The Special Purpose Exam (SPEX) is designed to assess the ability of a physician to apply the basic level of medical knowledge that is essential for the continuation of unsupervised practice. The exam is used by state medical boards to re-examine a licensed, or previously licensed, physician’s level of basic knowledge considered essential.
Test candidates may be nominated by a medical licensing board (Board-sponsored) or self-nominated. Board-sponsored candidates are those who hold or have held a valid, unrestricted license in a U.S. or Canada, and who have met the eligibility requirements of their local licensing board. Self-nominated candidates are those who hold a valid, unrestricted license to practice medicine in a U.S. or Canada.
Before you can register for the exam, you need to apply online on the Federation of State Medical Boards (FSMB) website. Once you complete the application, submit the required forms, and pay the application fee, you will be notified by email when your application is approved.
The application fee is $1400 and is paid by credit card only. You will have 90 days from the time your application is approved to schedule your exam.
Once you receive your scheduling permit, contact Prometric to schedule your exam. Prometric will ask for information that is found on your scheduling permit – be sure to have it accessible. Testing centers are located nationwide and in Canada; tests are scheduled during regular business hours, holidays excluded.
The exam is taken on a computer at a testing center. The appointment time is six hours and is divided into five blocks of 40 multiple-choice questions. Each block has a time limit of 60 minutes. You are allotted 45 minutes for breaks and 15 minutes for familiarization before beginning the exam. The exam is divided into two knowledge areas, general principles and organ systems.
When you arrive at your testing center, present your scheduling permit and government-issued identification for verification. You will sign the test center log, have your photograph taken, and undergo security measures. You will place your belongings in an assigned locker and be escorted to your testing station. Laminated sheets are provided to take notes and make calculations during your exam. The sheets are returned at the conclusion of your exam.
You are given 45 minutes for breaks. You can divide the time between blocks or take the entire time at once for a longer break. Once you have used all of the provided break time, any additional breaks will reduce your testing time so monitor your use carefully. When you have completed your exam, you are escorted away from your testing station.
Your raw score, the number of questions answered correctly, is determined and then converted to a two-digit scaled score. There is no penalty for incorrect or unanswered questions. All blocks must be completed to receive a score.
The recommended passing score is 75, but medical licensing authorities may establish their passing score. Two to four weeks after you complete the exam, you are typically notified of your score. If you are board-sponsored, your score is reported to you and your licensing board. If you are self-sponsored, your score is reported to you and maintained in the FSMB database.