Frequently Asked Questions
You must hold, or have held at some point, an active, unstricted medical license in the U.S. or Canada in order to apply for SPEX.
If you have a current, active, unrestricted license to practice medicine in the U.S. or Canada, you can take the SPEX via the self-nominated process or the board-sponsored process.
If you do not have a current, active, unrestricted license in the U.S. or Canada, you must take SPEX through the board-sponsored process. The sponsoring board may have additional eligibility requirements that you must meet in order to take SPEX.
The following rules apply to retakes:
- You may take SPEX no more than three times within a 12-month period
- You can retake the exam after your first attempt with no waiting period
- A third attempt requires a mandatory 90-day waiting period from the previous attempt
- Any attempts after the third 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.
Submit an application using the SPEX online application and mail in a completed Certification of Identity (CID) form. Allow one to three weeks for the processing of your application. We will email you once your application is approved. Three to five days later you will receive another email with a link to access and print your Scheduling Permit; you must use the SPEX ID provided in the approval email to access your permit.
The SPEX is administered at Prometric Testing Centers in the U.S. The test can be scheduled Monday through Friday throughout the year; some locations have Saturday hours. Test site information is available on Prometric's website.
The SPEX fee is $1300 per application and is non-refundable and non-transferable from one eligibility period to another or from one application to another. Fees must be paid via American Express, MasterCard or Visa. If you schedule an examination but do not take it and do not cancel with Prometric, you will forfeit your entire SPEX fee.
SPEX is a one-day, computer-administered examination that focuses on a core of clinical knowledge and relevant underlying basic science principles deemed necessary to form a reasonable foundation for the safe and effective practice of medicine. Content of the SPEX is intended to reflect the knowledge and cognitive abilities of all practicing physicians, regardless of specialty practiced. The exam consists of five blocks of 60 minutes each (40 items in each block).
The FSMB provides the SPEX Information Bulletin and a free, paper & pencil practice test that should provide familiarity with the formats used in the exam. A computer-based Comprehensive Clinical Medicine Self-Assessment (CCMSA) is also available for a small fee and helps you become familiar with how to navigate the examination.
Every physician, regardless of specialty, is expected to be familiar with a core of clinical principles that are essential for safe and effective patient care. Examinees who have stayed current with the general medical literature are unlikely to encounter many questions on the SPEX with which they are totally unfamiliar. SPEX content is constructed around two primary dimensions reflecting experience in medical practice - disease categories and physician tasks - not by specialty areas. A complete description of the examination content is outlined in the SPEX Information Bulletin.
Your scheduling permit will include the beginning and end dates for a 90-day eligibility period in which to take the exam. If your eligibility expires before you take the exam, you must submit either an eligibility extension request (see below) or a new application and fee.
NOTE: Scheduling Permits are only available electronically. You must provide your email address on your application in order to receive the email notice that your Scheduling Permit is available. This email will include a link for accessing and printing your permit.
Yes, if you are unable to take the test within your eligibility period, a one-time contiguous 90 day extension to your eligibility period is possible. 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 the original eligibility period. You can apply for an eligibility extension here.
Yes, but with certain restrictions. In order to reschedule within your eligibility period, Prometric must be notified at least 5 business days in advance of your test date. To reschedule your examination, you must call the 800-telephone number provided on your scheduling permit. To cancel your application, you must submit a letter, with your signature, to the FSMB at:
Federation of State Medical Boards
400 Fuller Wiser Road
Euless, TX 76039
Fax: (817) 868-4098
Scan and email: firstname.lastname@example.org
Forty-five minutes is allotted for break time and can be divided in any manner you prefer. For example, you can take a short break at your seat after you complete a block, or you can take a longer break for a meal outside the test center after you complete a few blocks. If you complete a block of the test or tutorial section early, the remaining time will be available for breaks. It will not be available to complete other blocks of the test. As you progress through the blocks of the test, you should monitor how many blocks are remaining and how much break time is remaining. If you take a long break and exceed the allocated or accumulated break time, your time to complete the last block(s) in the testing session will be reduced. When section time runs out, you will not be able to move to any new screens. The computer will close the section.
Examinees who take the new SPEX during the first few months of 2019 will experience delays in receiving their scores (e.g., examinees who take the new SPEX late January 2019 will have their scores released in mid-April 2019, at the earliest.). This is necessary for us to complete the quality assurance procedures for the new version of the exam. Once the quality assurance process is complete, we will be able to resume the customary 2-4 weeks timeframe for reporting scores.
Please note! We anticipate completing the new exam implementation process within the first 3 months of testing. However, low testing volume could delay completion of the process. Therefore, the 8-10 week turnaround for score reporting could potentially impact examinees who test within the first 4-5 months (January – May).
Scores are reported by mail on official transcript paper and will not be given out over the telephone, by fax, or by email.
Generally, passing SPEX scores are accepted by a licensing board regardless of the jurisdiction for which the exam is taken. However, because each board establishes its own pass/fail score requirements as well as other specific requirements for licensure, it is recommended that you contact the board from which you desire licensure to confirm the acceptance of the SPEX.
The SPEX program provides reasonable accommodations to examinees with documented disabilities as defined by the Americans with Disabilities Act as amended in 2008, together (ADA). Disabled applicants who are covered under the ADA and require test accommodations should click here for information regarding the application process and documentation requirements. Requests for test accommodations must be made in writing at the time the SPEX application is submitted.