How to Select the Best SPEX Exam Review in 2025

Every day, customers ask us the same question in several variations: What is the best Special Purpose Exam (SPEX exam) board review? Why is your Qbank the top SPEX exam board review? How does Blueprint/Rosh Review’s SPEX Exam Qbank compare to Exam Master and BoardVitals?

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We understand the importance of the question. Now that the focus has been on self-directed learning due to coronavirus (COVID-19), purchasing a Qbank for your SPEX exam costs more than money. Depending on the quality of the Qbank and how you do on the SPEX exam, it will save or cost you time. And time is a limited resource. Depending on your 2025 SPEX exam date, you may still have plenty of time to choose a Qbank.

Let’s state the obvious: we sell Qbanks for SPEX board review, but a Blueprint/Rosh Review Qbank might not be the best fit for you and you might need more personalization. BoardVitals or Exam Master might be a better fit for your SPEX exam prep. In fact, you might not even need a Qbank and would benefit more from Mometrix flashcards or a do-it-yourself program. This article will discuss the key decision criteria that will help you answer your most important question: Which board review is right for me?

Do You Really Need a Qbank to prepare for the SPEX exam? 

Some individuals do not use a Qbank for their SPEX exam preparation. However, whether you’re studying for the SPEX or looking for an internal medicine board review, consider these questions if you think you may be able to forgo a Qbank: 

• Do you have the self-discipline to study practice questions on your own?
• Do you like curating your own curriculum and practice questions around the Federation of State Medical Boards (FSMB) Exam Blueprint by reading journals and using review books, listening to podcasts, or reviewing free content available on the web?
• Can you make the content relatable enough without a question bank to remember it out of context for questions on the real certification exam?
• How much time can you invest in preparing for the SPEX exam, and how much time will you invest?
• How much money can you invest in this tool?
• Are you using this question bank as your only exam preparation tool? Are you using it to supplement self-study or another Qbank?

As you answer these questions, consider the many options available to you along the spectrum of your investment of time and money, such as the following:

• Practice tests and self-assessments for the SPEX exam are available through the National Board of Medical Examiners (NBME). These allow you to familiarize yourself with the SPEX question formatting including any test example that might be relevant.
• Free Open Access to Medical Education, which offers quality content at no cost. As a side benefit, you can learn from your home, favorite coffee shop, or the beach. Check out Foam4GP.

Picture yourself in each of these settings: Sitting at your desk, googling “acute pancreatitis” on your computer as you self-study for the SPEX exam. Or, answering hundreds of curated questions from your smartphone between shifts or at a cafe. You might picture yourself in all three scenarios. You need to be ruthlessly honest with yourself about what is best for you as you consider these options. 

If you believe you still need a SPEX Qbank, read on. If you’re studying to become an ENP or are looking for a good pediatric board review, the SPEX exam can be a good starting point for general medical knowledge. If not, you can save time and click on another SPEX board review article on the web.

Content, Content, Content

Now that you’ve determined you need a Qbank, you have many options when it comes to SPEX exam prep. You need selection criteria that provide the best outcome for you, not the marketer. 

Hint: It’s all about the content.

High-quality content should be the primary decision criteria (nobody selects low-quality content, at least not intentionally). Your challenge begins here. Every Qbank company claims to offer high-quality content in different forms such as “closest to the boards,” “meticulously crafted,” and “high yield.” When it comes to preparing for your SPEX exam, what is the definition of high-quality content that suits your needs? 

Every SPEX Qbank you consider should provide content around these building blocks:

1. Authored and peer-reviewed by physicians, faculty, and program directors.
2. Created to align with the NBME format. There should be no “negatively phrased” questions, no “all of the following except,” no “A and B”…you know what we mean. 
3. Addresses the right content and is well structured. These two basic criteria are imperative in order for a test question to be high quality. 
4. Explains why an answer is correct or incorrect. Understanding why an answer choice is incorrect is just as important as knowing why it is correct.

If the Qbank you are considering for your SPEX exam prep does not meet these basic requirements, you should quickly eliminate it from your consideration. 

