This workflow is for higher specialty trainees, usually ST4 and above, sitting the SCE in Respiratory Medicine within the next four to six weeks who want to use British Thoracic Society (BTS) material deliberately rather than endlessly. It addresses the only component the SCE has — the written best-of-five paper — and specifically the calibration step. The principal limitation is worth stating plainly at the top: BTS publishes authoritative guidelines and runs an examiner-led course, but it is not a large timed practice-question engine, so it calibrates your knowledge, it does not drill it.
The distinction matters because most candidates in the final month do the opposite of what the evidence supports. They grind a commercial bank to a higher percentage while leaving the highest-authority content — the guidelines the examiners write from — as background reading. A calibration protocol reverses that: you sit a finite, high-authority set once under exam conditions, read the coded results honestly, and spend the remaining weeks fixing measured gaps with fresh questions.
What British Thoracic Society material offers for SCE Respiratory Medicine right now
BTS is a specialty society, not a subscription question vendor. There is no BTS "question bank" with a live question count, no adaptive or AI feature, and no per-question subscription price to quote. What it provides is the underlying knowledge standard plus signposting. The table below is a current-state snapshot; treat every figure as vendor-reported and verify it on the source page before you rely on it.
| Item | What it actually is | Practice questions? | Access / price (vendor-reported, 21 July 2026) |
|---|---|---|---|
| BTS clinical guidelines, quality standards and clinical statements | The authoritative UK respiratory content standard (asthma, COPD, pleural disease, DPLD, pulmonary infection, oxygen, sleep) | No — reference content | Free to read on brit-thoracic.org.uk |
| Annual BTS SCE examination short course | Examiner-led walk-through of the syllabus and question technique; recorded versions listed | A small number of worked examples | Course fee vendor-reported — verify current fee and dates |
| BTS SCE resources page (curated links) | Points to the MRCP(UK) sample paper, BMJ OnExamination and revision books | Signposting only | Free page; linked products priced separately |
| Not a BTS product: MRCP(UK)/Federation official sample | Around 100 practice questions released by the exam body | Yes — the genuine official calibration set | Free via the Federation/MRCP(UK) |
The honest reading is that BTS gives you the content gold-standard and a course, and points you at the true official practice set held by the exam body. It does not give you unseen volume. That is the job you have to fill elsewhere — with a genuine SCE specialist bank (StudyPRN and RevisionPro SCE both publish respiratory SCE material, and BMJ OnExamination covers the specialty) or with a cross-specialty unseen-question layer such as iatroX. Do not expect a UWorld-style engine from BTS; that is not what it is for.
The exam you are actually calibrating for
Every SCE, across all specialties, uses the same structure. The SCE in Respiratory Medicine is two papers of 100 best-of-five (BOF) questions each — 200 questions in total — with each paper lasting three hours, sat on one day, computer-based on the Surpass platform at a test centre, one mark per correct answer, and no negative marking. Only the blueprint changes between specialties. Because there is no negative marking, you answer every question; a blank scores the same as a wrong answer.
The Federation publishes an indicative blueprint. The single most useful thing you can do before the final month is internalise its weighting, because self-directed revision drifts towards familiar topics rather than heavily weighted ones. The indicative distribution across both papers is below; actual numbers vary per sitting, and this is the official weighting, not a third-party vendor's claim about its own coverage.
| Blueprint area | Indicative questions (of 200) |
|---|---|
| Diffuse parenchymal lung disease (DPLD/ILD) | 25 |
| COPD | 20 |
| Imaging | 20 |
| Physiology | 20 |
| Pulmonary infections | 20 |
| Thoracic oncology | 20 |
| Disorders of the pleura and mediastinum (incl. pneumothorax) | 15 |
| Pulmonary vascular disease | 15 |
| Occupational and environmental disease | 10 |
| Tuberculosis and opportunistic mycobacterial disease | 10 |
| Other (ethics, pharmacology, statistics) | 10 |
| Asthma | 5 |
| Cystic fibrosis | 5 |
| Sleep-related breathing disorders and hypoventilation | 5 |
Note where the marks sit. DPLD is the largest single area at around 25 questions, and imaging plus physiology together carry roughly 40. Asthma and COPD — the conditions trainees see most and revise most confidently — carry 25 between them. Candidates who over-index on airways disease and under-prepare interstitial disease, imaging and physiology are optimising against the wrong distribution.
