The Ultimate Guide to the SCFHS Neurology Prometric Exam: Your Complete Roadmap to Success in 2025

When you’re preparing for the SCFHS Neurology Prometric exam, you’re not just studying for any licensing test—you’re working toward a credential that unlocks your career across the entire Gulf region. Yet despite its critical importance, finding a comprehensive, trustworthy guide specifically tailored to this exam has been nearly impossible. Most resources online are either outdated, overly generic, or focus on selling MCQ banks rather than actually helping you understand what you’re up against.

This guide is different. It’s built on official SCFHS blueprints, real exam structures, and the proven strategies that work for neurologists and clinical neurophysiologists seeking specialist or consultant classification in Saudi Arabia and beyond.

Understanding the SCFHS Neurology Prometric Exam

The SCFHS (Saudi Commission for Health Specialties) Neurology Prometric exam is the standardized licensing assessment required for medical professionals seeking professional classification and practice rights across Saudi Arabia and multiple GCC countries. While other Gulf nations like the UAE (DHA), Oman (DOH), and Qatar (QCHP) have similar examinations, the SCFHS framework represents the most comprehensive and widely recognized licensing standard in the region.

Who Absolutely Needs This Exam?

Neurology Specialists and Residents
If you’ve completed your neurology training and want to practice in Saudi Arabia, this exam is non-negotiable. It’s the official assessment tool used by SCFHS to verify that your clinical knowledge meets Saudi healthcare standards.

Clinical Neurophysiologists (EEG/EMG Specialists)
Even though clinical neurophysiology is sometimes recognized as a separate specialty in some countries, SCFHS classifies it under neurology. If you specialize in electromyography, nerve conduction studies, or electroencephalography, you’ll be taking the same neurology exam. There’s no separate pathway for clinical neurophysiologists—it’s all neurology from SCFHS’s perspective.

International Medical Graduates (IMGs)
Neurologists trained outside the Kingdom face additional scrutiny and must prove their competence through this examination. The exam is particularly critical if you’ve trained in countries like India, Pakistan, Egypt, the United Kingdom, or the United States, as it’s SCFHS’s way of ensuring equivalency in knowledge and clinical reasoning.

Physicians Seeking Career Advancement
Many hospitals in Saudi Arabia won’t finalize your employment contract or promote you to specialist or consultant status without a passing score. This exam often becomes a mandatory professional milestone before you can take on leadership roles or higher-paying positions.

The Official Exam Structure: What You Need to Know

SCFHS has been transparent about the exam format, and understanding it exactly is your first competitive advantage.

Exam Format and Content

Format: Computer-Based Test (CBT) administered through Prometric centers worldwide

Duration: 4 hours (240 minutes) with no break built in

Number of Questions: 200 Multiple-Choice Questions (MCQs), single-best-answer format

Question Types: All questions follow the K1, K2, and K3 difficulty levels:

• K1 (Knowledge): Pure recall of facts and definitions

• K2 (Comprehension): Understanding and interpreting clinical information

• K3 (Application): Applying knowledge to real clinical scenarios and decision-making

Delivery: Online proctored or in-person at authorized Prometric test centers

Passing Scores (The Official Numbers)

• Registrar/Specialist Level: 65% 

• Senior Registrar: 70% 

Important: These scores can be adjusted slightly by SCFHS depending on the statistical performance of the entire cohort. If fewer than 70% of candidates pass, the score may be lowered incrementally, but it will never go below 60%. This is helpful to know—a difficult year may work in your favor.

The Official SCFHS Neurology Blueprint (2024-2025)

This is the exact content distribution directly from SCFHS. Knowing these percentages should completely shape your study strategy.

Note: Blueprint distributions may vary by ±5% in each category. Always check the official SCFHS website for the most current version.

This blueprint is your bible. Everything you study should tie back to this distribution. If cerebrovascular disorders are 15% of the exam, they deserve 15% of your study time—not less.

High-Yield Topics: Where Your Study Time Matters Most

The following topics appear repeatedly on the exam and often determine who passes and who doesn’t. These are the areas where a single missed question can cost you.

