How to Solve IMLE Exam Questions: A Step-by-Step Approach

The Israeli Medical Licensing Exam (IMLE) is a must for foreign-trained doctors who want to practice in Israel, yet fewer than 30% of candidates pass on their first attempt. This often happens because students haven’t developed question-solving skills that help them reach the correct answer faster and in a systematic way.

In this blog, I’ll break down IMLE question types, walk you through an example case, and give you a simple, systematic method to tackle every question.

Step-by-Step Approach to IMLE Exam Questions

Case Scenario

Step 1: Focus on the Question

Before reading the entire scenario, highlight the question itself. Ask: What is it specifically asking?

In this example, it asks for the “most appropriate initial management”, guiding your reasoning toward immediate interventions.

Step 2: Read the Scenario Carefully

After narrowing options, read the case thoroughly. Note key details such as:

• Age: 62 → higher cardiovascular risk

• STEMI: anterior (V2-V5) → large infarct area, higher risk of remodeling

• Treatment: thrombolytics + PCI → reperfusion done

• Discharge: long-term secondary prevention is needed

Key point: Long-term mortality reduction is important in post-MI patients.

Write quick notes beside the scenario to keep important points visible.

Step 3: Identify Keywords

Look for phrases that guide the answer:

• “long-term medications” → chronic therapy, not acute

• “improved mortality” → only drugs proven to reduce death post-MI

• Patient stabilized and preparing for discharge → think secondary prevention

Step 4: Consider the Patient’s Context

Think about risk factors and comorbidities.

in this case you should think about post-MI standard of care:

• ACE inhibitors (e.g., Lisinopril) → especially beneficial in anterior MI or reduced ejection fraction

• Beta-blockers → also improve survival (not listed in options)

• Statins / antiplatelets → improve survival (not listed)

• Drugs like diuretics or nitrates mainly relieve symptoms

Context check: Large anterior MI → ACE inhibitor is strongly indicated.

Step 5: Eliminate Clearly Wrong Answers

Scan the choices quickly and remove options that are obviously inappropriate.

Use the Process of Elimination (POE) and Look at each option and ask: Does this drug improve survival after MI?

• Furosemide → Loop diuretic; mainly symptom relief in heart failure. Does NOT improve mortality.

• Digoxin → Improves symptoms in heart failure, no mortality benefit post-MI.

• Nitrates → Mainly symptom relief (angina), no proven mortality benefit post-MI.

• Nifedipine → Calcium channel blocker; may help angina, but not mortality after MI.

• Lisinopril → ACE inhibitor; reduces mortality and prevents remodeling post-MI.

Step 6: Make Your Best Guess

If uncertainty remains, choose the most evidence-based option.

Trust your reasoning based on scenario analysis rather than instinct alone.

• In this case: Only Lisinopril is evidence-based for mortality reduction post-MI. All others are either for symptom relief or hemodynamic management.

Step 7: Review if Time Allows

Return to any flagged questions and double-check your rationale.

Ensure you haven’t overlooked vital details or misread keywords.

Key Takeaways for Answering IMLE Questions

• Focus first on what the question asks before analyzing the case.

• Use the process of elimination to discard incorrect answers quickly.

• Pay attention to patient history, vital signs, and comorbidities.

• Identify keywords that indicate urgency or the primary problem.

• Align choices with evidence-based guidelines.

• Review flagged questions if time permits.

• Practice with USMLE-style questions—these are highly similar to the IMLE format.

Recommended Articles for IMLE Exam Prep

1- IMLE Exam Failure: 7 Mistakes Foreign Medical Graduates Must Avoid

2- IMLE Exam Prep: 6-Month Plan to Pass on Your First Try

3- Best IMLE Course to pass first-time

4- Top IMLE Exam Course: Dr.Mahdi talk about his experieince with Brocali platform

5- Top IMLE Exam Study Resources to Help You Pass