UPSC CMS 2024 Previous Year Questions

Paper I tested endocrinology, hepatology, and neurology with clinical vignettes. Paper II focused on laparoscopic surgery, high-risk obstetrics, and epidemiological study design with more calculation-based Biostatistics. The most significant structural change in 2024 was the PSM weightage increase to 50 questions in Paper II (from 40 in previous years), with a corresponding reduction in OBG to 30 questions. Cardiology led Paper I with 13 questions. Infectious Disease held at 12, while Pulmonology surged to 11. Pediatrics received a substantial boost to 38 questions. In Paper II, GI Surgery stayed competitive at 13 questions, and Urology emerged as a newly prominent topic with 5 questions.

Official UPSC CMS 2024 answer keys were published on upsc.gov.in. CMS Prep has cross-verified answers against official keys and corrigenda. Several Biostatistics questions had borderline rounding differences in answer disputes. CMS Prep includes step-by-step solutions for all calculation questions. Some Surgery answers required referencing specific surgical textbook editions.

Download the UPSC CMS 2024 question paper PDF and official answer key from our Telegram channel.

The 2024 Paper I saw a dramatic reshuffling. Cardiology's rise to 13 questions made it the single most-tested subject, with valvular heart disease, heart failure management, and ECG interpretation featuring heavily. Pulmonology at 11 questions covered COPD, asthma, and respiratory infections in detail. Gastroenterology dropped sharply from its 2023 peak of 19 to just 8 questions — the biggest single-topic decline in the series. Endocrinology also fell to 6 questions. These reductions freed space for the Pediatrics increase to 38 questions, including child development, nutrition, and paediatric infectious diseases. The Medicine share contracted to 82 questions, the lowest in the series.

The PSM increase to 50 questions was the headline change in Paper II. Communicable Diseases at 11 questions and Biostatistics at 6 questions drove this expansion, with more calculation-heavy problems on sensitivity, specificity, PPV, and NPV than any previous year. Urology's rise to 5 questions was significant, covering urinary stone disease, benign prostatic hyperplasia, and urological malignancies. OBG's reduction to 30 total questions meant fewer questions on routine topics, but those that remained were more clinically complex, focusing on high-risk obstetrics and gynaecological oncology.

2024 rebalanced toward Cardiology and Pulmonology in Paper I, alongside a continued emphasis on Infectious Disease. Paper II saw increased weight on Biostatistics and Urology — areas historically under-represented. The PSM expansion to 50 questions fundamentally changed the Paper II dynamic, rewarding candidates who had invested in public health concepts and epidemiological calculations. The paper was considered moderately difficult overall, but the Biostatistics calculations added a time-management challenge that many aspirants reported struggling with. The reduction in Gastroenterology and Endocrinology in Paper I was a relief for some but meant fewer expected high-yield questions for others. Question style continued the clinical vignette trend with increasingly sophisticated patient scenarios.

The 2024 paper introduced the most significant structural change in the series: PSM's expansion to 50 questions at the expense of OBG. If you are preparing for upcoming CMS exams, this paper is your most important reference for understanding the current exam pattern. The PSM weightage increase signals that UPSC expects CMS officers to have strong public health competencies, not just clinical skills. The Cardiology and Pulmonology emphasis in Paper I also suggests a shift toward organ-system-based testing rather than the traditional subject-based approach. Practice this paper alongside 2025 to see whether the PSM-heavy pattern was maintained or further intensified. Use the Biostatistics questions specifically for timed practice, as calculation speed is now a differentiator.

See how this year compares to all six years of UPSC CMS papers — subject weightage shifts, topic trends, and a measurable difficulty trend across 2020–2025.