The Specialty Certificate Examination, usually called the SCE, is the knowledge based exam that physicians in UK specialty training take in their own specialty. It is set by the Royal Colleges of Physicians together with the specialist societies, and passing it is a requirement for completing training in specialties such as acute medicine, rheumatology, geriatric medicine, endocrinology and diabetes, respiratory medicine, neurology, palliative medicine and medical oncology. In gastroenterology and nephrology the exam is now run jointly with the European specialist bodies, as the ESEGH and the ESENeph. Doctors outside the UK also sit it as an international mark of specialist knowledge.
The format
The SCE has 200 best of five questions, divided into two papers of 100 questions. Each paper lasts three hours, and the exam is computer based and taken at a test centre. Like MRCP Part 1, each question has one single best answer and four plausible distractors, and there is no negative marking.
How the SCE differs from MRCP Part 1
MRCP Part 1 asks what a well prepared junior physician should know across all of medicine. The SCE asks what a specialist should know at the end of training in one field. The questions are longer, they often include investigation results, images or trial data, and the distractors are closer to the correct answer. Many questions test judgement in complex or uncommon presentations rather than recall of a single fact. Candidates who passed Part 1 comfortably are sometimes surprised by how much more detail the SCE expects.
The curriculum is your map
Every SCE follows the curriculum of its specialty. The most useful first step is to download your specialty curriculum and the exam blueprint, list the topic areas, and mark each one as strong, average or weak. Rare conditions do appear, but most marks still come from common and important conditions approached at specialist depth, including their pathophysiology, investigation and the evidence behind current practice.
A revision plan that works
Most trainees prepare over four to six months. Start by reading around your weakest areas and the major national and international guidelines in your specialty, then add questions early rather than leaving them to the end. Questions show you the style and the depth expected, and the explanations fill gaps faster than reading alone. Keep notes short and organised by curriculum heading so they can be reviewed quickly in the final month. In the last weeks, sit full timed papers of 100 questions to practise concentration across a long exam day.
Common mistakes
The commonest mistakes are starting too late, reading textbooks without testing yourself, and ignoring areas of the curriculum that feel distant from daily clinical work, such as research methods, statistics or rarer conditions. Another is answering from local practice rather than from national guidance and published evidence, which is what the exam is based on.
Practising with License Medical
License Medical offers SCE question banks in several specialties, including Acute Medicine, Rheumatology, Nephrology and Palliative and Medical Oncology. The questions are written by a UK consultant physician at SCE level and arranged by curriculum area, with explanations that cover why each option is right or wrong and a Clinical Tip for quick revision.
Exam formats, dates and fees are set by the Royal Colleges of Physicians and can change. Check the official SCE pages for the current details before you apply.