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Japan Medical Management Practice Association (general incorporated association)

Iryo Keieishi Grade 1 (Healthcare Management Professional, Grade 1)

Iryo Keieishi Grade 1 is the top tier of the three-level Healthcare Management Professional system run by the Japan Medical Management Practice Association. Only candidates who have passed Grade 2 and are registered with the association as Grade 2 full members may sit it. The exam has two stages. The first is written: ten short written-answer questions in 90 minutes, followed by two essay questions in another 90 minutes. The second is an interview stage lasting 20 minutes in total, combining an oral examination in presentation format with an individual interview. Questions are drawn from three fields, "Hospital Management Strategy (I)" through "(III)". Nothing is multiple choice: candidates have to set out a management strategy in their own words and then explain it out loud. The level the association describes for Grade 1 holders is being able to support and carry out decision-making as part of the executive team, alongside the chairman and the hospital director. Since the fifth sitting, held in 2017, the separate qualification screening has been dropped, so experience working at a healthcare institution is not required. What is required is the Grade 2 pass and full membership.

Official page

Who takes it

  • People who have passed Iryo Keieishi Grade 2 and are registered with the association as Grade 2 full members (a hard requirement to sit)
  • Administrative directors of hospitals and clinics, and heads of management planning departments
  • Managers whose role is to support the decisions of the chairman or hospital director
  • Consultants and specialists who advise healthcare institutions on management

What it lets you do

  • Once registered with the association, holders may print "Iryo Keieishi Grade 1" (or "Iryo Keieishi" plus their Grade 1 registration number) on their business cards; it is a protected title
  • It is the top of the three-tier system. The association describes holders as having specialist knowledge of healthcare management and practical analytical methods, and as able to support and carry out decision-making as part of the executive team alongside the chairman and hospital director
  • Getting through the first-stage essays and the second-stage presentation leaves demonstrated ability to explain a hospital's management strategy both in writing and out loud
  • Since the fifth sitting, held in 2017, the separate qualification screening has been abolished, so experience working at a healthcare institution is not required in order to sit
  • Individual full members receive the journal Riron to Jissen (Theory and Practice), the monthly MMS News, a 20% discount on association-recommended books, and discounts on seminars

The exam

As published by Japan Medical Management Practice Association (general incorporated association). Anything we could not confirm is left out. Check the official page before you apply.

Questions
First stage: 10 short written-answer questions plus 2 essay questions. Second stage: an oral examination (presentation format) plus an individual interview
Time
First stage: 90 minutes for the short written answers plus 90 minutes for the essays. Second stage: 20 minutes in total for the oral examination and individual interview
Pass mark
Not published by the exam body (for the second stage the association states only that the main criterion is whether the candidate has the ability and character appropriate to an "Iryo Keieishi Grade 1")
Fee
JPY 50,000 (tax included); the transfer charge is paid by the candidate
Format
First stage: written exam (short written answers and essays). Second stage: interview. Both are held at a venue. A career history document must be submitted when registering
Languages
Japanese
When it runs
Once a year. For the 14th sitting, the first stage is Sunday 6 September 2026 and the second stage is Sunday 6 December 2026. The first stage is held at At Business Center Tokyo Station Yaesu-dori (Hatchobori, Chuo-ku, Tokyo); the second stage is planned for a venue in Chuo-ku, Tokyo
Validity and renewal
Certified Iryo Keieishi renew every three years, applying through the prescribed procedure (association page "From the exam to joining the association")

How hard it is

Official figures for the 13th sitting (held in 2025): first stage, 55 candidates, 25 passed, a pass rate of 45.5%; second stage, 25 candidates, 18 passed, a pass rate of 72.0%. Clearing the first stage makes the second comparatively likely to pass, but note that the candidate pool is limited to people who have already passed Grade 2 and registered as Grade 2 full members (source: the association's "Grade 1 candidate numbers over time").

How long people study

...instead points candidates to its recommended Iryo Keieishi Textbook Series (the "advanced" volumes correspond to Grade 1).

Syllabus

  • First stage, short written answers, Section A "Hospital Management Strategy (I)": 1. Hospital management strategy / 2. Balanced scorecard / 3. Clinical pathways and regional healthcare cooperation / 4. Medical-engineering collaboration / 5. Nursing-care management
  • First stage, short written answers, Section B "Hospital Management Strategy (II)": 1. Healthcare governance / 2. Healthcare quality management / 3. Medical information security management systems / 4. Medical accidents and crisis management
  • First stage, short written answers, Section C "Hospital Management Strategy (III)": 1. Strategic hospital management under DPC / 2. Management structures / 3. Communication in healthcare / 4. Services outside insurance coverage and ancillary businesses
  • First stage, essays: discuss the hospital management strategy and the methods of putting it into practice that you would adopt for the given theme (2 questions)
  • Second stage, oral examination: explain the assigned task in presentation format
  • Second stage, individual interview: whether the candidate has the ability and character appropriate to an "Iryo Keieishi Grade 1"

Our apps and books for this exam

  • Iryo Keieishi Level 1 Goukaku Taisaku Drill

    Japanese only

    Iryo Keieishi (Healthcare Management Professional) Level 1 exam drills

    This app's interface and questions are in Japanese.

    Download on the App StoreGet it on Google Play

  • 医療経営士1級 攻略ブック

    Japanese only — the book is written in Japanese.

    Available at Amazon

Questions people ask

Can I sit the exam if I don't work at a healthcare institution?
Work experience is not required. The association states that from the fifth Iryo Keieishi Grade 1 certification exam, held in 2017, the qualification screening was abolished and experience working at a healthcare institution became unnecessary. Passing Iryo Keieishi Grade 2 and being registered with the association as a Grade 2 full member remain mandatory, however.
What is the passing score?
It is not published by the exam body. Neither the Grade 1 exam overview page nor the "Exam format and fees" page gives a score-based standard. For the second stage the association says only that the main criterion is whether the candidate has the ability and character appropriate to an "Iryo Keieishi Grade 1". There is no numerical standard of the kind published for Grade 3 ("roughly 60% of the total score").
If I pass the first stage, can I take the second stage in a later year?
Eligibility for the second stage is written narrowly, as "those who passed the first stage of the 14th Iryo Keieishi Grade 1 certification exam held by this association" — that is, first-stage passers from the same sitting. The official pages say nothing about carrying a first-stage pass forward, so you would need to check with the association office.
Are there costs beyond the exam fee?
The exam fee is JPY 50,000 (tax included) and the candidate pays the transfer charge. Beyond that, Grade 1 certification is granted by changing your registration grade from "Iryo Keieishi Grade 2", so being a full member of the association is a precondition (registration fee and annual dues, JPY 11,000 each).
Is the exam held around the country?
No. Grade 3 and Grade 2 are held at ten venues from Sapporo to Okinawa, but for the 14th Grade 1 sitting the first stage is at At Business Center Tokyo Station Yaesu-dori in Hatchobori, Tokyo, and the second stage is planned for a venue in Chuo-ku, Tokyo.

Sources

These are the pages the figures came from. Some are published in Japanese only, and are marked as such — we keep the original titles rather than translating them, so you can match what you find on the official site. Exam rules change; check the official page before you apply.

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