How to Prepare for the MIR: A 12-Month Study Plan for 2027

The MIR is a ranking exam, not a pass/fail test. You are not trying to reach a fixed mark; you are trying to finish ahead of as many candidates as possible, because your rank decides which specialty and hospital you can choose. That changes how you should prepare.

This plan assumes you know the basics of the exam. If not, read our MIR guide first.

Start with the scoring rules

Three rules shape your whole strategy.

The exam has 200 scored questions plus 10 reserve questions, four options each, in four and a half hours. That is about 80 seconds per question, which is generous compared with many international exams. The challenge is not speed so much as keeping concentration for a long afternoon paper and knowing a very wide syllabus well.

The guessing maths

With four options and the −1 penalty:

• Pure guess: expected value zero. Leave it blank unless you have a reason.
• One option excluded: a guess between three is worth about +0.33 points on average.
• Two options excluded: a guess between two is worth +1 on average. Answer.

Set your personal rule in advance and test it in every mock. Candidates lose more points to inconsistent, tired guessing in the last hour than to any single hard topic.

Before you study: the admin that can stop you

For doctors trained outside Spain, the biggest risks are not academic.

• Homologation. Your degree must be homologated or recognised by the end of the September application window. Start this first; there is no fixed processing time.
• C1 Spanish. If Spanish is not an official language of your country, you need at least C1 to be admitted. A B2 certificate, which is enough for homologation, is not enough here.
• Transcript. Upload your academic transcript when you apply. Without it you get a default average of 5.00.

For the 2027 intake, applications ran from 1 to 14 September 2026 and the exam is on 23 January 2027. If you missed this window, plan for the next annual call.

A 12-month plan in three phases

The phases below are a framework, not a rule. Adjust the length of each to your starting level.

Phase 1: foundation (months 1–5)

Goal: cover the whole syllabus once, in Spanish.

• Work through the main clinical blocks one by one: cardiology, pulmonology, gastroenterology, nephrology, endocrinology, infectious diseases, neurology, haematology and oncology, rheumatology, paediatrics, obstetrics and gynaecology, psychiatry, surgery and its specialties, dermatology, ophthalmology, ENT, plus preventive medicine, epidemiology, statistics, ethics and the basic sciences.
• After each topic, do a short set of questions on that topic only. The aim is to find gaps early, not to score well.
• Build Spanish clinical vocabulary as you go. If you trained in another language, keep a running glossary of terms that differ from what you know.
• Start an error log from day one.

Phase 2: consolidation (months 6–9)

Goal: turn knowledge into reliable answers.

• Switch to mixed blocks of questions from all subjects, timed.
• Revisit weak topics from your error log every week.
• Work through recent past papers topic by topic. They show which areas the exam returns to year after year, and how images such as ECGs, radiographs and clinical photographs are used.
• Do a second, faster pass of the high-yield topics.

Phase 3: simulation (months 10–12)

Goal: perform on the day.

• Sit full papers of 200 questions in four and a half hours, at least weekly in the final two months.
• Start your mocks at 14:00 when possible, so your concentration peaks at the same time as on exam day.
• Review each mock fully within a day: every wrong answer and every correct guess.
• In the last two weeks, stop learning new material. Review your error log and summaries, sleep well and keep one or two light mocks.

How to use past papers properly

The Ministry of Health publishes every version of the question booklets and the final answer key after each exam. They are the most accurate guide to what the MIR asks.

• Do them under time. Reading past papers is not the same as answering them.
• Check against the final key, not the provisional one. After the claims period some questions are cancelled or their answer changed.
• Skip cancelled questions. Their key was found to be flawed.
• Look for patterns. Note which topics come up every year and which question formats you consistently get wrong.
• Watch for outdated answers. Guidelines change; if an old answer conflicts with current Spanish practice, learn the current one.

The error log

Your error log is the most valuable document you will make. For every wrong answer, and every right answer you guessed, record:

Over time the "type" column tells you what to change. Many knowledge gaps means more content study. Many misreads means slowing down. Many bad guesses means tightening your guessing rule.

A sample week in phase 2

Typical mistakes

• Leaving homologation or C1 Spanish too late. No amount of study helps if you are not admitted.
• Reading instead of answering. Questions teach you how the MIR thinks; passive reading does not.
• Answering everything. Blind guesses do not help on average and cost you when tired.
• Skipping full mocks. Four and a half hours is long; stamina has to be trained.
• Studying non-Spanish guidelines only. The expected answers follow Spanish practice.
• Ignoring weak subjects. The exam is broad; small subjects add up.

Practise every day

Short daily sessions add up over a year. You can start with free MIR-style questions on our course page and keep your daily blocks going in the MediFlow Exam Prep app, then review your mistakes the same day.

For the full picture of moving to Spain as a doctor, including homologation and specialist recognition, read Working as a doctor in Spain.