Prometric Exam for Nephrologists: Specialist Nephrology Licence for DHA, MOHAP, DOH, SCFHS & QCHP — the 14-Area Blueprint, 65% Pass Mark, Dialysis Unit Roles, DM and FCPS Recognition and Salaries (2026)
Diabetes and hypertension have given the Gulf some of the world's highest rates of kidney failure, and dialysis capacity is growing every year. This guide covers the Specialist Nephrology paper — 150 questions, three hours, 65% to pass — its fourteen official blueprint areas, the electrolyte, dialysis and transplant questions that repeat, how DM, DNB and FCPS nephrology are recognised, dialysis-unit director roles, and salaries.
Kidney failure in the Gulf tracks its diabetes and hypertension rates, which are among the highest anywhere. Saudi Arabia alone runs hundreds of dialysis centres, the UAE and Qatar are expanding transplant programmes, and every one of those units needs a licensed nephrologist responsible for it. For holders of a DM, DNB or DrNB in nephrology, FCPS nephrology, Arab Board or equivalent, the Specialist Nephrology paper is the gate.
The exam
- Specialist Nephrology (NEP5991): 150 single-best-answer questions, 3 hours, pass mark 65% — 98 correct answers
- References: Comprehensive Clinical Nephrology (Floege), Brenner and Rector, the Handbook of Dialysis (Daugirdas) and the Handbook of Kidney Transplantation (Danovitch)
Two handbooks on the list — dialysis and transplantation — tell you where the practical questions come from. Daugirdas in particular is worth reading cover to cover.
Nephrology is a subspecialty: check your title
Regulators license nephrology on a dedicated qualification built on internal medicine: DM or DNB/DrNB nephrology after MD medicine, FCPS nephrology, Arab Board nephrology, or UK and North American training with certification. MD medicine with years in a dialysis unit is licensed as Specialist Internal Medicine (INT5921), not as a nephrologist, and cannot then be the responsible physician for a dialysis facility. Read the recognition guide, the exemptions guide for Tier 1 holders, and run the eligibility check before paying for verification.
The fourteen blueprint areas
- Fluid and electrolytes — sodium disorders and safe correction, potassium emergencies, calcium, magnesium and phosphate, volume assessment
- Acid–base disorders — a structured approach to the gas, anion and osmolar gaps, renal tubular acidosis types
- Acute kidney injury — staging, pre-renal vs intrinsic vs obstructive, contrast and drug nephrotoxicity, hepatorenal and cardiorenal syndromes, when to start renal replacement
- Chronic kidney disease: detection and management — staging by eGFR and albuminuria, slowing progression (RAS blockade, SGLT2 inhibitors, newer agents), anaemia and iron, mineral bone disease, preparing for renal replacement
- Hypertension — resistant and secondary hypertension work-up, renovascular disease, hypertensive emergencies, pregnancy
- Glomerular and vascular disease — nephrotic vs nephritic presentations, the primary glomerulopathies and their treatments, lupus nephritis classes, ANCA vasculitis, anti-GBM disease, thrombotic microangiopathies, diabetic nephropathy
- Cystic and genetic disease — polycystic kidney disease and tolvaptan criteria, Alport syndrome, Fabry disease, tuberous sclerosis
- Nephrolithiasis — metabolic evaluation and prevention, particularly relevant in the Gulf's stone belt
- Haemodialysis — prescription and adequacy (Kt/V), vascular access and its complications, intradialytic hypotension, dialyser reactions, water quality, hepatitis B and C isolation practice, dialysis in the acute setting
- Peritoneal dialysis — modalities, prescription, adequacy, peritonitis diagnosis and empirical treatment, catheter problems, membrane testing
- Kidney transplantation — donor and recipient evaluation, immunosuppression regimens and drug levels, rejection types and biopsy findings, infections by time after transplant (CMV, BK virus), post-transplant diabetes and malignancy
- Professionalism and ethics — living donation, conservative kidney management, withdrawal of dialysis
- Patient safety — dialysis unit infection control, medication dosing in renal impairment
What repeats
- Hyperkalaemia treatment sequence and the ECG changes that trigger it.
- Hyponatraemia. Classification by volume status and osmolality, correction limits, osmotic demyelination.
- The nephrotic syndrome by age and histology — minimal change, FSGS, membranous (and its antibody), and the secondary causes to exclude.
- Lupus nephritis classes and the induction regimen for each.
- Dialysis adequacy arithmetic; access choice (fistula first); the intradialytic emergencies.
- PD peritonitis — cell count threshold, empirical antibiotics, when to remove the catheter.
- Transplant immunosuppression. Calcineurin inhibitor toxicity vs rejection, drug interactions, CMV and BK timing.
- CKD mineral bone disease targets and drug choice.
- Drug dosing in renal failure and in the three renal replacement modalities.
Dialysis unit roles
Facility licensing rules in every Gulf country require a named nephrologist as medical director of a dialysis unit, usually at Consultant grade for larger centres and Specialist grade for satellite units. That responsibility — water quality, infection control, hepatitis serology segregation, adequacy audits, adverse event reporting — is a real part of the job and is why the blueprint carries so much dialysis content. Private dialysis chains are among the most active recruiters of nephrologists in Saudi Arabia and the UAE. Interventional nephrology (access procedures, catheter insertion, biopsy) is privileged separately on documented training.
Process
- Portal registration and title selection (Sheryan, Mumaris+ or the relevant portal).
- DataFlow verification of the primary degree, the medicine qualification, the nephrology qualification, registration and experience — three qualifications cost more to verify (DataFlow guide, fees).
- Eligibility, booking (lead times), exam — Prometric for most authorities, Pearson VUE for DOH.
- Offer, credentialing and activation.
Salaries
Specialist nephrologists in the UAE typically earn AED 38,000–58,000 a month and Consultants AED 58,000–100,000; dialysis medical director posts and transplant nephrologists sit at the top. Saudi packages run SAR 32,000–55,000 for Specialists with housing, and private dialysis groups often pay per-session supplements. Qatar is comparable. Compare in the salary calculator and register in the talent pool.
Eight-week plan
- Weeks 1–2: fluids, electrolytes and acid–base — the arithmetic-heavy block.
- Week 3: AKI and CKD management.
- Week 4: glomerular disease and vasculitis.
- Week 5: haemodialysis and peritoneal dialysis.
- Week 6: transplantation.
- Week 7: hypertension, stones, cystic disease, ethics and safety.
- Week 8: two timed mocks from the Specialist Nephrology question bank.
How Specialist and Consultant titles differ is in the specialist overview; the dialysis technicians you will work with are covered in the dialysis technician guide.
Frequently asked questions
What is the pass mark for the Prometric nephrology exam?
65%. The Specialist Nephrology paper has 150 single-best-answer questions in three hours, so 98 correct answers are needed.
Can an MD medicine doctor running a dialysis unit be licensed as a nephrologist?
No. Nephrology is licensed on a dedicated qualification such as DM, DNB or FCPS nephrology. An MD in medicine leads to an internal medicine licence, which does not qualify for the responsible-physician role in a dialysis facility.
Which parts of the nephrology exam are most heavily tested?
Electrolytes and acid–base, dialysis prescription and complications, glomerular disease, and transplant immunosuppression. The dialysis and transplant handbooks on the official reference list reflect that weighting.
Do nephrologists need separate approval for access procedures?
Yes. Interventional procedures such as catheter insertion and kidney biopsy are privileged by each hospital on evidence of training and case numbers.
Practice banks for this exam
Chapter-wise MCQs with written reasoning on every question, and timed mocks at the real pass mark.