Basic or Comprehensive Content

Fortunately, most SPEX Qbanks create questions around these building blocks, but that may not help you to make your selection. You need to dig deeper to determine which type of content works best for your SPEX exam prep by asking the following questions:

• How strong are the distractors in the answers? The difficulty of a question is defined by the choice of distractors. Good distractors determine the difficulty level of a question.
• How detailed are the explanations? Too much and you feel like you’re reading a medical journal. Too little and you’re not getting enough supporting content to learn the topic well.
• Is there additional content to enhance your learning such as images, tables, video clips, teaching aids, or condensed bullet points? Are they memorable enough to stick with you on exam day?
• Do they offer multiple paths to understand and solidify your knowledge of the topic with additional questions on the topic?
• Do they offer multiple references and hyperlinks to those references if you want to dive deeper into the subject?

Again, you are in the best position to determine what you need from the content for your SPEX exam prep—whether that’s something that just scratches the surface or something more comprehensive that provides multiple viewpoints. This is analogous to ECG interpretation. Can you make a diagnosis looking only at a rhythm strip or the limb leads, or would more info from the precordial help you better interpret the ECG? If you only need the rhythm strip, consider a basic SPEX Qbank. If you need 12-leads, select a comprehensive SPEX Qbank that provides the context and reinforcement to gain a deeper understanding of each topic.

Where the Rubber Meets the Road

You’re making a big investment in time and money, which impacts your career, your patients, and your livelihood. The only way to assess the content is to experience it yourself. Sign up for a free trial for each Qbank that you are considering. Yes, you’ll probably get a few extra emails now that you shared your contact info, but the hassle of unsubscribing from the companies you don’t select will be outweighed by the confidence you gain by making the right decision.

If these SPEX Qbanks aren’t already on your evaluation list, you should add them. Check out the following (listed in alphabetical order to avoid bias): 

• Blueprint/Rosh Review
• BoardVitals
• Exam Master

Keep an open mind during the evaluation. Your due diligence will pay off. Once you get into study mode for your SPEX exam, you want to eliminate the time, energy, and distraction of questioning your Qbank decision.

SPEX Qbank Free Trial Evaluation

You’ve signed up for the free trial and are evaluating content based on what you need for a successful outcome. What else might you consider as you work through the content? These attributes will enhance or detract from your SPEX exam preparation, providing a “Wow” experience or an “Ugh” experience. Remember: you’ll be viewing hundreds, if not thousands, of questions. Small details matter when you repeat something over and over.

Software Design and Technology 

Do you like the way you experience the content? As you answer questions and read the explanations, take time to look at the buttons, fonts, colors, white space, and page layout. The software doesn’t need to be flashy. Rather, it needs to be highly functional so it doesn’t distract you from the content. The interface should be seamless and intuitive. After taking 10 or 20 questions, the software should become “invisible” so you can focus on learning.

Are time-saving features built into the platform? See if you can name your exams for better organization and retrieval. Check if you have the ability to search your answered questions. You can save precious time by being able to search your questions, answers, explanations, and images. 

Does the application function quickly? A three-second improvement in performance might not seem like a big deal, but when you multiply that by thousands of questions answered and explanations reviewed, that can add up. 

View the SPEX exam practice questions on the devices you plan to study on. If the Qbank offers an iPhone or Android app, take the time to download it to your phone or tablet. Will you be studying when you are not able to connect with Wi-Fi (e.g., on a clinical shift with tight IT firewalls or on the subway)? If so, make sure the Qbank you use has an “offline” mode. You want to prepare for all the situations and slices of time that you’re able to study.

Customer Support

You need to evaluate customer support in the same way you evaluate the content. SPEX Qbanks offer a wide spectrum of support options: 

• Basic: account administration and technical support
• Medium: content correction and updates
• Enhanced: physicians available to clarify questions, discuss conflicting evidence, and suggest strategies to understand the topic

Test them out by sending a support ticket. Do you receive a response? Do they publish customer support feedback? You will find varying levels of support and can determine whether their support model suits your needs. 

Learning Technologies

Learning technologies continue to emerge, advance, and disappear. They all center around learning and test theories combined with high volumes of data and vast computational power.

