SPEX Study Guide 2026–2027 | Special Purpose Examination Physician Exam Prep + Practice Tests

A complete study guide for the Special Purpose Examination (SPEX) of the Federation of State Medical Boards, for physicians preparing for relicensure exam, reactivation, endorsement or re-entry to practice.

What's Inside:

• Exam overview: the 5-block, about 200-item format, timing and breaks, item types, scoring and the FSMB content weights
• Content review in 17 sections and 200 topics following the SPEX outline: General Principles; Immune; Blood and Lymphoreticular; Behavioral Health; Nervous System and Special Senses; Skin; Musculoskeletal; Cardiovascular; Respiratory; Gastrointestinal; Renal and Urinary; Pregnancy and Childbirth; Female Reproductive and Breast; Male Reproductive; Endocrine; Multisystem Processes; Biostatistics, Epidemiology and Social Sciences
• Current, guideline-based diagnosis and management, with 90+ quick-reference tables, decision flows and fact boxes
• 2 full-length practice tests with 200 five-option clinical vignette questions, weighted like the real exam, including lab tables, journal abstracts and drug advertisement items
• Detailed answer explanations for every question, including why each wrong option is wrong
• Study schedules, test-taking strategies, FAQs and an exam-day checklist

Format:

• Digital PDF, instant download
• 435 printable US Letter pages

This is an independent study resource and is not affiliated with or endorsed by the Federation of State Medical Boards (FSMB).