100+ Free SMLE Practice Questions
Pass your Saudi Medical Licensing Examination (SMLE) (CBT via Prometric) exam on the first try — instant access, no signup required.
A 3-year-old child presents with sudden-onset coughing, choking, and unilateral wheeze after playing with small toys. Chest examination reveals reduced air entry on the right with hyperinflation on expiratory X-ray. What is the most likely diagnosis?
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Sample SMLE Practice Questions
Try these sample questions to test your SMLE exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A 58-year-old man presents with 30 minutes of crushing central chest pain radiating to the left arm. ECG shows 2 mm ST-segment elevation in leads II, III, and aVF. He arrives at a hospital with on-site primary PCI available within 60 minutes. What is the most appropriate immediate reperfusion strategy?
2A 70-year-old woman with ischemic cardiomyopathy presents with progressive dyspnea, bilateral basal crackles, and a third heart sound. Echocardiography shows an ejection fraction of 30%. Which medication class has the strongest evidence for reducing mortality in heart failure with reduced ejection fraction?
3A 68-year-old man is found to have an irregularly irregular pulse, and ECG confirms atrial fibrillation. He has hypertension and diabetes and a prior transient ischemic attack. His CHA2DS2-VASc score is 5. What is the most appropriate long-term management to reduce stroke risk?
4A 24-year-old man presents with episodic wheeze, cough, and breathlessness that worsen at night and with exercise. Spirometry shows an obstructive pattern that reverses by 15% after a bronchodilator. According to current asthma guidelines, what is the recommended controller foundation of therapy?
5A 67-year-old man with a 40-pack-year smoking history presents with chronic productive cough and progressive exertional dyspnea. Post-bronchodilator spirometry shows an FEV1/FVC ratio of 0.62. Which finding most strongly confirms a diagnosis of chronic obstructive pulmonary disease?
6A 45-year-old woman presents with sudden pleuritic chest pain and dyspnea 5 days after knee surgery. She is tachycardic with an oxygen saturation of 90%. A CT pulmonary angiogram confirms a pulmonary embolism, and she is hemodynamically stable. What is the most appropriate initial treatment?
7A 50-year-old man presents with epigastric pain relieved by food and antacids. Endoscopy shows a duodenal ulcer, and a urea breath test is positive for Helicobacter pylori. Which regimen is the most appropriate first-line eradication therapy?
8A 28-year-old woman presents with chronic bloody diarrhea, urgency, and tenesmus. Colonoscopy shows continuous inflammation extending proximally from the rectum with loss of vascular pattern, and biopsies show crypt abscesses limited to the mucosa. What is the most likely diagnosis?
9A 55-year-old man with chronic hepatitis B cirrhosis presents with increasing abdominal distension and confusion. Examination shows asterixis and ascites. His ammonia is elevated. What is the first-line treatment for his hepatic encephalopathy?
10A 62-year-old man develops acute kidney injury after starting an NSAID. Urinalysis shows muddy brown granular casts, and the fractional excretion of sodium is greater than 2%. Which type of acute kidney injury is most likely?
About the SMLE Exam
The SMLE is the Saudi Commission for Health Specialties' licensing examination required to practice medicine in Saudi Arabia or enter postgraduate (Saudi Board) training. Delivered as a computer-based test through Prometric, it now comprises 200 MCQs across four clinical disciplines, mapped to the SaudiMEDs competency framework.
Assessment
200 MCQs (up to 20 unscored pilot items) in two sections of 100 questions; single best answer from four options.
Time Limit
4 hours: two 120-minute sections with one 30-minute scheduled break.
Passing Score
560 on a 200-800 scaled score (standard-set in 2017, applied since June 2017).
Exam Fee
Approximately USD 220-250 through Prometric, varying by test center; rescheduling and cancellation fees apply. (Saudi Commission for Health Specialties (SCFHS))
SMLE Exam Content Outline
Medicine
Internal medicine across all major systems plus mapped preventive medicine, ethics, patient safety and biostatistics content.
Obstetrics and Gynecology
General obstetrics, intrapartum and antepartum care, and gynecology including bleeding disorders, infertility and oncology.
Pediatrics
Childhood acute and chronic conditions, neonatology, immunization and development across all organ systems.
Surgery
Basic surgical principles, general surgery, trauma and acute care surgery, and surgical subspecialties.
How to Pass the SMLE Exam
What You Need to Know
- Passing score: 560 on a 200-800 scaled score (standard-set in 2017, applied since June 2017).
- Assessment: 200 MCQs (up to 20 unscored pilot items) in two sections of 100 questions; single best answer from four options.
- Time limit: 4 hours: two 120-minute sections with one 30-minute scheduled break.
- Exam fee: Approximately USD 220-250 through Prometric, varying by test center; rescheduling and cancellation fees apply.
Keys to Passing
- Complete 500+ practice questions
- Score 80%+ consistently before scheduling
- Focus on highest-weighted sections
- Use our AI tutor for tough concepts
SMLE Study Tips from Top Performers
Frequently Asked Questions
How many questions are on the SMLE and how long is it?
The SMLE consists of 200 MCQs (including up to 20 unscored pilot items), split into two sections of 100 questions. The total testing time is 4 hours, with a single 30-minute scheduled break between the two 120-minute sections.
What is the passing score for the SMLE?
The SMLE is reported on a scaled score from 200 to 800. The passing score is 560, established through an SCFHS standard-setting exercise in April 2017 and applied to exams from June 2017 onward.
What topics does the SMLE cover and how are they weighted?
The official SCFHS blueprint weights four disciplines: Medicine 30%, Obstetrics and Gynecology 25%, Pediatrics 25%, and Surgery 20%. Distributions may vary by plus or minus 5% per category, and preventive medicine, ethics and biostatistics are embedded within these sections.
Who administers the SMLE and where is it taken?
The SMLE is run by the Saudi Commission for Health Specialties (SCFHS) and delivered as a computer-based test at approved Prometric testing centers in Saudi Arabia and internationally.