SCFHS Exam Questions and Answers 2026: What the Saudi SMLE, SNLE, SPLE and SDLE Test, Scaled Scoring and Format, and 20 Free Saudi-style Questions with Answers for Doctors, Nurses, Pharmacists and Dentists

The Saudi Commission for Health Specialties runs four large licensure exams that every international doctor, nurse, pharmacist and dentist must pass before registration: the SMLE, SNLE, SPLE and SDLE. They are delivered at Prometric centres worldwide, follow published blueprints, and differ from the UAE papers in two ways that matter: they are longer, and they are scored on a scale rather than a raw percentage. This guide explains the format and scoring and gives 20 free Saudi-style questions with answers. Exam-by-exam guides: SMLE, SNLE, SPLE, SDLE.

The four SCFHS exams at a glance (2026)

Exam	Who sits it	Questions and time	Scoring
SMLE (Saudi Medical Licensure Examination)	GPs and most specialists at classification (consultants with recognised boards may be exempt)	About 300 MCQs in two blocks over about 6 hours	Scaled score (commonly reported on a 0 to 800-type scale with a published cut-off); results stated as pass or fail with a score
SNLE (Saudi Nursing Licensure Examination)	Registered nurses (Nurse Specialist and Nurse Technician tracks)	About 150 MCQs in about 3 hours	Scaled score with cut-off
SPLE (Saudi Pharmacist Licensure Examination)	Pharmacists	About 150 to 200 MCQs in about 3 to 4 hours	Scaled score with cut-off
SDLE (Saudi Dental Licensure Examination)	General dentists (specialists at classification)	About 150 to 200 MCQs with images in about 3 to 4 hours	Scaled score with cut-off

Formats and cut-offs are set by SCFHS and change; your Mumaris+ exam eligibility and the SCFHS exam page are the authoritative sources. Fees and attempts are in SCFHS exam fees; the booking route is in Mumaris+ registration.

How scaled scoring works

SCFHS converts your raw score to a scaled score so that different forms of the exam are comparable; the pass cut-off is fixed on the scaled score, which usually corresponds to roughly 55 to 65% of questions correct depending on the form's difficulty. In practice, candidates who consistently score 70% or more in timed practice pass comfortably. Results are released on Mumaris+ within a few weeks, and the score report shows performance by domain, which is used to plan a retake.

20 free Saudi-style questions with answers

SMLE (doctors)

1. A 45-year-old Saudi man with type 2 diabetes has an eGFR of 45 and urine ACR of 60 mg/mmol. Beyond glucose and blood pressure control, the therapy that slows progression is: (A) a sulfonylurea (B) an ACE inhibitor or ARB plus an SGLT2 inhibitor (C) a thiazolidinedione (D) dual RAAS blockade. Answer: B.

2. A 30-year-old with recurrent fever, abdominal and pleuritic pain since childhood and an erysipelas-like leg rash has: (A) lupus (B) familial Mediterranean fever, treated with lifelong colchicine (C) Behçet's (D) brucellosis. Answer: B. Common in Arab populations; amyloidosis is the risk.

3. A farmer with undulating fever, sweats and arthralgia after drinking raw camel milk most likely has: (A) typhoid (B) brucellosis, treated with doxycycline plus rifampicin or an aminoglycoside (C) malaria (D) Q fever. Answer: B.

4. A 60-year-old diabetic with camel contact has severe pneumonia and acute kidney injury. The precaution and test are: (A) droplet; influenza swab (B) airborne and contact isolation; lower respiratory sample for MERS-CoV PCR (C) standard; sputum culture (D) no isolation. Answer: B.

5. A man collapses at 35 km of a Riyadh marathon with a rectal temperature of 41.5 °C and confusion. First: (A) transport then cool (B) immediate cold-water immersion to below 39 °C within 30 minutes, then transport (C) paracetamol (D) oral fluids. Answer: B.

Full set: questions for doctors and the General Practice bank.

SNLE (nurses)

6. A 6-year-old with sickle cell disease has severe limb pain and fever of 38.3 °C. Priorities: (A) paracetamol only (B) analgesia within 30 minutes including opioids, hydration, oxygen if hypoxic, cultures and antibiotics for fever, and monitoring for acute chest syndrome (C) cold compresses (D) withhold opioids. Answer: B. Sickle cell disease is common in the Eastern Province.

7. A woman at 30 weeks has blood pressure 160/105, headache and 3+ proteinuria. The nurse: (A) advises rest (B) recognises severe pre-eclampsia, notifies the doctor immediately, seizure precautions, prepares magnesium sulfate and antihypertensives (C) gives paracetamol (D) encourages walking. Answer: B.