Inventory your official material and label it honestly
The core error in official-material revision is contamination: the moment you review a question with its answer, it stops measuring you and starts rehearsing you. To protect calibration value, inventory every high-authority item and label it "unseen", "attempted once" or "contaminated by review" before you plan anything.
| Official / authoritative item | Honest status | Calibration value |
|---|---|---|
| MRCP(UK)/Federation official sample (~100 questions) | Should be "unseen" until your calibration sitting | Highest — sit once, timed, then retire it |
| BTS SCE course example questions | Usually "attempted once" if you have taken the course | Moderate — already partly seen |
| BTS guidelines, quality standards, clinical statements | "Reference" — not a mock | Content gold-standard, not a measurement |
| Any revision book you have worked through | "Contaminated by review" if reviewed repeatedly | Low as a mock, fine as content |
The rule that follows is simple: ring-fence the official sample. Do not "warm up" on it, do not read the answers the week before, and do not repeat it until you recognise items. You get one clean measurement from it, so spend it well.
Choose the calibration date
Sit your calibration late enough that it is meaningful and early enough that you can still act on it. Too early — before you have covered DPLD, imaging and pulmonary vascular disease — and it measures gaps you already know about. Too late — inside the final fortnight — and there is no time to convert findings into practice. For most trainees, four to five weeks out is the sweet spot: enough breadth covered to make the signal real, enough runway to fix two or three domains properly.
Reproduce exam conditions exactly
Calibration only works if the conditions match. That means the full BOF format, a genuine three-hour block, single-best-answer selection with one mark each, no notes, no phone, no mid-block guideline lookups, and — because there is no negative marking — an answer entered for every item. The official sample is around 100 questions, so run it as one timed block that mirrors a single paper. If you want a full 200-question rehearsal, pad the second block with a fresh, unseen third-party set, but keep the official items strictly separate and unrepeated. Sit at a desk, not on a sofa, and hold the pace: 200 questions in 360 minutes is a little under two minutes each, and imaging and physiology items eat time.
Code every error, not just the subject
A raw percentage tells you almost nothing about what to do next; your bank percentage is not your exam score, and treating it as one is the most common self-deception in the final month. After the sitting, code every error on three axes rather than one:
- Domain — which blueprint area (DPLD, imaging, physiology, infection, and so on). This tells you where to read.
- Cognitive process — a knowledge gap, a misread stem, a reasoning slip, or a guidance-recency error. This tells you whether to learn, slow down or update.
- Format — text-only, image (CXR/HRCT), physiology trace (spirometry/flow-volume loop), sleep study, or blood-gas data. This tells you whether the problem is knowledge or data interpretation.
The format axis is the one candidates skip, and in respiratory medicine it is the one that changes your plan most. If your wrong answers cluster on images and physiology traces rather than on text, more reading will not help; deliberate data-interpretation practice will.
Map each error to fresh practice — and leave the official set alone
Translate the coded errors into a small number of targeted jobs. A cluster of DPLD knowledge errors becomes a read of the relevant BTS/NICE guidance plus a fresh block of unseen DPLD questions. A cluster of imaging misreads becomes an imaging-only drill on new films. A recency error — say, an out-of-date view on a biologic or antifibrotic — becomes a check against current NICE guidance and the SmPC/eMC, never against memory. Crucially, none of this repetition touches the official sample. Fresh transfer questions do the drilling; the official items stay retired so they can be trusted if you ever need a second clean read.
Repeat only with genuinely unseen material
A second calibration is only worth doing if you can feed it genuinely unseen official material — a newly released sample or a mock you have never touched. If none exists, do not re-sit the same official set; you would be measuring recognition, not competence. Instead, use unseen third-party items as the proxy measurement: a timed, mixed, blueprint-weighted block from an SCE specialist bank or an iatroX unseen block stands in for the official sitting without contaminating it.
A seven-day plan for trainees revising around clinical work
Here is one week that pairs BTS material for a single defined job — being your content authority — with iatroX as the unseen transfer-practice layer. It assumes clinical commitments Monday to Friday and makes no claim to a proprietary algorithm; the "spacing" here is simply re-testing your own missed items a few days later.
| Day | Job with BTS material | Job with iatroX (unseen transfer) |
|---|---|---|
| Saturday | Calibration sitting: official sample, timed, unseen, once; then code errors | — |
| Sunday | Read the BTS guideline for your two weakest domains (e.g. DPLD, pleural disease) | 20-min unseen mixed block; log misses |
| Monday (clinical) | 15 min: guideline point relevant to the day's patients | 20-min unseen block on the weakest domain |
| Tuesday (clinical) | — | 20-min spaced re-test of Saturday's misses (transfer items, not official) |
| Wednesday (clinical) | Review a BTS imaging or physiology resource | Imaging/physiology format drill on fresh items |
| Thursday (clinical) | — | 60-min timed mixed block at exam pace |
| Friday | Re-read one guideline summary; note residual gaps | Re-code the week; decide continue / supplement / switch / stop |
The shape matters more than the exact hours: one authoritative content job per day, one unseen measurement job per day, and a weekly re-code so the plan responds to data rather than to habit.
