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SPEX Application & Scheduling Process

Applying for SPEX, test accommodations, and scheduling your exam

Eligibility Requirements 

To apply for SPEX, you must hold or have held an unrestricted medical license in the US or Canada, depending on your method of application:

  • Board-sponsored: You must hold or have held a valid, unrestricted license in the US or Canada. Board-sponsored candidates take SPEX at the request and approval of a state medical board and must meet all eligibility requirements established by the sponsoring board. Scores are reported to both the examinee and the sponsoring board. If you wish to take SPEX as a board-sponsored candidate, you should contact the licensing board to determine if you meet the board’s eligibility requirements.
  • Self-nominated: You must hold a current, unrestricted medical license to practice medicine in the US or Canada. Self-nominated candidates take the SPEX independent of any request or approval from a licensing board. Scores are reported to the examinee only.

Because decisions regarding acceptance of SPEX results and licensure eligibility are made by the individual licensing authority, eligibility to sit for SPEX does NOT automatically signify your eligibility for licensure. To obtain complete licensure information, you must contact the state medical board to which you are applying. 

Applying for SPEX

  • Create an account and submit your application and fees through the online application system.
    • The SPEX fee is $1300 per application, $650 of which is non-refundable. Your application fee must be paid by American Express, MasterCard or Visa. 
    • Provide an email address: This is the primary means for us to communicate with you regarding your application and will be used to notify you of your application and permit status. Please provide an email address that will accept an email from
  • Print and mail a completed, notarized Certification of Identity form (be sure to attach a photograph). You will be required to submit a new CID if there is any information missing or if a photograph is not attached. 
  • When you apply to take the SPEX, you are agreeing to the Rules of Conduct in the SPEX Information Bulletin. Failure to comply with these rules and proctors’ instructions may result in a determination of irregular behavior (which will be reported on your score report and transcripts) and you may be barred from taking SPEX in the future.
  • Supported browsers:  The SPEX online application may be completed using Internet Explorer Version 7 or higher, Safari Version 5 or above, Google Chrome Version 22 or above, or Mozilla Firefox Version 16 or higher. All supported browsers must allow cookies and have JavaScript enabled. All features may not be fully supported or available through other browsers.


Test Accommodations under the ADA

  • Requests for test accommodations must be made in writing at the time the SPEX application is submitted. 
  • Disabled applicants who are covered under the ADA and require test accommodations should click here for the request form and information regarding the accommodation process and documentation requirements. 


Processing of your SPEX Application

  • Applications are processed within 1-2 weeks.  Board-sponsored applications may take longer, as we obtain written authorization from the sponsoring board to approve the application.   
  • We will email you once your application is approved. You must provide a valid email address on your application in order for us to send you this email.  You will receive another email 3-5 business days later with an electronic link for accessing and printing your Scheduling Permit. 


Scheduling Permit

  • Approximately 3-5 business days after your application is approved, you will receive an email with an electronic link for accessing and printing your Scheduling Permit. You must provide a valid email address on your application in order for us to send you this email.
  • You must use the SPEX ID# provided in your approval email to access your permit.  
  • The Scheduling Permit will indicate your 90-day eligibility period. If you do not take the examination by the eligibility end date, you must either reqeust an eligiblity extension (see below) or submit a new application, including the full fee and any supporting documentation. 
  • The Scheduling Permit includes instructions for scheduling at a Prometric Testing Center. You must bring your Scheduling Permit to the test center on your testing date(s) in order to be able to test.
  • You may access your permit at any time by using this link:  Please contact us at (817) 868-4041 or if you are unable to access your Scheduling Permit.

Extending your Eligibility Period 

  • If you need to extend your eligibility period, you may submit an eligibility extension request and $65 processing fee.  
  • If your request is approved, a one-time contiguous 3-month extension will be granted. 
  • Eligibility extension requests can only be submitted after your original scheduling permit is available and must be received no later than 25 days after the end of your original eligibility period.
  • Requesting an extension of your eligibility period does not cancel a scheduled exam appointment. If you have a scheduled testing appointment during your original eligibility period and need to reschedule the appointment for an extended eligibility period, you must cancel or reschedule with Prometric. A fee may be charged if you change your appointment, depending upon how much notice you provide when making the change. 

Scheduling / Rescheduling / Canceling Your Exam 

  • Scheduling: Your Scheduling Permit must be available before you can schedule your exam. SPEX is administered through Prometric in the U.S. and Canada. Test site information is available on Prometric's website. You must provide Prometric with the Scheduling # on your permit to schedule your exam. Appointments are assigned on a first-come, first-served basis.
  • Rescheduling: You may change your scheduled date or center by following the instructions on your Scheduling Permit. The exam must be rescheduled within your eligibility period. To avoid a rescheduling fee, you must cancel or reschedule your appointment at least five business days before your scheduled test date.
  • Canceling: To cancel your application, you must submit a signed letter to the FSMB at or at the physical address below. If you have followed Prometric's cancellation procedures or have never scheduled an examination testing session with Prometric, you are eligible to request a partial refund of your SPEX fee. If you schedule an examination but do not take it and do not cancel with Prometric, you will forfeit the entire SPEX fee.

Federation of State Medical Boards
400 Fuller Wiser Road
Euless, TX 76039-3856


Examinees who Require Personal Items in the Testing Room

Unauthorized possession of personal items in the secure areas of the testing center is prohibited. However, in certain limited circumstances, exceptions to this policy may be made for medical reasons, provided that permission is granted in advance of the test date(s). To request such an exception, submit a written request to at least four weeks prior to your anticipated test date. You will need to explain the necessity for the exception and provide documentation from your medical professional substantiating your need to use the item(s) during test administration.

All personal items, including those permitted as an exception under this policy, are subject to inspection at the test center. If you bring an item to your test administration without obtaining permission in advance, you may not be permitted to test, you may be required to relinquish the item, you may be investigated for irregular behavior, and/or you may have your score held until you provide adequate documentation from your medical professional.