8. A patient after thyroidectomy has a tight neck, swelling and hoarseness six hours post-op. The nurse: (A) reassures (B) calls for help, sits the patient up, gives oxygen and prepares the clip remover at the bedside (C) gives antihistamine (D) loosens the dressing only. Answer: B.

9. Intravenous potassium chloride via a peripheral line is infused at no more than: (A) 40 mmol/h (B) 10 mmol/h (C) 1 mmol/min (D) any rate by pump. Answer: B.

10. A patient with suspected pulmonary tuberculosis needs: (A) droplet precautions (B) airborne precautions in a negative-pressure room with N95 respirators (C) contact precautions (D) standard precautions. Answer: B.

Full set: questions for nurses and the Registered Nurse bank.

SPLE (pharmacists)

11. Rasburicase is contraindicated in: (A) renal failure (B) G6PD deficiency, common in Saudi Arabia, because of haemolysis (C) diabetes (D) hypertension. Answer: B.

12. A patient on warfarin is prescribed clarithromycin. The pharmacist should: (A) dispense without comment (B) alert the prescriber to the interaction (raised INR) and recommend monitoring or an alternative (C) halve the warfarin dose independently (D) refuse to dispense. Answer: B.

13. Vancomycin dosing is now best guided by: (A) random levels (B) AUC/MIC of 400 to 600 using Bayesian software, with troughs as the older target (C) peak levels (D) no monitoring. Answer: B.

14. Under Saudi controlled-drug rules a narcotic prescription must be: (A) verbal (B) on the official narcotic prescription form with limited quantity and validity and full dispensing records (C) refillable for six months (D) dispensed without identification. Answer: B.

15. A patient with type 2 diabetes fasting in Ramadan on gliclazide should be advised to: (A) take the full dose at suhoor (B) take it with iftar with dose adjustment, monitor glucose and break the fast if glucose falls below 3.9 mmol/L (C) stop all medication (D) double the dose. Answer: B. IDF-DAR guidance.

Full set: questions for pharmacists and the Pharmacist bank.

SDLE (dentists)

16. A 60-year-old shammah (smokeless tobacco) user has a 2.5 cm indurated non-healing tongue ulcer. Next step: (A) antibiotics (B) biopsy within two weeks because it is suspicious for squamous cell carcinoma (C) chlorhexidine (D) review in three months. Answer: B.

17. A 6-year-old has a large asymptomatic occlusal-proximal lesion in a primary molar with no pulpal signs. A conservative evidence-based option is: (A) extraction (B) the Hall technique stainless steel crown (C) amalgam (D) composite without isolation. Answer: B.

18. A patient on warfarin with INR 2.8 needs two simple extractions. Management: (A) stop warfarin for five days (B) proceed with local haemostatic measures without stopping warfarin (C) admit for heparin bridging (D) give vitamin K. Answer: B.

19. An upper first molar's most commonly missed canal is: (A) palatal (B) MB2, palatal and slightly mesial to the main mesiobuccal orifice (C) distobuccal (D) a second palatal. Answer: B.

20. Bilateral submandibular and sublingual swelling with raised tongue, drooling and trismus is: (A) mumps (B) Ludwig's angina, an airway emergency needing early airway control, intravenous antibiotics and drainage (C) sialadenitis (D) allergy. Answer: B.

Full set: questions for dentists and the General Dentist bank.

What makes the Saudi papers different

• Length and stamina: the SMLE's two long blocks reward pacing; practise full-length timed mocks.
• Regional content: brucellosis, MERS-CoV, heat illness, sickle cell and G6PD, familial Mediterranean fever, Ramadan and diabetes, and Saudi controlled-drug rules appear more often than on UAE papers.
• Scaled scoring: aim for 70% in practice to clear the cut-off comfortably.
• Classification first: the Mumaris+ classification decides which exam and tier you sit (classification explained).

The Saudi-specific practice plan, with mocks at the real length, is in SCFHS practice questions online; the UAE comparison is in DHA vs SCFHS.

Frequently asked questions

What is the passing score for the SCFHS exam?

SCFHS uses a scaled score with a fixed cut-off, which usually corresponds to roughly 55 to 65% correct depending on the form; aim for 70% in timed practice.

How many questions are in the SMLE?

About 300 MCQs in two blocks over about 6 hours; the SNLE is about 150 questions in 3 hours.

Are SCFHS exam questions the same as DHA questions?

The blueprints overlap heavily, so the same preparation works, but the Saudi papers are longer, scaled and include more regional content.

Where can I practise free SCFHS questions?

The 20 questions above, the profession sets linked in this article, and the free chapter 1 of every exam bank.

How many attempts does SCFHS allow?

Usually three attempts with waiting periods, after which re-evaluation or a bridging requirement may apply; check your Mumaris+ eligibility.