Saudi Medical Licensure Examination

Saudi Medical Licensure Examination (SMLE)

General Rules

Saudi Medical Licensure Examination

Congratulations to those who are a year away from MBBS/MD graduation and the ones who have already graduated! We share the excitement and pride you feel at this moment of your life. Your future career is bright and holds many opportunities. We wish you all the success in your future endeavors and dreams.

At this stage, you must take the Saudi Medical Licensure Examination (SMLE) if you want to practice in Saudi Arabia or get admitted to a postgraduate training program at the Saudi Commission for Heath Specialties (SCFHS).

What is the SMLE?

The SMLE is an exam that assesses your readiness to practice and proceed to postgraduate training. It consists of 300 MCQs which may include up to 20 pilot questions. It is a six-hour MCQ examination with scheduled breaks. It is divided into two parts of 150 questions each with time allocation of 180 minutes for each part. There is a scheduled 30 minute break between the two parts. These questions have four options from which the candidate will choose one answer.

The examination shall contain recall questions that test knowledge and questions with scenarios that test other skills (interpretation, analysis, decision making, reasoning and problem solving).

What is a test blueprint, and what is its purpose?

A test blueprint is a document that reflects the content of the SMLE. The blueprint is the plan used for “building” the SMLE. The blueprint was established by the SMLE steering committee which consists of representatives from Saudi Medical College Deans. The purpose of the blueprint is to ensure including questions related to what you are expected to know before entry into supervised clinical practice.

Application and Eligibility

How to apply for the SMLE?

To apply for the SMLE, you must have a recognized primary degree (MBBS or equivalent) from an accredited health science program and commenced training in the internship year or student who are one year away from graduation.

Applying for the SMLE

When applying for the examination, you must apply through the following e-application: Once your application is processed, a scheduling permit with your eligibility period will be issued. You will receive an email with instructions for accessing your permit.

After obtaining the scheduling permit, you may visit the specified website to schedule a test date. Scheduling may not be available more than three months in advance.

From the end of February 2018, the SMLE will be offered in seven testing windows in Saudi Arabia and internationally as per the table below. No testing windows will be available in January.


Test Window Starts Ends # of Days Available test spots nationwide
1st Feb 25 Mar 29 25 10825
2nd Apr 15 May 17 25 10825
3rd July 1 July 26 20 8660
4th Aug 27 Sep 27 23 9959
5th Oct 14 Oct 31 14 6062
6th Nov 4 Nov 22 15 6495
7th Dec 2 Dec 27 20 8660


Important Notes:

  • Saudi university/college students can sit for SMLE-SDLE-SNLE during the final year of undergraduate studies.
  • For application to postgraduate training the last day to test is Dec 27.
  • There are 17 cities nationwide that deliver the tests during test windows with 433 seat/day.
  • Scheduling the allowed test attempts during the year is the sole responsibility of the candidate.
  • SCFHS is not responsible for delaying the test attempts till the end of the year and not finding a test spot.
  • Candidates can test in any SCFHS approved Prometric center locally and internationally as locations appear upon scheduling.
  • A candidate is not allowed to sit for the test twice in the same testing window. In this instance, the result of the first dated test will be announced and the second will be considered an attempt and result invalid.
  • All candidates must review the applicant guide before taking the test.

Exam Preparation Resources

Self-Administered Evaluating Examinations:

For an example of the kind of multiple-choice questions you will find in your SMLE, Please visit the link.

Exam Day

Instructions for examination day :

  • You will be continuously monitored by video, physical walk-throughs and the observation window during your test. All testing sessions are video and audio recorded.
  • You must bring valid (unexpired) and acceptable ID(s) (Saudi ID, Resident ID, or Passport) and exam schedule printed out to the examination hall, and present it at the registration desk.
  • Any clothing or jewelry items allowed to be worn in the test room must remain on your person at all times. Removed clothing or jewelry items must be stored in your locker.
  • You may not leave the examination hall before thirty minutes have elapsed and always accompanied by an invigilator if you wish to return.
  • You must conduct yourself in a civil manner at all times when on the premises of the testingcenter. Exhibiting abusive behavior towards the Test Center Administrator (TCA), or any other staff member of the testcenter, may result in legal prosecution.
  • To protect the privacy of all testers, the TCA can neither confirm nor deny if any particularindividual is present or scheduled at the test center.
  • Repeated or lengthy departures from the test room for unscheduled breaks will be reported by the TCA.
  • You must return all materials issued to you by the TCA at the end of your test.
  • You are required to sign out on the test center roster each time you leave the test room. Youmust also sign back in and show your ID to the TCA in order tobe re-admitted to the test room.
  • Persons not scheduled to take a test are not permitted to wait in the test center.