1. Cerebrovascular Disorders (15% – Your Highest Yield Topic)

Stroke is the most heavily weighted domain. Expect multiple questions on acute management, prevention, and long-term care.

Must-Know Sub-topics:

• IV Thrombolysis (rtPA/Alteplase): Inclusion/exclusion criteria, contraindications, time windows (3-4.5 hours), BP management before and after thrombolysis, monitoring for complications

• Mechanical Thrombectomy: Indications, patient selection, time window, large vessel occlusion (LVO) criteria

• Blood Pressure Management: Target BP pre-thrombolysis (< 185/110), post-thrombolysis management, when to lower BP and when not to

• Anticoagulation: Indications for anticoagulation, drug selection (warfarin vs. DOACs), contraindications, HAS-BLED scores

• Antiplatelet Therapy: When to start aspirin, clopidogrel resistance, dual antiplatelet therapy in acute stroke

• Stroke Mimics: Conditions that look like stroke but aren’t (hypoglycemia, seizures, migraine, Todd’s paralysis, functional disorders)

• Secondary Stroke Prevention: Statin therapy, blood pressure targets, lifestyle modifications, risk factor management

• Hemorrhagic Transformation: Timing, risk factors, clinical significance

• Posterior Circulation Stroke: Vertebrobasilar artery occlusion, specific management considerations

2. Epilepsy and Paroxysmal Disorders (15% – Second Highest)

This is equally weighted with stroke and demands equal preparation.

Must-Know Sub-topics:

• Status Epilepticus (SE): Definition (seizure lasting > 5 minutes), first-line treatment (benzodiazepines—lorazepam, midazolam), second-line agents (phenytoin, fosphenytoin, levetiracetam, valproate), third-line options (propofol, midazolam infusion)

• Seizure Classification: Generalized vs. focal seizures, tonic-clonic vs. absence vs. myoclonic, current ILAE classification

• EEG Patterns: 3-Hz spike-and-wave (absence seizures), focal spikes, polyspike-and-wave, generalized paroxysmal fast activity

• Antiepileptic Drugs (AEDs): First-line agents (valproate, levetiracetam, lamotrigine), second-line agents, teratogenicity concerns, drug interactions

• Special Populations: Pregnancy and AEDs, elderly patients, drug-drug interactions

• Provoked vs. Unprovoked Seizures: When to start long-term AED therapy

• Neonatal Seizures: Causes, phenobarbital use, timing of investigations

3. Cephalgia and Headache Disorders (15% – Equally Critical)

Headache is a common chief complaint, and SCFHS expects you to differentiate types and manage appropriately.

Must-Know Sub-topics:

• Red Flags in Headache: Thunderclap headaches, fever + meningismus, focal neurologic deficits, sudden onset in elderly, progressive nature, change in pattern

• Migraine: Diagnostic criteria, prodrome/aura, management (triptans, NSAIDs, antiemetics), preventive therapy (propranolol, amitriptyline, topiramate, CGRP inhibitors)

• Tension-Type Headache: Diagnostic features, management

• Cluster Headache: Clinical presentation, acute and preventive treatment (oxygen, triptans, verapamil)

• Idiopathic Intracranial Hypertension (IIH): Risk factors (obese females), papilledema, visual threats, LP findings, management

• Meningitis: Bacterial vs. viral, CSF findings, empiric antibiotic therapy timing

• Subarachnoid Hemorrhage (SAH): Classic thunderclap presentation, CT findings, LP (xanthochromia), ruptured aneurysm management, vasospasm prevention

• Medication Overuse Headache: When analgesics become the problem

• Secondary Headaches: Temporal arteritis (giant cell arteritis), hypertensive emergency, sinusitis

4. Neuromuscular Disorders (7% – High-Yield Details)

Clinical neurophysiology candidates should study this extensively.

