SPEX Practice Test 2026 — Free SPEX Exam Prep Questions
The SPEX is taken by licensed or previously licensed physicians whom a state medical board asks to demonstrate current general medical knowledge, for example for license reinstatement or endorsement. Our practice set uses clinical vignettes across organ systems and the five SPEX physician competencies: diagnosis, management, foundational science, communication and professionalism, and patient safety with biostatistics.
A new blood test for a disease is evaluated in 200 patients. Of 100 patients who have the disease, 90 test positive. Of 100 patients who do not have the disease, 20 test positive. What is the positive predictive value of the test in this study population?
SPEX format, scoring & key facts
Computer-based at Prometric test centers (US, Canada, Puerto Rico, Virgin Islands).
Facts last verified Oct 4, 2026. Source: www.fsmb.org/siteassets/spex/pdfs/spex-information-bulletin.pdf. Always confirm details with FSMB before your exam.
When can you take the SPEX?
Plan backwards from your exam date
What the SPEX covers
Every PrepBanq SPEX test mirrors the official domain weights.
Domain distribution
% of the exam| Content domain | Weight | ≈ Questions on exam | Our practice questions |
|---|---|---|---|
Medical Knowledge/Scientific ConceptsApplying foundational science (physiology, pharmacology, pathophysiology) to clinical situations. | 8% | ~16 | 2 questions → |
Patient Care: DiagnosisHistory and physical findings, laboratory and diagnostic studies, diagnosis, and prognosis/outcome. | 35% | ~70 | 9 questions → |
Patient Care: ManagementHealth maintenance and prevention, pharmacotherapy, clinical interventions and mixed management. | 35% | ~70 | 9 questions → |
Communication and ProfessionalismCommunication and interpersonal skills, professionalism, and legal and ethical issues. | 12% | ~24 | 3 questions → |
Systems-based Practice/Patient Safety and Practice-based LearningPatient safety and systems of care, biostatistics, epidemiology and interpretation of the medical literature. | 10% | ~20 | 2 questions → |
Your path to passing the SPEX
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SPEX FAQ
How many questions are on the SPEX?
The SPEX has 200 questions and you have 5 hours to finish. Question types: One-best-answer multiple choice: single-item vignettes, multiple-item sets, sequential item sets, drug-ad and abstract formats.
How long is the SPEX exam?
Testing time for the SPEX is 5 hours.
What is the passing score for the SPEX?
SPEX passing standard: 75 recommended (two-digit scaled score, not a percentage); boards may set their own standard.
What is on the SPEX?
The SPEX covers Medical Knowledge/Scientific Concepts (about 8%), Patient Care: Diagnosis (about 35%), Patient Care: Management (about 35%), Communication and Professionalism (about 12%), Systems-based Practice/Patient Safety and Practice-based Learning (about 10%).
Who administers the SPEX?
The Special Purpose Examination (SPEX) is administered by FSMB. Delivery: Computer-based at Prometric test centers (US, Canada, Puerto Rico, Virgin Islands).
Is there a free SPEX practice test?
Yes. PrepBanq has 3 free SPEX practice tests with 25 exam-style questions in the real SPEX formats, and every answer is explained. No credit card is needed.
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