Before the examination:

  • Seeking, providing, and/or obtaining unauthorized access to examination materials, providing false information or making false statements on or in connection with application forms, scheduling permits, or other exam-related documents.
  • Applying for an examination for which you are not eligible.
  • Communicating or attempting to communicate about specific test items, cases, answers, and/or exam results with an examiner, potential examiner, or formal or informal test developers at any time before, during, or after an examination.

During the examination:

  • Taking an examination for which you are not eligible
  • Taking an examination for someone or engaging someone to take an examination for you giving, receiving, or obtaining unauthorized assistance during the examination or attempting to do so
  • Making notes of any kind while in the secure areas of the test center, except on the writing materials provided at the test center for this purpose
  • Failing to adhere to any exam policy, procedure, or rule, including instructions of TCA
  • Verbal or physical harassment of test center staff or other examination staff, or other disruptive or unprofessional behavior during the registration, scheduling, or examination process
  • Possessing any unauthorized materials, including photographic equipment, communication or recording devices, and cell phones, in the secure testing areas
  • Any other electronic communication device, not herein mentioned, are prohibited in the examination hall irrespective if they are turned off, and no provision will be made to store them
  • Communicating or attempting to communicate about specific test items, cases, and/or answers with another examinee, or formal or informal test preparation group at any time before, during, or after an examination.

After the examination:

  • Altering or misrepresenting examination scores.
  • Any reproduction by any means, including, but not limited to, reconstruction through memorization, and/or dissemination of copyrighted examination materials by any means, including the internet.
  • Communicating or attempting to communicate about specific test items, cases, and/or answers with another examinee, potential examinee, or formal or informal test preparation group at any time before, during, or after an examination.
  • Failure to cooperate fully in any investigation of a violation of the SCFHS rules.

Frequently Asked Questions

1- How many times can I retake the SMLE?

  • All eligible candidates may take SMLE up to three times in one calendar year starting from the first attempt to obtain a pass score (during last year of studies & internship year).
  • SCFHS classification and registration rules and regulations apply to candidates who fail the SMLE for two years after graduation date.
  • After obtaining a pass score in the SMLE each candidate is eligible for two further attempts to improve their mark for the purpose of attaining a better opportunity for residency selection.
  • After one calendar year of the second attempt mentioned above each candidate is eligible for one further attempt annually to improve their mark for the purpose of attaining a better score for residency selection.
  1. How is the examination conducted?

SMLE is conducted using computer based testing. The testing period is 6 hours. After finishing the first set of 150 items a 30 minute scheduled break can be taken. Upon leaving the testing area candidates are required to sign-out and when entering again sign-in and go through security check.


  1. How are SMLE results announced?

SMLE contains 300 multiple-choice questions with the possibility of including up to 20 unscored items. Results are not provided instantly. During the window closing period, psychometric analysis is conducted and results are announced within 2-6 weeks of the end of a test window. Two reports will be provided to every candidate, statement of results and a feedback report on performance in comparison to other test-takers.

  1. How is the SMLE pass score established

The SCFHS brings together a panel of Saudi physicians to define an acceptable level of performance and establish the pass score for the SMLE through a standard setting exercise. The panel then recommends its pass score to the Central Assessment Committee (CAC) for approval.

In April 2017, the SCFHS conducted a rigorous standard setting exercise with a diverse panel of 14 physicians. Following the standard setting exercise, the panel recommended a pass score of 560 on the reporting scale of 200-800. This pass score was reviewed and approved by the CAC.

This will apply as of June 2017. If you took the SMLE prior to June 2017, your final result remains valid as per the approved validity period.

Appendix A: Important Instructions

What to Expect on Test Day?

  • All test centers follow the same procedures and rules, which you should get familiar with before test day.
  • Testing sessions for the Saudi Licensing Examinations are monitored by test center administrators (TCA), in person and through audio and visual recording. Staff are required to report any violations of assessment bylaws or test center rules.
  • You must follow instructions from TCA throughout the examinations; failure to do so may result in a finding of irregular behavior.
  • TCA are not authorized to answer questions regarding registration, examination content or format, testing software, scoring, or retesting.

Registration on Test Day

SCFHS test centers open at 7:30 a.m.. If you’re late more than 30 minutes from the time noted on your admission ticket or absent on test day, you will not be allowed to sit for the test and this will be considered an attempt unless an acceptable reason with required documentation is presented and accepted by the committee supervising the test as per the assessment rules and regulations.

