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How to Pass the Respiratory Specialty Certificate Exam (SCE)

So according to MRCP(UK), the specialty certificate exams are globally recognised postgraduate qualifications that demonstrate to prospective employers achievement of a standard required of UK specialist trainees. Essentially it’s the exam that medical registrars have to pass prior to attaining certificate of completion of training (CCT) and becoming a consultant in their chosen specialty. For example, there is a SCE in respiratory, one in acute medicine and one in medical oncology. Other medical specialties such as gastroenterology and cardiology have similar equivalent “exit” exams called the European Specialty Examination in Gastroenterology & Hepatology (ESEGH) and the European Examination in General Cardiology (EEGC) respectively.

The exam is usually delivered by Pearson Vue Centres both in the UK and internationally. It’s the same type of centre in which our theoretical driving tests were held. The exam itself is formatted very similarly to the MRCP Written Part 1 and 2 exams in the sense that each SCE paper usually consists of 100 best of five (BOF) questions lasting about 3 hours. There are two SCE papers separated by a 1 hour lunch break in the respiratory SCE. Whilst MRCP Written was delivered in paper, the SCE is usually organised on a computer screen similar to that of practice question websites.

The layout or blueprint of the exam is represented here. Although these are not set in stone, it’s usually a good idea to get a rough feel of how much weighting the exam gives to each area of expertise. For example, if you expect 35/200 (17.5%) marks will be occupied by questions of airway disease, perhaps it’s prudent to spend 17.5% of your revision time on this subject. Similarly, only 5/200 (2.5%) marks are given to sleep related breathing disorders so less time should be allocated to this area.

A quick note on some useful resources for this exam. The MRCP(UK) website has 100 free practice questions which are invaluable for getting a feel of how difficult the questions will be. Remember that they’re the organisation in charge of setting these exams. The British Thoracic Society (BTS) have significant input in the exam also and usually hold an annual course to prepare for the SCE. Candidates should be aware that guidelines exist for the European Respiratory Society (ERS) and American Thoracic Society (ATS) but perhaps most time should be spent on the BTS ones.

I found radiopedia one of the most useful resources to learn about radiology for respiratory pathology. If you’re sitting this later on in your training then maybe you’ll have already done a thoracic CT course. It’s also important to be confident in interpreting lung function.

In terms of further practice question banks, the main ones I’m aware of are OnExamination and StudyPRN. I’ve also written 10 practice questions on asthma and COPD with detailed explanations.

Useful resources

100 free respiratory SCE samples questions – MRCP(UK)

Radiology for respiratory SCE

BTS Guidelines

300 practice questions for Respiratory SCE

10 practice questions for Respiratory SCE on asthma/COPD

Dr Rory Chan passed the Respiratory SCE in 2018 as a ST4 on the first attempt. He’s currently pursuing a MD degree in severe asthma in Scotland and has 40 peer reviewed publications

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