SMLE Exam 2026: Cost, Format, Syllabus & How to Prepare
What the Saudi Medical Licensing Exam actually costs, how it's structured, what it covers, and how to prepare — with sources, and where to confirm current fees.
The Saudi Medical Licensing Exam (SMLE) is the Saudi Commission for Health Specialties' (SCFHS) standardized qualifying exam for medical graduates who want to practice in Saudi Arabia. Here's what the format, syllabus and cost actually look like — cross-checked across multiple sources, with the official channel to confirm anything time-sensitive.
Exam Format
- 200 questions total, split into two sections of 100 MCQs each.
- Single-best-answer format, delivered via Prometric computer-based testing centres worldwide.
- Roughly 4 hours of active exam time, with a scheduled break between sections.
- Scored on a 200–800 scale, with 560 commonly cited as the passing score.
Syllabus
SMLE tests a candidate's ability to diagnose, investigate and manage clinical scenarios across four core areas:
- Internal Medicine
- Surgery
- Pediatrics
- Obstetrics & Gynaecology
Questions are scenario-based rather than pure recall — a clinical vignette followed by a single best-answer choice, which is why practicing the reasoning pattern matters as much as reviewing facts.
Cost
Multiple independent sources put the registration fee at approximately SAR 3,340 (roughly $890 / PKR 258,000) as of recent cycles. SCFHS fees do change between cycles, so confirm the current figure directly on the SCFHS website or the Mumaris Plus portal before you budget or register — don't rely on any third-party summary, including this one, for the exact current number.
How to Prepare
- Practice scenario-based MCQs, not flashcards. SMLE's format rewards clinical reasoning under a single-best-answer structure, which single-fact recall drilling doesn't train well.
- Cover all four core subjects proportionally. Medicine, Surgery, Pediatrics and Obs & Gynae all appear — don't over-prepare one at the expense of the others.
- Time yourself. At 200 questions across roughly 4 hours, pacing (just over a minute per question) is itself something to practice, not something to discover on exam day.
HighYield's SMLE question bank covers all four core subjects with a full explanation on every question, timed mode included. Try the first 20 questions free, no sign-in required, from the SMLE question bank page. For sample practice questions, see our SMLE past papers & practice questions guide.