When you arrive at the test center, you must present your scheduling permit and the required identification.

Acceptable forms of unexpired identification include:

  • Passport
  • Driver’s license with photograph
  • National/Residence Identity Card
  • Other form of dated, unexpired, government-issued identification

Your name, as it appears on your scheduling permit, must match the name on your form(s) of identification exactly.

If you do not bring your scheduling permit on paper or electronically (e.g., via smartphone) and acceptable identification, you will not be admitted to the test and will be required to pay a fee to reschedule your test. Your rescheduled test date(s) must fall within your eligibility period.

During check-in, test center staff will conduct the appropriate security check before entering the testing room to confirm that you have no prohibited items.

You will be asked to repeat this process each time you return to the testing room after a break. Additionally, your photo ID and fingerprint may be scanned electronically and you must sign the test center log.

Before you enter the test room, TCA will give you laminated writing surfaces, erasers and markers to use for making notes and/or calculations during the testing session. They should be used only at your assigned testing station.


You must return laminated writing surfaces to test center staff at the end of the testing session. Do NOT write on anything other than the laminated writing surface (e.g., your hand, other body part, tissue, etc.). Failure to comply may result in a finding of irregular behavior.

TCA will escort you to your assigned testing station and provide brief instructions on use of the computer equipment. A brief tutorial is available before each examination.

Your test session is scheduled for a fixed amount of time and the computer keeps track of the time allocated for each block and for breaks.

Once you begin a testing block, the block time continues to run even if you leave the testing room (e.g., for a personal emergency).

If you leave during the block without permission from test proctor, the test center will file a report of the incident. Additionally, the unauthorized break screen, described in the examination tutorial, will appear on the monitor after a defined period of inactivity.

Each time you leave the testing room, you are required to sign out and sign in when you return.

You must present your identification each time you sign in.

Breaks between Test Blocks

  • Each time you leave the testing room, you are required to sign out and sign in when you return. You must present your identification each time you sign in.
  • If you take too much break time and exceed the allocated break time, next test block will start automatically and the excess time will be deducted from your testing time.
  • Ensure you arrive 10-15 minutes before the start of your next block to allow time for sign in as the sign process may take more around 15 minutes based on testing capacity.



Test # of Test Block(s) Duration of Each Block Break Time
SMLE 2 180 min 30 minutes

End of Test

The test session ends when you have started and exited all blocks or the total test time expires.

You will receive a notice during checkout that you have appeared for the test.

After you start taking an examination, you cannot cancel or reschedule that examination. If you experience a computer issue during the test, notify test center staff immediately. The testing software is designed to restart the test at the point that it was interrupted.

You will maintain the confidentiality of the materials, including, but not limited to, the multiple-choice items. You will not reproduce or attempt to reproduce examination materials through recording, memorization, or by any other means.

You will not provide information relating to examination content to anyone who may be taking or preparing others to take the examination. This includes postings regarding examination content and/or answers on the Internet.

Test results will be available online 2-6 weeks after the testing window you are currently taking the test on.

Appendix B: Saudi Medical Licensure Examination Blueprint


        Weight                   Domain      
  Section         # of Items           Clinical                
      %         Basic           Diagnosis     Management  
  Anesthesia/   3%   9   2   0     4   3  
  Critical Care              
  Community Medicine   5%   15   5   2   4   4  
  Emergency Medicine   10%   30   8   5   10   7  
  Family Medicine   13%   39   8   5     15   11  
  Internal Medicine   13%   39   8   5     15   11  
  General Surgery   13%   39   8   5     15   11  
  Obstetrics &   13%   39   8   5     15   11  
  Pediatrics   13%   39   8   5     15   11  
  Psychiatry   4%   12   0   3     5   4  
  ENT   3%   9   2   0     3   4  
  Ophthalmology   3%   9   2   0     3   4  
  Dermatology   3%   9   2   2     3   2  
  Ethics & Research   4%   12            
  Total     100%     300     61 (20%)     37 (12%)       107 (36%)     83 (28%)  



  1. Blueprint distributions of the examination may differ up to ±3% in each category.
  2. See the SCFHS website for the most up-to-date information

