The Respiratory Medicine SCE in full: two papers of 100 questions, how the pass mark is set, the 9 June 2027 date and fee, and where the marks are.
The Specialty Certificate Examination in Respiratory Medicine is the knowledge-based assessment that sits alongside workplace assessment in UK higher specialty training. Passing it entitles you to the post-nominal SCE (Respiratory Medicine). This guide covers what the exam actually is, how it is marked, when the next sittings are, and where the marks concentrate.
What the exam is for
The SCE tests whether you have the knowledge of a respiratory physician at the point of completing training. It is not a test of recall alone. The Federation describes the best-of-five format as assessing core knowledge, the interpretation of clinical information, and clinical problem-solving, which in practice means most questions give you a patient and ask you to decide something rather than to define something.
There are no entry requirements. UK trainees normally sit it in the penultimate year of higher specialty training, which is late enough to have seen the breadth of the specialty and early enough to resit without delaying certification.
Format and marking
| Papers | Two, both computer-based |
| Questions | 100 per paper, 200 in total |
| Question type | Best of five, one correct answer and four plausible alternatives |
| Time | Three hours per paper |
| Break | Usually one hour between papers |
| Marking | One mark per correct answer, nothing deducted for a wrong answer |
| Frequency | Delivered every nine months |
Two points follow from the marking scheme. Because nothing is deducted for a wrong answer, there is never a reason to leave a question blank, and because there are 200 questions across six hours you have a little under two minutes each. Most candidates who run out of time do so because they revisit uncertain questions rather than committing and moving on.
How the pass mark works
The SCE is criterion referenced. The pass mark is not a fixed percentage and it is not a quota of candidates. A panel judges the standard a competent specialist should reach on each question, and the mark required is derived from that judgement for the paper actually sat.
The practical consequence is that you cannot revise towards a number. What you can do is make sure there is no area where your knowledge sits clearly below what a day-one consultant would be expected to know, because it is the weak areas rather than the strong ones that decide a borderline result.
Dates and fees
| Sitting | Exam date | Applications open and close |
|---|---|---|
| 2026/01 | 2 September 2026 | Closed |
| 2027/01 | 9 June 2027 | 17 February to 17 March 2027 |
The fee is 700 pounds at a UK centre and 875 pounds internationally. Applications open and close at 8:00am UK time, and the window is four weeks. Transferring from a UK to an international centre after applying costs the 175 pound difference.
Six attempts are permitted automatically. Beyond six you must complete additional educational experience for each resit and submit evidence endorsed by your educational supervisor and training programme director. Note that failing to attend counts as an attempt, while a sitting cancelled by the Federation does not.
Where the marks actually are
The examination samples the whole curriculum against a predetermined blueprint, so no area is safe to ignore. That said, some areas generate far more questions than their share of the curriculum, and some generate questions that candidates consistently get wrong.
Interstitial lung disease
Reliably the highest-yielding area, and the one where candidates lose most marks. You need to be able to separate idiopathic pulmonary fibrosis from fibrotic hypersensitivity pneumonitis and from connective tissue disease associated ILD on the basis of the history, the autoantibody profile and the high-resolution CT pattern, not on one of those alone. Know which patterns are a confident radiological diagnosis and which require multidisciplinary discussion or biopsy. Know the indications for antifibrotic therapy and what each agent does and does not change.
Pleural disease
High-yield because the guidance changed. The conservative management of primary spontaneous pneumothorax, and the shift away from automatic intervention based on size alone, is a frequent question. For pleural infection, know the fluid parameters that indicate drainage and the evidence on intrapleural therapy. For malignant effusion, know how to choose between an indwelling pleural catheter and talc pleurodesis, and what the presence of a trapped lung does to that choice.
Asthma and the biologics
Questions here almost always turn on selecting the right biologic for the right phenotype. Know which thresholds of blood eosinophil count, exhaled nitric oxide and total IgE point to which agent, know which agents have an effect on nasal polyps and on oral corticosteroid sparing, and know what to check before starting. A question that looks like it is about severe asthma is usually about phenotyping.
Sleep and ventilation
Consistently under-revised relative to its weight. Know the thresholds that define obstructive sleep apnoea severity and when treatment is indicated irrespective of them, the difference between obstructive sleep apnoea and obesity hypoventilation and how the blood gas separates them, and the indications for home non-invasive ventilation in both neuromuscular disease and COPD.
Pulmonary hypertension
Know the five-group classification well enough to place a patient from the history alone, because the management follows entirely from the group. Know the haemodynamic definition from right heart catheterisation and why echocardiography cannot make the diagnosis. Group 1 therapy is examinable in detail; the other groups are examined mainly on the principle that treating them like group 1 is harmful.
Lung cancer
Staging, molecular testing and the sequence of treatment. Know which driver alterations have targeted therapy and which biomarker determines immunotherapy eligibility, and know the performance status and staging thresholds at which the intent of treatment changes.
Infection
Tuberculosis regimens, the management of drug resistance and the treatment of latent infection. Non-tuberculous mycobacterial disease, where the question is usually whether to treat at all. Bronchiectasis, including when to attempt Pseudomonas eradication and what long-term macrolide therapy requires you to check first.
Physiology
Flow-volume loops, and the interpretation of transfer factor with and without correction for alveolar volume. A reduced transfer factor with preserved spirometry is a favourite, and the discrimination between parenchymal disease, pulmonary vascular disease and anaemia rests on knowing what the corrected value adds.
Cystic fibrosis
Now largely a question about CFTR modulator therapy, who is eligible, and the complications of a population living considerably longer than it used to.
A twelve-week approach
Weeks one to four, cover interstitial lung disease, pleural disease and pulmonary hypertension, which are the three largest and least forgiving areas. Weeks five to eight, airways disease, infection, sleep and ventilation. Weeks nine to ten, lung cancer, occupational disease, transplantation and the smaller topics. Weeks eleven and twelve, no new material, only questions under timed conditions and the review of everything you got wrong.
Build the whole plan around answering questions rather than reading. Reading respiratory medicine produces recognition, which feels like knowledge until you meet five plausible options. Working through best-of-five questions and reading the explanation for the options you rejected is what converts recognition into the ability to choose.
What separates a pass from a near miss
The candidates who fail narrowly are rarely weak across the board. Usually they have one or two areas they avoided because they found them uninteresting, most often sleep medicine, pulmonary hypertension or physiology, and the blueprint found them anyway. Revise the area you least want to revise first.
Clinical Tip: when a question gives you a transfer factor, check whether it is the uncorrected or the corrected value before you look at the options. The two point to different diagnoses from the same spirometry, and the examiners rely on candidates reading past the distinction.
Our Respiratory Medicine SCE question bank is written in the exam format, with explanations covering the mechanism, why each wrong option is wrong, and the management decision the question is testing. Free sample questions are available without payment. Respiratory Medicine SCE question bank
Related: Specialty Certificate Exams explained · How to interpret an ABG
Exam format, dates and fees in this article are taken from the Federation of Royal Colleges of Physicians of the UK. Confirm all dates and fees on their site before applying, as sittings are occasionally added or moved.