Purpose: In 2002, extended-matching type (R-type) items were introduced to the Korean Medical Licensing Examination. To evaluate the usability of R-type items, the results of the Korean Medical Licensing Examination in 2002 and 2003 were analyzed based on item types and knowledge levels. Methods: Item parameters, such as difficulty and discrimination indexes, were calculated using the classical test theory. The item parameters were compared across three item types and three knowledge levels. Results: The values of R-type item parameters were higher than those of A- or K-type items. There was no significant difference in item parameters according to knowledge level, including recall, interpretation, and problem solving. The reliability of R-type items exceeded 0.99. With the R-type, an increasing number in correct answers was associated with a decreasing difficulty index. Conclusion: The introduction of R-type items is favorable from the perspective of item parameters. However, an increase in the number of correct answers in pick ‘n - type questions results in the items being more difficult to solve.