Suggested Reference Books

  Medicine Kumar P and Clark M (2012). Clinical Medicine. 7th ed.  
  Edinburgh: Elsevier Saunders.  
  General Surgery Becker J, Stucchi A (2005). Essentials of Surgery. Saunders,  
  Elsevier, Churchill Livingstone, UK.  
    Bonita R, Beaglehole R, Kjellstrom T (2007). Basic  
  Community Medicine Epidemiology. World Health  Organisation. 2nd edition.  
    World Health Organisation.  
    Olsen B, Laake P, Benestad H. (2007). Research  
  Research Methodology & Biostatistics Methodology in the Medical and Biological Sciences.  
    Academic Press, New York, USA.  
  Medical Radiology Rockall AG , HatricK A, Armstrong P, Wastie M (2013).  
  Diagnostic Imaging, 7th Edition. Wiley-Blackwell, UK.  
  Obstetrics and Gynecology Oats J., Abraham S (2010). Llewellyn-Jones Fundamentals  
  of Obstetrics and  Gynecology, 9th edition, Elsevier  
  Primary Health Care Simon C, Van Dorp F, Everitt H (2014). Oxford Handbook of  
  General Practice,  Fourth Edition, OUP Oxford.  
    Solomon L, Apley GA (2005). Concise System of  
  Orthopaedics Orthopaedics and Fractures,  Third Edition, Morgan  
    Kaufmann Publishers.  
Psychiatry Stead L, Kaufman M, Yanofski J (2011). First Aid for the
Psychiatry Clerkship, Third Edition, McGraw-Hill Medical.
  Becker W, Naumann H, Pfaltz C (1994). Ear, Nose, and
Otolaryngology Throat Diseases: A Pocket Reference, 2nd Edition,
  Richard A Harper (2010). Basic Ophthalmology for Medical
Ophthalmology Students and Primary Care Residents, 9th Edition,
  American Academy of Ophthalmology.
Dermatology Mackie RM (2003). Clinical Dermatology: An Oxford Core
Text, Fifth Edition,  OUP Oxford.
Paediatrics Lissauer T and Clayden G (2011) .Illustrated Textbook
of Paediatrics; 4th Edition. Elsevier, Mosby, UK
Critical Care Paul L Marino. The ICU Book (2013). Wolters Kluwer,
Lippincott Williams and Wilkins
  Judith E. Tintinalli, J. Stephan Stapczynski, O. John Ma
Emergency Medicine (2010). Tintinalli’s  Emergency Medicine: A
Comprehensive Study Guide, Seventh Edition. The
  American College of Emergency Physicians
Anaesthesia Patrick J. Sullivan (Editor) (2013). Ottawa Anesthesia
Primer. Echo Book Publishing.


Example Questions

SMLE questions testing higher cognition


A 35 year-old car driver crashed into a concrete block without a safety belt on. Thirty minutes after and on the way by ambulance to the hospital he begins to become breathless. On administration of 100% oxygen there is not much improvement in this condition. On arrival at the Emergency Department he has lost consciousness and appears cyanosed with markedly distended jugular veins.

Blood pressure         80/40 mmHg

Heart rate                120/min

Respiratory rate        34/min

Temperature            36.6°C

Oxygen saturation     60% on room air

What immediate action should be taken?

  1. Intubation and 100% oxygen
  2. Rapid infusion of crystalloid
  3. Needle decompression
  4. IV 0.2 mg adrenaline


A mother is running after her child as he runs into the road. Almost as she reaches the road a car comes by and she must stop suddenly to avoid being hit by the car. As she stops, she falls forwards and is unable to get up and has to be carried by stretcher into an ambulance. On admission to the Emergency Department her right knee is swollen and twice its normal size.

What structure of the knee is most likely to have been injured?

  1. Lateral collateral ligament
  2. Infra patella ligament
  3. Anterior cruciate
  4. Medial meniscus


A fifteen year-old boy is very concerned that he may be developing the same disease as his father who died aged 37 years old of colon cancer. The boy has noticed he has developed unexpected episodes of diarrhoea and lower abdominal pain. These patients also develop other comorbities.

Which of the following would be a typical example?

  1. Astrocytoma
  2. Osteosarcoma
  3. Retinoblastoma
  4. Duodenal carcinoma


A 26 year-old man presented to the Outpatient Department with the history of frequent chest pain for one month. The pain is associated with exercise and relieved by rest. Both his parents have elevated serum cholesterol and serum LDL levels. On examination, there is no clubbing or palmar erythema. Xanthomas are present on the elbows and knees and have been there since he was eleven years old (see lab results).

Test Result Normal Values
Total Cholesterol 9.8 <5.1 mmol/L
Triglycerides 2.8 <2.16 mmol/L
HDL 1.5 0.8–1.8 mmol/L
LDL (cholesterol) 7.9 <4.0 mmol/L

Which of the following familial conditions is this most likely to be?

  1. Apoprotein CII deficiency
  2. Hypercholesterolaemia
  3. Hyperchylomicronemia
  4. Hypertriglyceridemia


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