Here are the classic learning techniques:

• Retrieval practice: recalling facts, concepts, or events from memory
• Spaced repetition: studying information more than once but leaving considerable time between practice sessions
• Interleaving: studying two or more topics at a time
• Elaboration: finding additional layers of meaning in new material
• Generation: attempting to answer a question or solve a problem before being shown the answer

Test theories:

• Classical Test Theory (CTT): Your goal with SPEX exams (and question banks) is to get the most correct answers. Exam providers report percent correct, and exam takers strive to score 100%. Scores are evaluated independently.
• Item Response Theory (IRT): Assumes that questions measure some underlying latent trait. Exam providers view responses simultaneously, looking at thousands of test takers and thousands of questions. 

While reviewing SPEX Qbanks, you might find the term “adaptive learning.” You’ll see it in other forms such as smartbank or prescriptive learning, and it can be defined in many ways. Adaptive learning originated in the K12 market. Companies are testing this technology in the graduate medical education (GME) market to determine whether these concepts can improve outcomes. If you value this feature when it comes to your SPEX exam prep, ask more questions about the underlying technology and algorithms incorporated into the product. 

As you review the learning and testing theories, you’ll see that many of these concepts can be applied to your SPEX exam preparation with or without a technology assist. Technology can be helpful, but it also can be a distraction. Good practice will always beat theory.

Predictive Analytics, Peer Comparison, Performance Analysis

Qbanks can offer lots of data to help you identify your unknown unknowns, self-remediate, and predict your score. Check out their performance dashboards to see what tools you might use to streamline your SPEX exam preparation time. 

Basic information should include the following:

• Number of questions (total, used, unused)
• Performance based on FSMB Blueprint 

Enhanced information includes additional data:

• Projected exam score
• Probability of passing
• FSMB Blueprint subcategories
• Performance breakdown based on age, acuity, type (e.g., first order, second order), and Bloom’s Taxonomy
• Options to count skipped and unanswered questions

How are you doing relative to your peers who are preparing for the same SPEX exam? Did the majority of examinees miss the same question? Or are you in the minority that missed this particular question? Many individuals find this data motivational. Others find it a distraction. 

The SPEX Qbank Comparison Matrix

Now that we’ve covered the major factors to consider during your free trials, it’s time to create your grid. This decision needs to be right for you, not a marketer.

Download the Special Purpose Exam Qbank Comparison Matrix

Here are the steps we recommend taking to complete an effective evaluation using the Special Purpose Exam Qbank Comparison Matrix:

1. Narrow the SPEX Exam Qbanks you want to compare to three. The incremental benefit of adding additional Qbanks to the evaluation is low.
2. Rank the Qbanks using the criteria: 3 = excellent, 2 = average, 1 = poor.
3. Add up the points in each column.

You will note that we included cost and company culture at the bottom of the matrix. You can use these as tiebreakers. 

Comparing the Costs of SPEX Qbanks

We rarely complain about paying too much for something that is high quality—a product that delivers on its promises. We also know what it feels like when we purchase something cheap that disappoints. That’s why we place costs near the bottom of the criteria list when it comes to SPEX exam prep. 

Are CME credits included? Is there group pricing or military discounts? Do a web search with the product name plus “discount” to see what’s available so you save money where you can. If price is the most important criterion for you, calculate the cost per question and skip the evaluation.

Company Culture and Values

Do a web search on the company. Who leads it—a physician or business operator? Does leadership include experienced educators, faculty, and former program directors? Individuals who have dedicated their lives to fostering the success of others on their medical education journey? Or is the company led by venture-funded marketing gurus?

When you purchase a SPEX exam Qbank, you not only invest in your personal success but also in the success of others. Your money goes towards the cost of producing and supporting the product, the livelihood of the company’s employees, and the company’s profits. Does the organization align with your values? Do the profits flow to shareholders with dividends, to customers through more innovation, to the medical community with scholarships and grants, to programs that eliminate disparity in education, to initiatives to help eliminate the world’s most pressing health crises? 

Decide and Act

Now it’s time to make your decision. At this stage, your head and heart (some say gut) should be aligned. Enjoy the purchase of your SPEX exam Qbank and prepare to conquer this next milestone in your career. We’re cheering for you.