Background <p>Given the importance of aligning assessments with curriculum standards and the necessity for valid, structured, and standardized multiple-choice tests, this study aimed to conduct a quantitative and qualitative analysis of MCQ exams within the basic medical sciences departments at the Faculty of Medicine of Tabriz University of Medical Sciences in 2023.</p> Methods <p>This descriptive-analytical study was conducted to quantitatively and qualitatively analyze all tests administered in the basic medical sciences groups at Tabriz University of Medical Sciences during the first semester of the 2023 academic year. The core basic courses evaluated in this study included Anatomical Sciences, Physiology, Microbiology &amp; Parasitology, Immunology, Medical Physics, Biochemistry, and Genetics. The questions' Facility Value, discrimination index, and each exam’s internal consistency (by KR20) were evaluated. Qualitative assessments of the tests were conducted to assess content validity, and reliability, ensuring alignment with the educational objectives of basic medical sciences.</p> Results <p>Overall analysis revealed that 404 (50%) questions were appropriately difficult. The effectiveness of distractors was commendable, with only 1.8% being classified as non-functional. Of 810 questions, only 1.2% had a negative discrimination index, while 559(69%) showed a good discrimination index. Validity analysis revealed that 96.6% of the curriculum content was adequately covered in the exams based on the blueprints. All of the questions assessed recall level of cognition.</p> Conclusion <p>This analysis showed that most questions were functioning effectively. However, a subset could benefit from refinement to enhance their clarity and effectiveness in assessment.</p>