The objective of this study is to present a new approaches of development systems of test items that will be applied to the National Medical Licensing Examinations. In order to relate all elements of the evaluation process in building a new system, we used the systems approach to problem-solving which involves the development of an overall plan incorporating the interrelated parts of an evaluation process in a sequential pattern. The method we have applied focuses on valid and relevant test items of each subject as an outcome. We have designed the six individual programs that would be a part of whole processes which consists of three different phases such as before-test, test and after-test. The six programs involves sequentially planning of test, requesting test item development, construc ting MCQ, managing test item bank, preparation of test sheets, and test item analysis. One of the characteristic feature of new system is running test item development committees which are made up of subject-matter specialists who together with the nation-wide specialists who are primarily responsible to construct test items, and also with education specialists to refine the structures of each test items.