SMLE Structure, Blueprint & Exam-Day Guide
The Saudi Medical Licensure Examination (SMLE), run by the Saudi Commission for Health Specialties (SCFHS), is required before you can practise medicine or enter a postgraduate training program in Saudi Arabia. It is a long exam — 6 hours across 3 sections — built from an official blueprint that weights disciplines unevenly. Here is exactly how it is structured and what that means for how you prepare.
Structure
| Item | Detail |
|---|---|
| Total MCQs | 300 (up to 20 may be unscored pilot items) |
| Sections | 3, of 100 questions each |
| Time per section | 120 minutes |
| Total testing time | 6 hours |
| Breaks | 45 minutes total, split between the two section breaks as you prefer |
| Question format | 4 options, one best answer |
| Format | Computer-based, at Prometric test centres |
| Conducted by | Saudi Commission for Health Specialties (SCFHS) |
What the SMLE actually tests
- Recall questions that test knowledge directly, and scenario-based questions that test interpretation, analysis, decision-making, reasoning and problem-solving.
- Every item is mapped to the SaudiMEDs framework — the national competency framework for physicians in Saudi Arabia — not just to a subject list.
- The blueprint can shift by up to ±5% per category between test forms, so treat the weightings below as the reliable planning range, not an exact fixed split.
Blueprint — weight by section
| Section | Weight |
|---|---|
| Medicine | 30% |
| Obstetrics and Gynecology | 25% |
| Pediatrics | 25% |
| Surgery | 20% |
Dimensions of care & physician activities
Beyond the four subject sections, every item is also classified against these:
- Health promotion & illness prevention — screening, periodic health exams, patient education, community and population health.
- Acute — new presentations, urgent/emergent/life-threatening conditions, exacerbations.
- Chronic — illnesses of long duration, including slowly progressive disease.
- Psychosocial aspects — presentations rooted in social/psychological determinants of health.
- Assessment/diagnosis — history, physical exam and investigation to reach a diagnosis.
- Management — planning and organizing safe, effective care in collaboration with the patient and team.
- Communication — patient-centred interviewing, informed consent, disclosure, inter/intraprofessional collaboration.
Eligibility & attempts
| Item | Detail |
|---|---|
| Who can apply | Holders of a recognized primary medical degree (MBBS or equivalent) from an accredited program, candidates in their internship year, or students one year from graduation |
| Attempts per year | Up to 4, from your first attempt until you pass |
| After passing | 2 further attempts allowed to improve your score for residency selection |
| After that | 1 further attempt annually, starting one calendar year after the 2nd improvement attempt |
| Repeat failure | SCFHS classification/registration rules apply to candidates who fail for 2 years after graduation |
How to apply
- 1Submit the e-applicationApply online with the required attachments through the SCFHS system.
- 2Receive your scheduling permitOnce processed, you get an eligibility period and an email with instructions to access your permit.
- 3Book a test dateSchedule at any SCFHS-approved Prometric centre, locally or internationally — up to 3 months in advance. You cannot sit the test twice in the same testing window; a second same-window attempt is invalidated.
Scoring
| Item | Detail |
|---|---|
| Reporting scale | 200–800 |
| Pass score | 560 (set by a physician panel via standard-setting exercise, April 2017; applied since June 2017) |
| Results timeline | 2–6 weeks after the testing window closes |
| What you receive | A statement of results, plus a feedback report comparing your performance to other test-takers |
Exam-day rules
- Bring a valid, unexpired Saudi ID, Resident ID, or Passport, plus your printed exam schedule — the name must match exactly.
- Arrive on time: 30 minutes late and you are marked a no-show, with no entry to the test hallway.
- You are continuously monitored — video, physical walk-throughs and an observation window — and every session is recorded.
- You must sign out and back in (with ID) every time you leave the room, including for breaks.
- No phones, cameras, recording or communication devices of any kind are allowed in the secure testing area, on or off.
- You may not leave in the first 30 minutes of a block, and must always be accompanied by an invigilator if you step out and return.
Suggested reference textbooks (per SCFHS)
From the official applicant guide's reference list — provided as a study aid only, not an indication that exam questions are drawn from these specific sources.
- Medicine — Toronto Notes; Davidson's Principles and Practice of Medicine; Harrison's Principles of Internal Medicine; Kumar and Clark's Clinical Medicine.
- Obstetrics & Gynecology — Hacker and Moore's Essentials of Obstetrics and Gynecology; Current Diagnosis & Treatment: Obstetrics and Gynecology; Gynaecology by Ten Teachers; Llewellyn-Jones Fundamentals of Obstetrics and Gynaecology.
- Pediatrics — Pediatrics for Medical Students; Nelson Essentials of Pediatrics; Illustrated Textbook of Pediatrics.
- Surgery — Current Surgical Therapy; Bailey and Love's Short Practice of Surgery; The Mont Reid Surgical Handbook.
- Patient safety, preventive medicine & ethics — WHO Patient Safety Curriculum Guide; Jekel's Epidemiology, Biostatistics, Preventive Medicine and Public Health; USPSTF Guide to Clinical Preventive Services; SCFHS Professionalism and Ethics Handbook for Residents.
Download the official SCFHS applicant guide
The complete 41-page SMLE Applicant Guide — full content outline by discipline with per-topic emphasis, the SaudiMEDs framework, exam-day rules, and the reference list above.
Frequently asked questions
How many questions are on the SMLE and how long is it?+
300 MCQs (up to 20 may be unscored pilot items) across 3 sections of 100, each 120 minutes, for 6 hours of total testing time plus up to 45 minutes of breaks.
What is the SMLE pass score?+
560 on a 200–800 reporting scale, set by a panel of Saudi physicians through a standard-setting exercise and applied since June 2017.
How is the SMLE weighted by discipline?+
Medicine 30%, Obstetrics and Gynecology 25%, Pediatrics 25%, Surgery 20% — though the blueprint can vary by up to ±5% per category between test forms.
How many times can I take the SMLE?+
Up to 4 times a year until you pass. After passing, you get 2 further attempts to improve your score, then 1 further attempt annually after that.
How long until I get my results?+
2–6 weeks after the testing window closes — results are not available immediately because of the psychometric analysis SCFHS runs first.
Can I sit the SMLE twice in the same testing window?+
No. Only your first dated attempt in a window counts; a second attempt in the same window is invalidated.
Know the rules. Now practise.
Understanding the exam is step one. Drill past-paper style MCQs with detailed explanations and track your accuracy by subject.
Practise SMLE MCQsGuidance is provided for candidates' convenience and is not an official SCFHS publication. Always confirm current rules and criteria at www.scfhs.org.sa.