get the specialty you want. On the flip side, you can outperform your academic average with a killer exam performance.

2. What Does the MIR Actually Test?

The exam is broad and demanding. It covers all areas of medicine, with an emphasis on internal medicine, pediatrics, obstetrics and gynecology, surgery, psychiatry, microbiology, public health, and clinical reasoning.

Core Areas Include:

• Cardiology
• Respiratory medicine
• Endocrinology and diabetes
• Nephrology
• Neurology
• Infectious diseases
• Oncology
• Emergency medicine
• Radiology and imaging
• Bioethics and legal medicine

Most questions are clinical case scenarios that require you to apply integrated knowledge. They aren’t pure recall—they test your judgment, reasoning, and ability to prioritize.

3. Eligibility: Who Can Take the MIR?

You can take the MIR if:

• You have a medical degree recognized by Spanish authorities
• For non-EU doctors, you must have your title homologated
• You apply via the Ministry of Health’s official website, usually in September or October
• You choose your exam center (Madrid, Barcelona, Valencia, etc.)

Many foreign doctors prepare for the MIR every year—especially from Latin America, the Middle East, and Eastern Europe—hoping to enter Spain’s respected medical system.

4. The Numbers: How Competitive Is It?

• Around 15,000–16,000 applicants yearly
• Around 8,000–9,000 residency spots
• Only the top 3,000–4,000 get to pick highly desired specialties like dermatology, plastic surgery, cardiology, or ophthalmology
• Lower ranks may be limited to family medicine or underfilled specialties

This makes the MIR one of the most competitive residency exams in Europe.

5. The Official Study Timeline: How Long Should You Prepare?

The average MIR candidate studies for 6 to 9 months full-time. Many start in March or April of the year before their exam (usually held in January).

Ideal Timeline:

• Month 1–2: Understand the format, gather materials, and start light reading
• Month 3–6: Full-time study mode, completing first pass of the material
• Month 7–9: Practice exams, high-yield review, and full mock simulations

If you’re working or in school, your timeline will vary—but the golden rule is: The earlier, the better.

6. Best Resources for MIR Preparation

Here’s what most top-scorers use:

Study Programs:

• AMIR
• CTO Medicina
• MIR Asturias
• PROMIR (Digital Platform by Editorial Médica Panamericana)

These programs offer:

• Structured curriculums
• Video lectures
• PDF summaries
• Question banks
• Mock exams
• Personalized tutoring (optional)

Books:

• Manual CTO: Most popular among Spanish students
• Manual AMIR: Preferred by some for its readability and diagrams
• Self-made summaries or "esquemas": High yield and visual for fast review

Question Banks:

• CTO QBank
• AMIR QBank
• ExamenMIR (Past questions from previous years)

Doing past papers is essential—patterns do repeat, and you’ll start recognizing traps and logic.

7. How to Structure Your Study Plan

Every study plan should include:

A. First Pass (Months 1–3)

• Read each subject once thoroughly
• Watch lectures
• Take light notes or highlight PDFs
• Start light question practice

B. Second Pass (Months 4–6)

• Intensify questions (200–300 per week)
• Focus on weak subjects
• Attend live or online reviews
• Use spaced repetition

C. Final Months (Months 7–9)

• Simulate full MIR tests weekly
• Practice time management
• Focus on high-yield topics
• Use summary notes or "last-minute" books

Daily Routine Sample (Full-Time):

• Morning: Study two major subjects (e.g., cardio + micro)
• Afternoon: Practice questions + review mistakes
• Evening: Light revision, flashcards, or group discussion

8. Tips for Foreign and International Students

• Get your title homologated early—it can take several months
• Start learning Spanish medical terminology if not fluent
• Understand that cultural context may affect some questions
• Use bilingual materials if necessary in early phases
• Join support forums or WhatsApp groups of foreign MIR takers

Many Latin American doctors have succeeded in the MIR despite language or system differences.

9. Time Management and Test Strategy

On Test Day:

• You'll have 210 questions in 4 hours (~1.1 minutes per question)
• Do two passes:
  • First: Answer what you’re sure of
  • Second: Revisit doubtful ones
• Mark your answers clearly and carefully
• Watch for trap questions: eliminate options instead of guessing blindly
• Bring snacks, ID, water, and confirmation papers

10. Common Mistakes to Avoid

• Cramming without reviewing: Review is just as important as learning
• Focusing too much on rare diseases
• Skipping practice exams
• Ignoring clinical logic and over-memorizing
• Burning out—you must schedule breaks and protect mental health

The MIR is a marathon, not a sprint. You need sustained energy, not overnight genius.

11. What Happens After the MIR?

After results are released:

• You receive your ranking
• Based on your score, you choose your specialty and location
• Choices are made on the Sede Electrónica del Ministerio de Sanidad
• Once accepted, you begin residency in May of the same year

Residency in Spain lasts:

• 4 years for most specialties
• 5 years for surgical and complex specialties

Final Words: MIR Is Tough, But You’re Tougher

The Spanish MIR exam is grueling—but also fair. If you put in the time, study smart, and stay disciplined, you can land a top specialty in one of Europe’s best healthcare systems.

Thousands of candidates have done it—and many more will. There’s a seat with your name on it if you're willing to earn it. So, take a breath, build your plan, and start studying. Spain is waiting.