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RUOK

Japan Medical Management Practice Association (general incorporated association)

Iryo Keieishi Grade 2 (Healthcare Management Professional, Grade 2)

Iryo Keieishi Grade 2 is the middle tier of the three-level qualification run by the Japan Medical Management Practice Association. To sit it you must have passed Grade 3 and be registered with the association as an Individual Full Member or a Corporate Full Member. The exam is split into two fields, each of 50 five-option multiple-choice questions answered on a mark sheet in 80 minutes. Field 1 covers management strategy, organizational management, human resource management, hospital accounting and hospital finance; Field 2 covers the medical fee schedule and medical revenue, management accounting, healthcare and nursing-care cooperation, and multidisciplinary collaboration. Candidates who pass only one field must pass the other within two years of the date their pass certificate was issued. The level the association describes is a mid-level manager who can analyse healthcare management problems and solve them in practice. Grade 2 also functions as a gateway: Grade 1 requires both a Grade 2 pass and registration as a Grade 2 full member.

Official page

Who takes it

  • People who have passed Iryo Keieishi Grade 3 and are registered as an Individual Full Member or a Corporate Full Member (a hard requirement to sit)
  • Mid-career staff running the day-to-day work of a hospital's administrative or medical affairs department
  • Clinical professionals who lead a department, such as head nurses and chief technologists
  • Sales and planning staff at companies serving healthcare institutions (pharmaceuticals, medical devices, healthcare-related services)
  • Anyone aiming at Iryo Keieishi Grade 1, which requires a Grade 2 pass plus Grade 2 full membership

What it lets you do

  • It is what makes you eligible for Grade 1, whose requirements are a pass in the Iryo Keieishi Grade 2 exam and registration as a Grade 2 full member
  • The syllabus is built from items that bear directly on a hospital's finances: the medical fee schedule and medical revenue, management accounting, hospital finance, and healthcare and nursing-care cooperation
  • The level the association describes is having knowledge of healthcare management and the analytical skill to solve management problems, and being able to apply both — the knowledge and problem-solving ability a mid-level manager should have
  • Registering as a full member lets you print "Iryo Keieishi Grade 2" (or "Iryo Keieishi" plus your Grade 2 registration number) on your business card
  • Field 1 and Field 2 can be passed separately, so within a two-year window a pass can be built up over two sittings

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
50 questions in Field 1 plus 50 in Field 2 (100 in total if both fields are taken)
Time
80 minutes for Field 1 plus 80 minutes for Field 2 (160 minutes in total if both fields are taken)
Pass mark
Not published by the exam body (neither the Grade 2 exam overview page nor the "Exam format and fees" page states a passing standard; only Grade 3 carries an explicit figure, "roughly 60% of the total score")
Fee
Both fields: JPY 16,000 (tax included, handling fee separate). Single field, for candidates who have already passed one field: JPY 14,000 (tax included, handling fee separate)
Format
Five-option multiple choice, answered on a mark sheet, at a venue. On top of a Grade 3 pass, registration as an Individual Full Member or a Corporate Full Member is required in order to sit
Languages
Japanese
When it runs
Twice a year (June and October). In fiscal 2026 the 31st sitting was held on Sunday 14 June 2026 and the 32nd is on Sunday 18 October 2026. The 33rd is planned for around mid-June 2027 (details not yet fixed). Ten venues: Sapporo, Sendai, Tokyo, Kanazawa, Nagoya, Osaka, Hiroshima, Takamatsu, Fukuoka and Okinawa
Validity and renewal
Certified Iryo Keieishi renew every three years, applying through the prescribed procedure. A pass in only Field 1 or Field 2 is valid only for sittings held within two years of the issue of the pass certificate (the date the pass number is issued)

How hard it is

Official figures for the 31st sitting (held in 2026): 329 candidates, 60 passed, a pass rate of 18.2%. Recent sittings have stayed in the 18% range — 18.5% (29th), 18.7% (30th), 18.2% (31st) — a long way from Grade 3, whose most recent sitting (the 48th) was 45.7% (source: the association's "Grade 2 candidate numbers over time").

How long people study

...instead points candidates to its recommended Iryo Keieishi Textbook Series (the "intermediate" volumes correspond to Grade 2).

Syllabus

  • Field 1, 1. Introduction to healthcare management
  • Field 1, 2. Management philosophy and vision / management strategy
  • Field 1, 3. Healthcare marketing and regional healthcare
  • Field 1, 4. Healthcare ICT systems
  • Field 1, 5. Organizational management / organizational reform
  • Field 1, 6. Human resource management
  • Field 1, 7. Administrative management / supplies management
  • Field 1, 8. Hospital accounting
  • Field 1, 9. Hospital finance
  • Field 1, 10. Medical law / safety management in healthcare
  • Field 1, 11. Recent trends and current affairs in healthcare
  • Field 2, 1. The medical fee schedule system and medical revenue
  • Field 2, 2. Public relations and advertising / branding / marketing
  • Field 2, 3. Management accounting
  • Field 2, 4. Healthcare and nursing-care cooperation
  • Field 2, 5. New strategies in management methods
  • Field 2, 6. Multidisciplinary collaboration
  • Field 2, 7. Business reform and improvement
  • Field 2, 8. Team-based care and frontline capability
  • Field 2, 9. Diversification of healthcare services and putting it into practice
  • Field 2, 10. Recent trends and current affairs in healthcare

Our apps and books for this exam

  • Iryo Keieishi Level 2 Goukaku Taisaku Drill

    Japanese only

    Iryo Keieishi (Healthcare Management Professional) Level 2 exam drills

    This app's interface and questions are in Japanese.

    Download on the App Store

  • 医療経営士2級 攻略ブック

    Japanese only — the book is written in Japanese.

    Available at Amazon

Questions people ask

I've passed Grade 3. Can I sit Grade 2 straight away?
No. On top of the Grade 3 pass, registration as an Individual Full Member or a Corporate Full Member is required. The association states that eligibility to join and register is valid for six months from the issue of the pass certificate (the date the pass number is issued), and that once that period is over the entitlement to join and register lapses.
What score do I need to pass?
It is not published by the exam body. Grade 3 carries the wording "The passing standard for the Iryo Keieishi Grade 3 certification exam is roughly 60% of the total score", but neither the Grade 2 exam overview page nor the "Exam format and fees" page states a passing standard.
What happens if I only pass Field 1?
You can sit just the field you failed, at any Grade 2 exam held within two years of the issue of your pass certificate (the date the pass number is issued). The fee in that case is the single-field fee of JPY 14,000 (tax included, handling fee separate). Beyond two years you have to take Field 1 and Field 2 again from scratch.
Can I take both fields on the same day?
Yes. For the 32nd sitting, candidates taking both fields are scheduled from 13:05 to 16:25 and sit Field 1 (80 minutes) and Field 2 (80 minutes) back to back. Candidates taking a single field sit Field 1 from 13:05 to 14:25 or Field 2 from 15:05 to 16:25.
How much harder is it than Grade 3?
On the published pass rates, the last three Grade 2 sittings (29th to 31st) were 18.5%, 18.7% and 18.2%, while the last three Grade 3 sittings (46th to 48th) were 40.1%, 49.4% and 45.7%. On the numbers, the gap is more than twofold.

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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