You must hold, or have held at some point, an active, unrestricted medical license in the U.S. or Canada to apply for SPEX.

If you have a current, active, unrestricted license to practice medicine in the U.S. or Canada, you can take SPEX via the self-nominated process or the state medical 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 state medical board-sponsored process. The sponsoring board may have additional eligibility requirements that you must meet 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 subsequent attempt must be at least 12 months after the first attempt and at least six months after the most recent attempt

State medical board-sponsored examinees may not be subject to the same waiting periods. Any additional retake eligibility requirements and procedures are set by the individual licensing boards, according to their statutes and regulations.

Apply using the SPEX online application and mail in a completed Certification of Identity (CID) form. Please allow one to three weeks to process 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.

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 currently $1,400 per application.

The fee is non-refundable and non-transferable. 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. It focuses on core clinical knowledge and the underlying basic science principles considered essential for the safe and effective practice of medicine. SPEX content is intended to reflect the knowledge and cognitive abilities of all practicing physicians, regardless of specialty. The exam consists of five blocks of 60 minutes each, with 40 items in each block.

FSMB provides the SPEX Information Bulletin and a free paper and pencil practice test to help you get familiar 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 clinical principles that are essential for safe and effective patient care. SPEX content is constructed around two primary dimensions reflecting experience in medical practice, disease categories, and physician tasks, rather than specialty areas. A complete description of the examination content is outlined in the SPEX Information Bulletin.

Your scheduling permit will include the dates for a 90-day eligibility period in which to take the exam. If your eligibility period 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 will receive an email with a link to access and print your permit. 

Yes, if you are unable to take the test within your eligibility period, you can request a one-time, 90-day 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 the original eligibility period. You can apply for an eligibility extension here.

Yes, but you must notify Prometric at least five business days in advance of your test date. To reschedule your examination, you must call the number provided on your scheduling permit. To cancel your application, you must send an email to the FSMB at spex@fsmb.org.

Yes, 45 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.

Scores are typically released within two to four weeks of testing. We report scores by mail only, and we will not give them out by phone, fax, or email.

Generally, state medical boards accept passing SPEX scores no matter where you took the exam. However, because each board establishes its own pass/fail score requirements as well as other specific requirements for licensure, we recommend you contact the board from which you desire licensure to confirm the acceptance of SPEX.

The SPEX program provides reasonable accommodations to examinees with documented disabilities as defined by the Americans with Disabilities Act (ADA) as amended in 2008).  If you require test accommodations, click here for information regarding the application process and documentation requirements.You must request test accommodations in writing when you submit your SPEX application.