Must-Know Sub-topics:

• Myasthenia Gravis (MG): Antibody testing (anti-acetylcholine receptor), repetitive nerve stimulation (>10% decrement = post-synaptic), single-fiber EMG, edrophonium test, management (anticholinesterase, immunosuppression)

• Guillain-Barré Syndrome (GBS): Ascending paralysis, autonomic instability, CSF findings (albuminocytologic dissociation), EMG patterns, management (IVIG, plasmapheresis)

• CIDP (Chronic Inflammatory Demyelinating Polyneuropathy): Demyelination on EMG, progressive nature, treatment escalation

• ALS (Amyotrophic Lateral Sclerosis): UMN + LMN signs, fasciculations, El Escorial criteria, bulbar involvement, respiratory compromise

• Muscular Dystrophies: Duchenne vs. Becker, dystrophin, elevated CPK, muscle biopsy findings

• Neuropathies: Diabetic (distal sensorimotor), inflammatory, toxic (alcohol, chemotherapy), nutritional, NCS/EMG patterns

5. Movement Disorders (7%)

Must-Know Sub-topics:

• Parkinson’s Disease: Cardinal features (bradykinesia, rigidity, resting tremor, postural instability), dopamine agonists, L-DOPA, motor fluctuations, on-off phenomenon

• Wilson Disease: Ceruloplasmin, slit-lamp examination (Kayser-Fleischer rings), MRI findings, chelation therapy

• Essential Tremor vs. Parkinson’s Tremor: Distinguishing features, management

• Dystonia: Task-specific vs. generalized, treatment with botulinum toxin

• Tremor Differential: Resting, postural, kinetic, orthostatic

6. Neuro-Immunological Disorders (7%)

Must-Know Sub-topics:

• Multiple Sclerosis (MS): McDonald Criteria for diagnosis, demyelinating plaques on MRI, oligoclonal bands in CSF, MS subtypes (RRMS, PPMS, SPMS), disease-modifying therapies, relapse management with high-dose IV methylprednisolone

• Transverse Myelitis (TM): Complete or incomplete myelitis, CSF findings, MRI cord lesions

• ADEM (Acute Disseminated Encephalomyelitis): Monophasic vs. MS, multifocal white matter lesions, CSF findings

• NMO Spectrum Disorder (NMOSD): Aquaporin-4 antibodies, optic neuritis + myelitis, management differences from MS

7. Neuro-Infectious Disorders (7%)

Must-Know Sub-topics:

• Bacterial Meningitis: Classic CSF findings (elevated WBC with PMN predominance, elevated protein, low glucose), empiric antibiotics (ceftriaxone, vancomycin), dexamethasone timing

• Viral Meningitis/Encephalitis: HSV encephalitis (temporal lobe involvement on MRI), acyclovir therapy, CSF findings (lymphocytic predominance, normal glucose)

• TB Meningitis: Subacute presentation, very high protein in CSF, low glucose, acid-fast bacilli, isoniazid + rifampicin + pyrazinamide + ethambutol

• Fungal Meningitis: CSF India ink, cryptococcal antigen testing, amphotericin B

• Neurosyphilis: Neurosyphilis serology, CSF VDRL, penicillin treatment

• HIV-Related Neurologic Complications: CD4 count thresholds for opportunistic infections (CMV at CD4 < 50), PML, cryptococcosis

8. Clinical Neurophysiology (EEG/EMG – 5%)

Critical for clinical neurophysiologist candidates.

Must-Know Sub-topics:

• EEG Interpretation: Normal rhythms (alpha, beta, theta, delta), abnormal patterns (spike-and-wave, focal slowing), burst suppression

• EMG Basics: Motor units, recruitment patterns, interference patterns, fibrillations, fasciculations, motor unit action potentials (MUAPs)

• NCS (Nerve Conduction Studies): Demyelination vs. axonal patterns, conduction blocks, slowed velocities

• Repetitive Nerve Stimulation: Neuromuscular junction disorders

• Single-Fiber EMG: Increased “jitter” in myasthenia gravis

9. Patient Safety and Professionalism (10% Combined – Don’t Overlook)

This often determines the difference between a pass and a fail because candidates underestimate it.

