Free Practice Questions for SMLE
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Sample SMLE Practice Questions
Try these sample questions to review concepts for the SMLE exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 116+ 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 listed medication class reduces 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 with an FEV1 increase of 15% and 250 mL 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 several days of gentamicin therapy. 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 Saudi Medical Licensure Examination is SCFHS's computer-based assessment of knowledge and its application for safe medical practice. SCFHS approves candidate eligibility; booking uses a scheduling permit at an approved Prometric centre. Passing does not itself complete professional registration or guarantee residency admission.
Exam sponsor: Saudi Commission for Health Specialties (SCFHS). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.
Assessment
200 multiple-choice questions in two parts of 100; up to 10% may be pilot questions; four options with one best answer.
Time Limit
240 minutes of testing (two 120-minute parts), plus a 30-minute scheduled break
Passing Score
560 on the SCFHS reporting scale of 200–800
Exam / Certification Fees
Check the current SCFHS/Prometric booking fee for your eligibility and test location
Exam sponsor websiteFees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.
Our practice resources: topics covered
We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.
Medicine
Adult medicine across the systems and topics listed in the current SCFHS clinical blueprint; the separate patient safety, preventive medicine and ethics list has no published independent weight.
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.
Preparing for the SMLE Exam
What You Need to Know
- Passing score: 560 on the SCFHS reporting scale of 200–800
- Assessment: 200 multiple-choice questions in two parts of 100; up to 10% may be pilot questions; four options with one best answer.
- Time limit: 240 minutes of testing (two 120-minute parts), plus a 30-minute scheduled break
- Exam / certification fees: Check the current SCFHS/Prometric booking fee for your eligibility and test location Official sources
Using Our Practice Resources
- Work through all 116 available questions
- Review every answer and explanation
- Track weak areas and revisit them
- Use our AI tutor for tough concepts
SMLE: Suggested Study Strategy
Frequently Asked Questions
How many questions and how much testing time does the current SMLE have?
The currently linked SCFHS 2026 guideline specifies two parts of 100 questions, each lasting 120 minutes, plus a scheduled 30-minute break. Up to 10% may be pilot questions. The 50 flashcards here are a study-set count, not the real exam length.
What is the SMLE passing score?
SCFHS's current content guideline states 560 on a reporting scale of 200–800. This is a scaled score, not a raw percentage or a guaranteed number of correct answers.
How are these cards distributed?
SCFHS publishes Medicine 30%, OB-GYN 25%, Pediatrics 25% and Surgery 20%. This independent 50-card selection uses 15, 13, 12 and 10 cards respectively, with the rounding tie assigned to OB-GYN. It is a selective recall aid, not a complete syllabus or an official question set.
Who can apply for the SMLE?
The current SCFHS guide lists a recognised MBBS or equivalent degree, commencement of internship training, or being a student one year away from graduation. Saudi university/college students may sit during their final undergraduate year. SCFHS must approve eligibility and issue a scheduling permit before booking.
How many attempts and what retake wait apply?
SCFHS publications differ: its licensure-exams hub grants two additional attempts after an unsuccessful first attempt and says opportunities may renew one year from that first attempt; the currently linked SMLE 2026 PDF says up to four attempts a year from the first attempt. The PDF prohibits two sittings in one testing window. Confirm the opportunities and dates in your current Mumaris+ eligibility with SCFHS; these sources do not establish a universal fixed-day wait.
What SMLE pass rate should I use?
SCFHS's university-performance reporting uses passing attempts divided by all attempts during the academic year, including repeat attempts. Institution and reporting-period results do not predict an individual candidate's result; no universal current rate is asserted here.