The Specialty Certificate Examination (SCE) in Palliative Medicine is the knowledge-based exam that UK palliative medicine trainees sit before completing higher specialty training. It is run by the Federation of the Royal Colleges of Physicians of the UK and is open to doctors worldwide. This guide covers the exam format, the next dates, the topics that matter most and a practical 12-week revision plan.

Palliative Medicine SCE at a glance

  • Next exam: 16 June 2027 (applications open 24 February and close 24 March 2027).
  • Frequency: the exam now runs roughly every nine months.
  • Format: best-of-five multiple-choice questions – one correct answer and four plausible distractors. The exam has traditionally been sat as two three-hour papers of 100 questions each.
  • Where: from June 2026, SCEs are delivered in test centres in the UK and internationally.
  • Fees: £700 in the UK and £875 internationally (check the Federation's website before applying, as fees can change).
  • Eligibility: there are no formal entry requirements. UK trainees usually sit the exam in their penultimate year of higher specialty training.

Always confirm dates, fees and the current candidate guidance on the official Federation SCE pages before you apply.

What does the exam test?

Questions are mapped to the Palliative Medicine specialty training curriculum and the published SCE blueprint. Most questions are clinical scenarios asking for the single best next step, diagnosis or explanation. Areas that candidates consistently find high-yield include:

  • Pain management – opioid choice and switching, opioid toxicity, neuropathic pain, adjuvant analgesics and interventional options.
  • Other symptom control – breathlessness, nausea and vomiting, bowel obstruction, constipation, delirium, agitation and terminal secretions.
  • Palliative emergencies – metastatic spinal cord compression, hypercalcaemia, superior vena cava obstruction, catastrophic haemorrhage and seizures.
  • Prescribing in organ failure – drug choice and dose adjustment in renal and hepatic impairment, and continuous subcutaneous infusions (syringe drivers).
  • Non-malignant disease – heart failure, COPD, end-stage kidney disease, liver disease, neurological conditions and dementia.
  • Care in the last days of life – recognising dying, anticipatory prescribing and supporting families.
  • Ethics and law – mental capacity, best interests, advance care planning, DNACPR decisions and withdrawing treatment.
  • Psychological, social and spiritual care – communication, depression, anxiety and bereavement.

A 12-week revision plan

Weeks 1–3: map the curriculum

Download the blueprint and the curriculum, list every topic and rate your confidence. Start with a timed block of questions to find your weakest areas – this is far more useful than reading a textbook cover to cover.

Weeks 4–8: topic-by-topic question practice

Work through one or two areas each week. Do 30–50 best-of-five questions a day, read every explanation (including for the questions you got right) and keep a short "error log" of facts you missed. Revisit national guidance – NICE, SIGN and the Scottish Palliative Care Guidelines – for the areas you keep getting wrong.

Weeks 9–11: mixed, timed practice

Switch to mixed questions under exam timing to build stamina and pacing. Aim to finish each block with time to review flagged questions. Go back over your error log every few days.

Week 12: consolidate

Sit a full mock exam, rest well and focus on high-yield summaries rather than new material.

Top tips from candidates

  • Read the last line of each question first so you know what is being asked.
  • Look for the "best" answer, not just a correct one – several options may be reasonable.
  • Practise opioid conversions and dose calculations until they are routine.
  • Do not neglect ethics, law and non-malignant disease; they are easy marks to lose.

Practise with License Medical

Our Palliative Medicine SCE question bank has 175 best-of-five questions with explanations, written and reviewed by UK consultant physicians and based on UK guidelines. You can start with free sample questions and study in timed or untimed mode.