You graduate from med school. After graduation you choose a placement be kilil malet new. Every kilils rule to take the residency exam is different. For example in Somalia region you hv to hv 0 experience then you can take the exam but in amhara region you have to work for 2 years to take it. And after you pass the exam you're placement is via the government I think with the new rule. You'll learn and after you become a senior you have to work off your debt in their placement of choice for the same time you learnt for example if its surgery 4 years if its pediatrics 3 years or pay 1.2 million birr. Then you're free. About the exam your GPA doesn't matter but you have to get top result to get into the field and teaching hospital you desire