The SMLE is the Saudi Medical Licensing Exam, run by the Saudi Commission for Health Specialties. Candidates include holders of a recognized primary degree such as MBBS, internship trainees, and students one year away from graduation. This page gives you free practice sets by specialty, three worked questions with full explanations, a study plan, and answers to common questions, to use alongside the official blueprint.
Numbers in brackets link to the official sources listed under Sources & last verified. Dates that have passed are removed automatically.
| Item | Detail | Source · Verified |
|---|---|---|
| Passing score | 560 on a 200–800 reporting scale[1] | Saudi Commission for Health Specialties · Oct 27, 2026 |
| Exam fee | SAR 120 service fee[2] | Saudi Commission for Health Specialties · Oct 27, 2026 |
| Retake policy | Up to 4 attempts per year; max 1 attempt per window; 2 improvement attempts after passing[1] | Saudi Commission for Health Specialties · Oct 27, 2026 |
| Delivery | Computer-based testing at SCFHS-approved Prometric test centers (Saudi Arabia and abroad)[1] | Saudi Commission for Health Specialties · Oct 27, 2026 |
| Eligibility | Recognized primary degree (MBBS or equivalent), internship trainee, or student one year away from graduation[1] | Saudi Commission for Health Specialties · Oct 27, 2026 |
| Score release | Within 2–6 weeks of the end of a testing window[1] | Saudi Commission for Health Specialties · Oct 27, 2026 |
| Testing window | November 1–24, 2026[3] | Saudi Commission for Health Specialties · Oct 27, 2026 |
According to Saudi Commission for Health Specialties, “Following the standard-setting exercise, the passing score was determined as 560 on the reporting scale of 200-800. This passing score was reviewed and approved by the Central Assessment Committee (CAC).”[1]
The SMLE is the licensing exam for medical graduates and trainees who want to practise in Saudi Arabia. The Saudi Commission for Health Specialties (SCFHS) sets and runs it, and its published blueprint is the authority on content and rules.
The exam is computer-based and taken at SCFHS-approved Prometric test centers, in Saudi Arabia and abroad. It is divided into two parts of 100 questions each, with 120 minutes allowed for each part.
Results are reported on a 200 to 800 scale. The passing score is 560, set through a standard-setting exercise and approved by the Central Assessment Committee. Scores are announced within 2 to 6 weeks of the end of a testing window, so expect to wait after you sit the exam.
To apply, you need a recognized primary degree (MBBS or equivalent), or you must be an internship trainee, or a student one year away from graduation. The service fee is SAR 120.
Retakes are limited. You can take the exam up to 4 times a year, with a maximum of 1 attempt per window. After you pass, you are eligible for 2 improvement attempts. The current window listed on the official dates page runs from November 1 to 24, 2026. Fees, dates and rules can change, so check the SCFHS website before you book.
Prepare for the SMLE - Saudi Medical Licensing Exam exam with our free practice test modules. Each quiz covers key topics to help you pass on your first try.
These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.
Question: A 42-year-old woman with a BMI of 38 presents with right upper quadrant pain after a fatty meal, fever, and a positive Murphy sign. What is the most appropriate initial imaging?
Answer: C. Abdominal ultrasound
Explanation:
Right upper quadrant pain after a fatty meal, fever and a positive Murphy sign point to acute cholecystitis, and abdominal ultrasound is the right first test. It is quick, avoids radiation, and shows gallstones, a thickened gallbladder wall and fluid around the gallbladder. CT with contrast is slower, adds radiation and is less sensitive for gallstones, so it is kept for unclear or complicated cases. A plain abdominal X-ray misses most gallstones because they are often not radio-opaque. MRCP is useful when a bile duct stone is suspected, but it is not the starting test. Rule to remember: for suspected biliary disease, start with ultrasound.
Question: A 60-year-old male presents with a pulsatile, expansile abdominal mass. CT angiography shows an infrarenal abdominal aortic aneurysm measuring 6.5 cm. What is the recommended management?
Answer: C. Elective surgical repair (open or EVAR)
Explanation:
An infrarenal aneurysm of 6.5 cm is large enough that the risk of rupture outweighs the risk of an operation in a fit patient, so elective repair, open or EVAR, is the answer. Annual ultrasound surveillance suits small aneurysms, not this size. Blood pressure control and observation is part of care for every patient, but it is not treatment for an aneurysm that has already reached the repair threshold. Waiting for symptoms is wrong because rupture can be the first event and carries a high mortality. Rule to remember: an aneurysm above the repair threshold means planned repair, and symptoms make it urgent rather than optional.
Question: A newborn presents with bilious vomiting within the first 24 hours of life. An upper GI series shows a 'corkscrew' pattern. What is the most likely diagnosis?
Answer: B. Midgut volvulus
Explanation:
Bilious vomiting in a newborn means obstruction until proven otherwise, and a corkscrew pattern on upper GI series is the classic sign of midgut volvulus from malrotation. Pyloric stenosis causes non-bilious projectile vomiting and appears later, not in the first 24 hours. Duodenal atresia can cause bilious vomiting, but the image would show a double bubble, not a corkscrew. Hirschsprung disease presents with delayed passage of meconium and abdominal distension, and an upper GI series is not its diagnostic test. Rule to remember: bilious vomiting in a neonate needs urgent imaging, and volvulus needs urgent surgery.
Start with the official SCFHS blueprint and read it fully, so you know what the exam covers and how it is scored. Then use these practice sets to find your weak areas rather than to chase a score.
Our questions are written by us and are not real exam questions, so treat them as practice, not a prediction.
The passing score is 560 on the 200 to 800 reporting scale. SCFHS set it through a standard-setting exercise, and the Central Assessment Committee reviewed and approved it. Your result is reported on that scale, so aim to be clearly above 560 in practice rather than just at the line.
The exam is computer-based and divided into two parts of 100 questions each. Each part has 120 minutes allowed. It is taken at SCFHS-approved Prometric test centers in Saudi Arabia and abroad. Practise in timed blocks to match that pace.
You need a recognized primary degree (MBBS or equivalent) from an accredited health science program. Internship trainees can apply, as can students who are one year away from graduation. Check the SCFHS website for current application requirements and documents before you apply.
The listed service fee is SAR 120. Fees can change, so confirm the amount on the official SCFHS service page when you book. This site does not collect any exam fee, and our practice sets are free to use.
You can take the SMLE up to 4 times a year, with a maximum of 1 attempt per testing window. After you obtain a passing score, you are eligible for 2 further improvement attempts. Read the retake section of the official blueprint for the exact conditions.
Results are announced within 2 to 6 weeks of the end of a testing window, after psychometric analysis is completed. The current window listed on the SCFHS dates page runs from November 1 to 24, 2026. Check that page for the latest dates.
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