Must-Know Sub-topics:

• Medication Safety: Correct dosing, avoiding drug interactions, checking for allergies

• Infection Control: Hand hygiene, sterile procedures, isolation precautions

• Informed Consent: Ethical principles, shared decision-making

• Confidentiality and Data Privacy: Patient information protection

• Falls Prevention: Especially in elderly patients

• Diagnostic Errors: Common pitfalls in neurology (stroke mimics, misdiagnosed seizures)

The Official Registration and Exam Booking Process

Navigating the SCFHS bureaucracy can be frustrating, but understanding each step will prevent months of delays.

Step 1: Initial Application Through Mumaris Plus

Access the SCFHS online portal at Mumaris Plus (mumaris.scfhs.org.sa). Create your account and select “Professional Classification” for specialist or consultant-level applicants.

Required Documents:

• Original MBBS or equivalent medical degree certificate

• Residency/specialization completion certificate

• Internship (house job) certificate

• Training logbook (if applicable)

• Experience certificates from previous employers

• Valid passport with bio page

• Recent passport-style photograph (white background)

• Professional license from your home country

Ensure every single detail on these documents matches perfectly. Discrepancies in name spellings, dates, or credentials are the #1 cause of application rejection.

Step 2: SCFHS Document Review and Classification

SCFHS staff review your submitted documents to verify that your qualifications meet their Professional Qualification Requirements (PQR). If approved, they officially “classify” you, recognizing your specialist designation.

This step typically takes 2-4 weeks but can extend longer if documents are incomplete.

Step 3: The DataFlow Primary Source Verification (PSV)

This is mandatory and non-negotiable. SCFHS will automatically initiate a case with DataFlow Group, an independent credential verification company. DataFlow contacts your:

• Universities (degree verification)

• Previous employers (experience verification)

• Professional licensing boards (licensure verification)

This verification period takes 3-8 weeks, depending on how quickly your institutions respond. International universities and licensing bodies often move slowly, so factor in extra time if you trained abroad.

You cannot proceed to book the exam without a completed and “Positive” DataFlow report.

Step 4: Receive Your Eligibility Number

Once DataFlow confirms everything and SCFHS approves your application, you’ll receive an Eligibility Number in your Mumaris Plus dashboard. This is your golden ticket.

Step 5: Book Your Prometric Exam

Visit the official Prometric website (prometric.com), enter your eligibility number, and select:

• SCFHS as the testing authority

• Your preferred test center (Prometric has centers in most countries)

• Your desired exam date

Exam Fees:

• SCFHS Classification fee: ~SAR 200

• DataFlow PSV fee: SAR 400-900 (varies by document count)

• Prometric exam fee: ~$220-250 USD

Total Expected Cost: $400-600 USD

Step 6: Take the Exam

Arrive 30 minutes early. Bring:

• Valid passport (required for identification)

• Exam confirmation letter (from Prometric)

• Any other documents requested in your appointment confirmation

The exam is administered at a computer terminal with strict proctoring. You cannot bring notes, calculators, or unauthorized materials.

Step 7: Results

SCFHS typically releases results within 7-14 days. Your Mumaris Plus dashboard will automatically update with your pass/fail status.

Official SCFHS Study Resources and References

SCFHS officially recommends these textbooks. While they don’t endorse any single resource exclusively, these are the gold standard:

Core Neurology Textbooks

1. Bradley’s Neurology in Clinical Practice – Comprehensive, modern, excellent for clinical correlation

2. Principles of Neurology (Adams & Victor) – Classic reference, detailed pathophysiology

3. Merritt’s Neurology – Practical, clinically oriented, easier to read than Adams

4. Localization in Clinical Neurology (Brazis, Masdeu, Biller) – Essential for understanding where lesions are

5. Neurological Differential Diagnosis (John Patten) – Perfect for MCQ preparation

Ethics and Professionalism

• Professionalism and Ethics Handbook for Residents – SCFHS official resource

• Essentials of Patient Safety – SCFHS official resource

These SCFHS-published ethics and safety documents are often the source of 5-10% of exam questions. Download them directly from SCFHS.