A deep dive into the Computer Adaptive Test (CAT) format, scoring system, and question types you will encounter.
11/23/2025 · 8 min read
Tags: EXAM FORMAT, CAT, SCORING, QUESTION TYPES
The AMC MCQ examination is unique in its delivery. Unlike traditional paper-based exams, it uses a Computer Adaptive Test (CAT) format. Understanding how this system works is crucial for your strategy, as it directly influences how your score is calculated.
What is a Computer Adaptive Test (CAT)?
In a CAT exam, the difficulty of the questions adapts to your ability level in real-time.
- The exam starts with a question of average difficulty.
- If you answer correctly, the next question will be slightly harder.
- If you answer incorrectly, the next question will be easier.
The goal: The system tries to find your "ability level" where you answer approximately 50% of questions correctly. Your final score is determined by the difficulty level of the questions you were answering at the end, not just the raw number of correct answers.
Exam structure breakdown
Duration & questions
- Total time: 3.5 hours (210 minutes)
- Total questions: 150 questions
- Scored questions: 120 questions
- Pilot (unscored) questions: 30 questions
You won't know which questions are pilot questions, so treat every question as if it counts.
Scoring
- Scale: 0 to 500
- Pass mark: 250
- Feedback: You receive a breakdown by domain if you fail.
Question types
All questions are A-type MCQs (one best answer out of 5 options). They typically follow this structure:
1. The stem (vignette)
A clinical scenario presenting a patient's age, gender, presenting complaint, history, and examination findings.
2. The lead-in question
"What is the most likely diagnosis?", "What is the most appropriate initial investigation?", "What is the next best step in management?"
3. The options
5 options. One is the correct (best) answer. The others are distractors which may be partially correct but not the best answer for the specific scenario.
Strategic implications for you
- No going back: Once you click 'Next', your answer is locked. You cannot review previous questions.
- Consistency matters: The CAT algorithm penalises inconsistent performance (e.g., getting a hard question right but an easy one wrong).
- Finish the exam: There is a heavy penalty for not finishing all 150 questions. It is better to guess the last few than to leave them blank.