SPEX Practice Test

Prepare for your test with realistic questions.

The Special Purpose Examination (SPEX) is specifically used in the United States and Canada to re-assess physicians and their ability to understand basic medical knowledge.

Click “Start Test” above to take a free SPEX practice test, and check out our premium-quality SPEX test prep resources by clicking the links below!

SPEX Exam Eligibility

To be eligible for the exam, you must hold a current, unrestricted license in the US or Canada. If you are taking the exam via a board-sponsored process, you must also meet the board’s eligibility requirements.

SPEX Exam Outline

The SPEX exam contains approximately 200 questions and is timed at 5 hours.

The questions on the exam fall under two methods of categorization: systems and tasks/competencies.

General principles (not limited to organ systems)1.5%
Immune System
Blood and Lymphoreticular System
Behavioral Health
Nervous System and Special Senses
Skin and Subcutaneous Tissue
Musculoskeletal System
Cardiovascular System
Respiratory System
Gastrointestinal System
Renal and Urinary System
Pregnancy, Childbirth, and the Puerperium
Female Reproductive System and Breast
Male Reproductive System
Endocrine System
Multisystem Processes and Disorders
Biostatistics and Epidemiology/Population Health and Interpretation of Medical Literature/Social Sciences22%


Medical knowledge/scientific concepts8%
Patient care: diagnosis35%
Patient care: management35%
Communication and professionalism12%
Systems-based practice/patient safety and practice-based learning10%


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SPEX Exam Registration

To register for the exam, you must create an online SFMB account and submit your application, certification of identity form (if applicable), and $1,400 fee.

Once your application has been reviewed and approved, you will receive an email. This typically takes 5-7 days. After you receive approval, you will be emailed a copy of your Scheduling Permit. The permit is used to schedule your exam.

Test Day

In-person Testing

On test day, you should arrive about 30 minutes early to the testing center, which will leave time for the check-in process to take place. This process involves checking your ID and signing a confidentiality form.

Once you are checked in, you will be asked to place all personal or prohibited items in a secure locker outside the testing area, and you will be given a piece of scratch paper and two pencils to take notes with during the exam.

Once you are ready, the proctor will lead you to the testing station and provide a brief introduction to the testing system before the exam begins.

Remote Testing

Before you check in for your test, you must clear your table/desk of electronics, resource materials, books, and recording devices. The only things allowed in your testing area are one piece of scratch paper and two pencils.

The remote proctor will first ask you to show your ID. They will then ask you to scan your room with your webcam to show that you have no prohibited items in the area.

Once the proctor is satisfied that the remote testing requirements are met, they will walk you through the examination process and help you begin your exam.

How the SPEX Exam is Scored

Your SPEX score is determined using a scaled scoring system. This scoring system takes your raw score, which is the number of questions you answered correctly, and converts it to a numerical score on a scale from 10 to 100. It is recommended that you get a scaled score of at least 75 to pass the exam.

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How many questions are on the SPEX exam?


There are approximately 200 questions on the exam.


How long is the SPEX exam?


The time limit for the exam is 5 hours.


What is the passing score for the SPEX exam?


The recommended minimum scaled score to obtain is 75.


How much does the SPEX exam cost?


The applcation fee is $1,400.

By Kate Nockunas

Kate has been Mometrix’s Nursing and Medical Editor for over four years. She has a bachelor’s degree in Communications from Vanderbilt University, a bachelor’s degree in Nursing from Marymount University, and a master’s degree in Education from Johns Hopkins. Kate is a critical care registered nurse who still works occasionally in the ICU and PACU.


by Mometrix Test Preparation | Last Updated: December 29, 2023