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SPECIAL PURPOSE EXAMINATION (SPEX ®)
Application Methods
All SPEX applicants must hold or have held an unrestricted medical license in a U.S. or Canadian jurisdiction, depending on the method of application:
Board-sponsored: Applicants must have held a valid, unrestricted license in a U.S. or Canadian jurisdiction. Board-sponsored candidates take the SPEX at the request and approval of a state licensing board and must meet the eligibility requirements established by the SPEX program and the sponsoring licensing 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 sponsoring licensing board to determine your eligibility according to the requirements of the jurisdiction.
Self-nominated: Applicants must hold a current, unrestricted medical license to practice medicine in a U.S. or Canadian jurisdiction. Self-nominated candidates take the SPEX independent of any request or approval from a licensing board. Scores are reported to the examinee only.
Application Fee
The SPEX exam fee is $1250 per administration, $412 of which is non-refundable.
Application Process
The SPEX application and registration materials are available from this website through a four part application process. The completed application, fees and supporting documentation must be submitted to the Federation of State Medical Boards (FSMB) at the address provided on the application instructions. Please allow one to three weeks for processing. A Scheduling Permit will be sent to you upon completion of the registration process.
You must submit a copy of your medical license with your application. If you are unable to submit a copy of your license, you must provide one of the following:
- A signed, written explanation by you explaining why a copy of the license cannot be provided (e.g., was surrendered to the licensing authority).
- A signed, written explanation by a licensing authority verifying that you do or did have a license. The letter must be on the licensing authority's letterhead and must indicate when the license was issued and whether it is currently in good standing.
The letter should be mailed to:
SPEX
Federation of State Medical Boards
400 Fuller Wiser Road Suite 300
Euless TX 76039
Name and Address Changes
If your name or address changes after you submit your SPEX application, please use the following forms to notify us of the required changes.
Eligibility Period & Scheduling Permit
Upon approval to take the SPEX, you will be sent a Scheduling Permit that includes a 90-day "eligibility period" in which to take the exam. If you do not take the examination by the eligibility deadline date, you are no longer eligible and must submit a new application, including the full fee and any supporting documentation. The SPEX fee is not transferable from one application to another.
The Scheduling Permit includes a toll-free number and instructions for scheduling at a Prometric Testing Center location of your choice. You must bring your Scheduling Permit to the test center on your scheduled testing date(s) in order to be able to test. Contact the FSMB immediately at (817) 868-4041 or via e-mail at spex@fsmb.org if the Scheduling Permit is lost. Rescheduling of the testing appointment may be required (see details below).
Scheduling / Rescheduling / Canceling
Scheduling
SPEX is administered through Prometric Testing Centers in the United States and Canada. You may take the test on any day that it is offered during the assigned eligibility period. The test can be scheduled Monday through Friday throughout the year; some locations have Saturday hours. Test site information will be provided upon contacting Prometric to schedule the exam and is also available on Prometric's website. The Scheduling Permit must be received before you can contact Prometric to schedule a testing appointment. Appointments are assigned on a "first-come, first-served" basis; therefore, you should contact Prometric as soon as possible after receiving your Scheduling Permit.
Rescheduling
Rescheduling is allowed, but with certain restrictions. The exam must be rescheduled within the eligibility period. You will not be allowed to reschedule beyond your eligibility deadline. You may change your scheduled date or center by following the instructions on your Scheduling Permit for contacting Prometric. To avoid a rescheduling fee, you must cancel or reschedule your appointment no later than 5 business days prior your scheduled test date. You will need to provide your Prometric Confirmation Number when rescheduling. Rescheduling or cancellations must be made and confirmed by direct contact with Prometric; leaving a message on a recorder or by voice mail is not sufficient to confirm these changes.
If you do not cancel your examination testing session per Prometric's procedures, you will be required to pay additional fees directly to Prometric in order to reschedule the examination. Prometric rescheduling fees will also apply if you need to reschedule because you did not provide adequate identification at the time of admission to your testing session, or you arrive too late to begin the examination without disrupting the test center's schedule.
Canceling
To cancel an application, you must submit a signed letter, either by mail or by fax, to the Federation of State Medical Boards (FSMB) at the address or the fax number 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.
SPEX
Federation of State Medical Boards
400 Fuller Wiser Road Suite 300
Euless TX 76039-3856
Fax: (817) 868-4098
Preparation
There are no test preparation courses affiliated with, or sanctioned by, the SPEX program. The most appropriate preparation for the SPEX is a well-planned and comprehensive review of up-to-date textbooks, clinical review publications and periodicals. The SPEX program provides a practice test that may be printed and is available to anyone who is interested in it. Review of the information in the SPEX Information Bulletin and the practice test should provide familiarity with the formats used in the exam.
A web-based "self-assessment" - the Comprehensive Clinical Medicine Self-Assessment (CCMSA) - is also available. The content of the items in the CCMSA resembles the content in SPEX. The CCMSA will also help you become familiar with the question formats used in the examination and with how to maneuver within the examination. The CCMSA is available on the NBME website at: https://nsas.nbme.org/nsasweb/servlet/mesa_main.
Retakes
Self-nominated examinees are limited to 3 attempts within a 12-month period. Examinees may retake the SPEX after the initial attempt with no waiting period and submission of a new application and fee. A third attempt requires a mandatory 90-day waiting period from the previous attempt. Any subsequent attempts require a one-year waiting period from the initial attempt.
Board-sponsored examinees, at the sponsoring board's discretion, may not be subject to the same waiting periods. Any additional reexamination eligibility requirements and procedures for unsuccessful examinees are established by the individual licensing boards pursuant to their statutes and regulations.
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