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SPEX Board Review Questions

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About the SPEX Exam

The Special Purpose Exam (SPEX) examination was developed through a collaboration between the National Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMD). The purpose of the SPEX is to re-examine the general medical knowledge (regardless of specialty) of physicians who currently hold, or have held a valid medical license and are seeking reinstatement or reactivation. It is most commonly used for physicians who are looking to be re-licensed after a period of inactivity.

How do I pass the SPEX Exam?

The SPEX does not have an established passing score, but rather a recommended minimum passing score of 75. A score of 75 is not a percentage, but a value on a scale that satisfies the criteria of licensing board statutes and regulations. Medical licensing boards may determine their own standards of what they deem a passing score.

How long is the SPEX Exam?

The SPEX is offered year round and is computer-administered. The exam lasts one day and is comprised of seven blocks of 64 minutes each with each block containing 48 questions. Questions are in single best answer multiple choice formats. The exam takes approximately eight hours with an allotted 45-minutes of break time, which can be divided in any manner that fits the examinees preference.

What is tested on the SPEX Exam?

The SPEX Exam focuses on a core of clinical knowledge and relevant underlying basic science principles deemed necessary to form a reasonable foundation for the safe and effective practice of medicine, as outlined in the SPEX Information Bulletin. The SPEX Exam is structured along two dimensions: disease categories and physician tasks.

SPEX Dimension 1: Disease Categories

  • General Principles
  • Blood and Lymphoreticular System
  • Behavioral Health
  • Nervous System & Special Senses
  • Skin and Subcutaneous Tissue
  • Musculoskeletal System
  • Cardiovascular System
  • Respiratory System
  • Gastrointestinal System
  • Renal and Urinary System
  • Pregnancy, Childbirth, and the Puerperium
  • Female Reproductive System and Breast
  • Male Reproductive System
  • Endocrine System
  • Multisystem Processes and Disorders
  • Biostatics and Epidemiology/Population Health
  • Population Health
  • Interpretation of Medical Literature/Social Sciences

SPEX Dimension 2: Physician Tasks

The physician tasks dimension is a competency-based objective consisting of actions taken by physicians in clinical practice. These items are constructed to focus on assessing one of the following:

  • Medical Knowledge/scientific concepts: Applying foundational science concepts
  • Patient Care: Diagnosis
  • Patient Care: Management
  • Communication and Interpersonal Skills
  • Professionalism, including Legal and Ethical Issues
  • Systems-based Practice, including Patient Safety
  • Practice-based Learning, including Biostatistics and Epidemiology

In addition to the BoardVitals question bank, make sure to review the FSMB SPEX Practice Test.