The Medical Oncology SCE in full: two papers of 100 questions, how the pass mark is set, the 8 September 2027 date and fee, and where the marks are.
The Specialty Certificate Examination in Medical Oncology is the knowledge assessment for UK higher specialty training in medical oncology. Passing entitles you to the post-nominal SCE (Medical Oncology). It is the SCE that dates fastest, because a meaningful share of the questions concern agents and indications that have entered practice within the last few years, and candidates who revise from older material lose marks they did not need to lose.
Format and marking
| Papers | Two, both computer-based |
| Questions | 100 per paper, 200 in total |
| Question type | Best of five |
| Time | Three hours per paper |
| Break | Usually one hour between papers |
| Marking | One mark per correct answer, no deduction for a wrong one |
No prerequisites for entry. Six attempts automatically, after which further educational experience and supervisor endorsement are required for each resit. Non-attendance counts as an attempt.
How the pass mark works
The exam is criterion referenced: the standard is judged by a panel against what a competent specialist should know, and the pass mark follows from that for the paper actually sat. There is no fixed percentage and no fixed pass rate.
Dates and fees
| Sitting | Exam date | Applications open and close |
|---|---|---|
| 2026/01 | 9 September 2026 | Closed |
| 2027/01 | 8 September 2027 | 19 May to 16 June 2027 |
The fee is 700 pounds at a UK centre and 875 pounds internationally. Applications open and close at 8:00am UK time, four weeks apart.
Where the marks actually are
Immunotherapy toxicity
If you revise one thing properly, revise this. It generates questions in every sitting, it crosses every tumour site, and it is where candidates most often choose a plausible wrong answer. Know the grading of colitis, hepatitis, pneumonitis, thyroid and pituitary dysfunction, and the cutaneous toxicities, and know for each one the grade at which you withhold therapy, the grade at which you stop permanently, the steroid dose and route, and the second-line agent when steroids fail.
Two points are disproportionately examinable. Checkpoint inhibitor myocarditis is rare and lethal and is managed quite differently from the rest. And endocrine toxicity, unlike the others, usually means replacing the hormone and continuing the drug rather than stopping it.
Oncological emergencies
Neutropenic sepsis and the timing of antibiotics, risk stratification, and when outpatient management is defensible. Metastatic spinal cord compression, where the examinable point is the urgency of imaging and dexamethasone before a definitive plan. Superior vena cava obstruction. Tumour lysis syndrome, including who needs rasburicase rather than allopurinol and why that choice matters in G6PD deficiency. Hypercalcaemia of malignancy.
Breast cancer
Receptor status drives everything, so questions test whether you can act on it. Know where CDK4/6 inhibition sits in hormone receptor positive disease, the antibody-drug conjugate that changed the management of low-level HER2 expression, the role of PARP inhibition in germline BRCA carriers, and when a genomic recurrence score changes an adjuvant chemotherapy decision.
Lung cancer
Know which driver alterations have a targeted agent and the sequence when resistance develops, which biomarker governs immunotherapy, and how stage and performance status move treatment from curative to palliative intent. Small cell disease is examined separately and briefly.
Gastrointestinal cancers
Colorectal disease is the densest: know the molecular markers that determine both prognosis and the choice of systemic therapy, which marker predicts a striking response to immunotherapy, and the adjuvant duration question. Know first-line combination chemotherapy in pancreatic cancer and what performance status permits it, the two biomarkers that matter in gastro-oesophageal cancer, and first-line systemic therapy in hepatocellular carcinoma and the vascular contraindication to it.
Urological cancers
Prostate cancer sequencing, including the agents used in hormone-sensitive metastatic disease and the radioligand therapy used later. Renal cancer first-line combinations. Bladder cancer, including the perioperative chemotherapy question.
Melanoma and gynaecological cancers
For melanoma, targeted therapy by mutation status against immunotherapy, and the adjuvant setting. For ovarian cancer, maintenance PARP inhibition and which patients derive most benefit.
Trial design and statistics
Consistently under-revised and consistently examined. Know how to read a hazard ratio and its confidence interval, what a non-inferiority design is testing and how its margin is chosen, the difference between progression-free and overall survival as endpoints and the problem with surrogate endpoints, intention-to-treat against per-protocol analysis, and the effect of crossover on a survival result. These are free marks for a candidate who has spent two evenings on them.
Pharmacogenomics and toxicity prediction
Know the enzyme deficiencies that cause severe fluoropyrimidine toxicity and the testing now expected before treatment, and the thiopurine enzyme question. Capecitabine toxicity in a patient with an untested deficiency is a standard stem.
Cancer genetics
Lynch syndrome, hereditary breast and ovarian cancer, and the thresholds for germline testing and for referral.
Supportive and palliative care
Antiemetic selection by emetogenic risk, bone-modifying agents and their complications, management of venous thromboembolism in active cancer and the anticoagulant choice in gastrointestinal and urothelial tumours, and cancer pain including opioid conversion.
Less common but examinable
Carcinoma of unknown primary and how far to investigate, neuroendocrine tumours and their functional syndromes, sarcoma in outline, and central nervous system tumours.
A twelve-week approach
Weeks one to three, immunotherapy toxicity and oncological emergencies, in that order, because they recur across every site and they are the questions a borderline candidate can least afford to lose. Weeks four to eight, the tumour sites, roughly one week each for breast, lung, gastrointestinal, urological, and gynaecological with melanoma. Weeks nine and ten, trial design and statistics, pharmacogenomics, genetics, and supportive care. Weeks eleven and twelve, timed questions only, with a deliberate return to anything answered wrongly.
Two habits make a difference in this exam specifically. Keep a single page per tumour site listing the current first-line options and the biomarker that selects each, and update it as you revise, because that page is what most questions are really asking about. And read the explanation for the options you rejected, not only the one you chose, because in oncology the wrong options are usually agents that are correct in an adjacent situation.
Clinical Tip: when an immunotherapy toxicity question involves an endocrine organ, check whether the answer is to replace the hormone and continue treatment before you reach for steroids and permanent discontinuation. Endocrine toxicity is the exception to the pattern the other organ systems follow.
Our Medical Oncology SCE question bank is written in the exam format, with explanations covering the mechanism, why each wrong option is wrong, and the treatment decision under test. Free sample questions are available without payment. Medical Oncology SCE question bank
Related: Specialty Certificate Exams explained · Palliative Medicine SCE 2027
Exam format, dates and fees are taken from the Federation of Royal Colleges of Physicians of the UK. Systemic therapy indications change frequently; confirm current practice against the relevant national guidance before relying on any statement here clinically.