The Intermedical School Physiology Quiz (IMSPQ) was initiated in 2003 during the author's last sabbatical from the University of Malaya. At this inaugural event, there were just seven competing teams from Malaysian medical schools. The challenge trophy for the IMSPQ is named in honor of Prof. A. Raman, who was the first Malaysian Professor of Physiology at the University of Malaya. The interest generated by this physiology quiz has been very encouraging as the competition expanded to more than 30 university teams with more than half of the teams from overseas. The IMSPQ has become a wonderful platform for international students to meet and establish friendships. The accompanying lecturers of the teams have also the opportunity to network and share interest in the teaching of physiology. This article discusses the mechanism of the quiz and how the quiz questions are designed. It also presents some sample quiz questions and insights and gains from the IMSPQ.