SMLE Exam 2026: Format, Sections and Scoring
Published Oct 9, 2026 · Updated Oct 10, 2026
The SMLE exam is the Saudi Medical Licensure Examination, which you need to practise in Saudi Arabia or to enter SCFHS postgraduate training. Here is how it is built, scored and booked, according to the SCFHS Applicant Guide.
How many questions are on the SMLE exam?
The SMLE has 200 multiple-choice questions, and up to 20 of them are pilot questions that don’t count towards your score. You can’t tell which ones they are. Each question has four options and one best answer. Some questions test recall, and others give a clinical scenario and test interpretation, analysis, decision making, reasoning and problem solving.
To see the format, try 20 SMLE sample questions with answers.
Sections and timing
The exam lasts four hours and is computer based. It is split into two sections of 100 questions, with 120 minutes for each section and one scheduled 30-minute break between them. If your break runs over, the next section starts anyway and the extra time comes off your testing time.
Check-in, ID and break rules are covered in what happens on SMLE test day.
What the questions cover
SCFHS builds every exam from a blueprint: medicine 30%, obstetrics and gynaecology 25%, paediatrics 25% and surgery 20%, and each share can vary by up to 5% either way. The guide’s content outline also covers patient safety, preventive medicine and ethics. Every item in the SCFHS exam bank is mapped to the SaudiMEDs framework.
The topics SCFHS rates highest in each discipline are listed in the SMLE blueprint guide.
The scaled score and the pass score
Results are reported on a scale of 200 to 800. The pass score is 560. A panel of Saudi physicians recommended it in a standard-setting exercise in April 2017, the Central Assessment Committee approved it, and it has applied since June 2017.
The Applicant Guide gives the pass score but no overall pass rate. More on that in SMLE passing score and pass rate.
How results are reported
Results aren’t given on the day. After a testing window closes, SCFHS runs a psychometric analysis and announces results within 2 to 6 weeks of the end of the window. Every candidate gets two reports: a statement of results, and a feedback report that compares your performance with other test-takers.
Registering and booking
You can apply with a recognised primary medical degree (MBBS or equivalent), during your internship year, or as a student one year away from graduation. You apply through SCFHS’s e-application with the required attachments. Once it is processed, you receive a scheduling permit by email that shows your eligibility period.
With the permit, you book a test date on the scheduling website. Dates can’t be booked more than three months ahead. The SMLE runs in 11 testing windows a year, at SCFHS-approved Prometric test centres in Saudi Arabia and abroad, and you can’t sit it twice in the same window. Attempt limits are covered in how many times you can retake the SMLE.
SCFHS also offers an SMLE mock exam sampled from its own item bank; see the SCFHS website for details. For more practice, the TopQbank SMLE question bank has timed and tutor-mode exams with explanations, reviewed by licensed doctors.
Study takeaway: with 100 questions in each 120-minute section, you have a little over a minute per question. Practise in timed blocks of 100 questions, and split your practice the way the blueprint does: medicine, obstetrics and gynaecology, paediatrics and surgery.