SCFHS Internal Medicine Exam MCQs 2026

Saudi Internal Medicine Prometric Exam Overview

The Saudi Commission for Health Specialties (SCFHS) conducts this computer-based licensing test for physicians seeking classification as an Internal Medicine Specialist, Registrar, or Senior Registrar across public hospitals, specialized military complexes, university medical centers, and private healthcare institutions in Saudi Arabia. The exam assesses advanced diagnostic reasoning, evidence-based management of acute and chronic systemic diseases, critical care stabilization, and therapeutic safety across adult pathology. Candidates can schedule their Prometric sitting once their postgraduate specialty credentials, residency training, and DataFlow primary source verification are approved through the SCFHS Mumaris+ platform.

Exam Parameter	Details
Exam Title	Saudi Internal Medicine Prometric Exam (Internal Medicine Specialist / Registrar)
Authority	Saudi Commission for Health Specialties (SCFHS)
Delivery Mode	Prometric Computer-Based Test (CBT)
Exam Code	MED-REG / INTM-REG
Question Format	Multiple-Choice (Single Best Answer)
Number of MCQs	150 to 200 questions (split into 2 clinical blocks)
Exam Duration	3.5 to 4 hours (with a scheduled 30-minute midpoint break)
Passing Score	65% for Registrar; 70% for Senior Registrar
Negative Marking	None
Language	English
Score Result	Pass / Fail report accessible via the Mumaris+ portal within 7 to 10 working days
Score Validity	5 years

Detailed Syllabus & Domain Breakdown

The SCFHS Internal Medicine blueprint evaluates clinical competence across the full spectrum of adult subspecialties. Test vignettes emphasize real-world clinical judgment, requiring candidates to interpret multi-panel laboratory results, diagnostic imaging, and hemodynamic data while balancing complex comorbidities, acute inpatient decompensation, and outpatient maintenance therapy.

Specialty Module	Core Topics	Key Focus Areas & Clinical Scenarios
Cardiovascular Medicine	Coronary artery disease, acute coronary syndromes (STEMI, NSTEMI, unstable angina), heart failure phenotypes (HFrEF vs. HFpEF), valvular disorders, arrhythmias (AFib, SVT, VT), and secondary hypertension.	Implementing four-pillar guideline-directed medical therapy (GDMT) for heart failure, 12-lead ECG localization of acute ischemia and bundle branch blocks, acute cardiogenic pulmonary edema stabilization, and anticoagulation stratification using CHA2DS2-VASc vs. HAS-BLED.
Pulmonary & Critical Care Medicine	Chronic obstructive pulmonary disease (COPD) exacerbations, severe refractory asthma, community-acquired and hospital-acquired pneumonia, interstitial lung diseases, pulmonary embolism, and acute respiratory distress syndrome (ARDS).	Interpreting arterial blood gas (ABG) panels with mixed acid-base derangements, low tidal volume lung-protective ventilation in ARDS, Wells score risk-stratification with CT pulmonary angiogram selection, and non-invasive ventilation (BiPAP/CPAP) indications.
Gastroenterology & Hepatology	Upper and lower gastrointestinal bleeding, peptic ulcer disease, inflammatory bowel disease (Crohn's disease, ulcerative colitis), acute pancreatitis (revised Atlanta criteria), cirrhosis complications, and abnormal liver biochemistries.	Acute resuscitation and pharmacotherapy for bleeding esophageal varices (octreotide, terlipressin, prophylactic ceftriaxone), managing spontaneous bacterial peritonitis (SBP), and diagnostic workup of drug-induced liver injury.
Endocrinology, Diabetes & Metabolism	Type 1 and Type 2 diabetes mellitus, acute diabetic emergencies (DKA, HHS), thyroid dysfunction and thyroid storm, myxedema coma, primary vs. secondary adrenal insufficiency, Cushing's syndrome, and calcium disorders.	Titrating intravenous fluids and fixed-rate insulin infusions in DKA while monitoring serum potassium, diagnostic confirmation of primary aldosteronism (Conn's syndrome), and acute crisis management of symptomatic severe hypercalcemia.
Nephrology & Acid-Base/Electrolyte Disorders	Acute kidney injury (KDIGO criteria, prerenal vs. intrinsic vs. postrenal), chronic kidney disease progression, glomerulonephritis, nephrotic syndrome, and life-threatening electrolyte disturbances.	Rapid membrane stabilization with IV calcium gluconate for severe hyperkalemic ECG changes, calculating free water deficits, safe sodium correction rates to avoid osmotic demyelination syndrome, and urgent hemodialysis indications (AEIOU).
Infectious Diseases & Antimicrobial Stewardship	Sepsis and septic shock bundles, infective endocarditis (Duke criteria), central nervous system infections (meningitis, encephalitis), healthcare-associated infections, tuberculosis, HIV/AIDS opportunistic infections, and multi-drug resistant pathogens.	Empiric antimicrobial coverage for neutropenic fever, targeted de-escalation based on minimum inhibitory concentration (MIC) reports, central line-associated infection interventions, and evaluating persistent fever of unknown origin (FUO).
Hematology & Medical Oncology	Microcytic, normocytic, and macrocytic anemias, thrombocytopenias (ITP, TTP-HUS, HIT), acute and chronic leukemias, lymphomas, deep vein thrombosis/pulmonary embolism prophylaxis, and oncologic emergencies.	Urgent recognition of thrombotic thrombocytopenic purpura (pentad) and initiation of therapeutic plasma exchange, managing tumor lysis syndrome with rasburicase, and peripheral smear evaluation (schistocytes, Auer rods).
Rheumatology & Autoimmune Disorders	Rheumatoid arthritis, systemic lupus erythematosus (SLE), systemic sclerosis, crystalline arthropathies (gout, pseudogout), axial spondyloarthritis, and systemic vasculitides (giant cell arteritis, ANCA vasculitis).	Synovial fluid crystal polarization microscopy, interpreting autoantibody profiles (ANA, anti-dsDNA, ENA panel), managing acute lupus nephritis flares, and immediate high-dose glucocorticoid therapy to preserve vision in temporal arteritis.
Neurology for Internists	Acute ischemic stroke, intracerebral hemorrhage, transient ischemic attack (TIA), status epilepticus, acute confusional states (delirium vs. dementia), Guillain-Barré syndrome, and myasthenic crises.	Thrombolysis (IV alteplase/tenecteplase) and mechanical thrombectomy eligibility criteria within time windows, emergency seizure cessation algorithms, CSF diagnostic differentiation, and respiratory monitoring in acute neuromuscular weakness.
Patient Safety, Healthcare Governance & Medical Ethics	Informed consent, surrogate decision-making, Do-Not-Resuscitate (DNR) policies, root cause analysis for sentinel hospital events, Saudi patient rights charters, and SCFHS regulations.	Resolving end-of-life care and withdrawal-of-support dilemmas, handling confidential medical disclosures, leading hospital quality improvement initiatives, and fulfilling mandatory disease reporting under Saudi health law.

SCFHS Internal Medicine Exam MCQs