Posted: April 3, 2020

Next-Step Medical Questions: Multiple Choice Questions for Primary Care Medical Education


This resource is a learning exercise for faculty to use to educate medical students, especially suited for those students in 3rd and 4th year primary care clinical clerkships. It consists of 40 multiple choice questions each of which is a stand-alone case vignette followed by 5 possible choices. The stem of each question ends with the phrase “What would be an appropriate course of action at this point in the case?” Thus they are called Next-Step Medical Questions (NSMQ). There are 4 NSMQ covering common and/or catastrophic diseases in each of 10 human body systems. It is noteworthy that the correct answers as well as the incorrect answers for each vignette are deeply rooted in basic medical science principles and a comprehensive knowledge of pre-clinical medicine is recommended in using this resource.


Stuart Nelson, PhD, retired Medical School Professor

Learner Audience

Undergraduate Medical Education (UME)


Medical Knowledge

Resource Type(s)

Distance Learning - Asynchronous

Instructional Method(s)

Self-Directed Learning


Continuing Medical Education, Graduate Medical Education, Multiple Choice Questions, Undergraduate Medical Education, Primary Care Medical Education, Clinical Clerkships, Clinical Vignettes