Decision checklist: continue, supplement, switch or stop
Make the next-action decision on measured gaps, not on novelty or on how much you have already spent:
- Continue current sources if your unseen, timed accuracy is rising and errors are spread thinly rather than clustered.
- Supplement with a second bank if one blueprint domain stays weak on unseen items after focused reading — add narrow, unseen volume there, following the two-Q-bank rule so you do not duplicate questions or wreck your calibration.
- Switch primary source only if your current bank is out of date against current guidance or systematically off-blueprint, not because a competitor looks shinier.
- Stop adding new material and consolidate when unseen timed performance has plateaued at a comfortable margin and your remaining errors are careless rather than knowledge-based; at that point rest and light review beat more questions.
Three mistakes this protocol is designed to stop
Burning the official sample. Reviewing the official questions repeatedly converts your one clean measurement into a memory test. Sit it once, then retire it.
Treating guidelines as a mock. BTS guidelines are the content standard, not a way to measure yourself. Reading them raises knowledge; only unseen questions tell you whether it transferred.
Optimising against the wrong distribution. Revising asthma and COPD to comfort while neglecting DPLD, imaging and physiology means polishing 25 marks and skimping on more than 65. Let the blueprint, not your comfort, set your quotas.
Frequently asked questions
Is British Thoracic Society material enough for SCE Respiratory Medicine on its own? No, and it is not designed to be. BTS gives you the authoritative content standard, an examiner-led course and links to the official sample, but it does not provide the large volume of unseen, timed, blueprint-weighted questions that build and measure exam readiness. Used as your content authority alongside a genuine SCE question bank and an unseen-practice layer, it is a strong foundation; used alone, it leaves the measurement job undone.
Which SCE Respiratory Medicine component does British Thoracic Society material not reproduce well? The timed, high-volume best-of-five practice under exam conditions. The SCE is 200 BOF questions across two three-hour papers, and BTS supplies only a handful of worked examples plus signposting to the official sample. It reproduces the knowledge base and the examiner's perspective well; it does not reproduce the experience of sitting question after question at pace, which is exactly what you need to rehearse in the final month.
How many British Thoracic Society questions should I complete per day for SCE Respiratory Medicine? This is the wrong metric for BTS, because it is not a per-day question source. Reserve its finite official-linked questions for one timed calibration sitting rather than a daily quota, and use its guidelines as reading targeted at your coded weaknesses. For daily question volume, set a quota against a genuine bank — for many trainees 40 to 60 unseen questions a day in the final month is realistic around clinical work — and keep the official material out of that rotation.
When should I stop using British Thoracic Society material and move to mixed mocks? You should be doing both in parallel, not sequentially. Use BTS guidelines throughout as the content reference you check coded errors against, and run mixed, timed, unseen mocks from the outset of your final month so you are always measuring. The only thing you "stop" is any repeated exposure to the finite official sample: use it once for calibration, then move measurement onto fresh unseen material.
How should I combine British Thoracic Society material with iatroX without duplicating practice? Give each a distinct job. BTS is your content authority and your one-time official calibration; iatroX is the cross-specialty, unseen-question and spaced-retrieval layer that supplies the daily measurement BTS cannot. Because iatroX is not a specialty-specific respiratory SCE bank, it does not overlap with BTS's authoritative content — it measures whether that content transfers to unseen items. Keep the official sample retired after its single sitting, and let iatroX drill the domains and formats your calibration flagged.
Editorial notes and references
Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 21 July 2026. Vendor figures — course fees, question counts and access periods for BTS, StudyPRN, BMJ OnExamination and any bank named here — are vendor-reported as at 21 July 2026 and change without notice; verify the current figure on the relevant product page before relying on it. Disclosure: iatroX operates a competing question and clinical-knowledge platform, and its role in this article is confined to the jobs BTS does not claim to do — unseen, cross-specialty question practice and spaced retrieval, not authoritative respiratory guideline content and not a specialty-specific respiratory SCE bank. Corrections are welcome via the feedback route on iatrox.com.
References: the Federation of Royal Colleges of Physicians (thefederation.uk) SCE Respiratory Medicine examination page and blueprint; British Thoracic Society SCE resources and guidelines (brit-thoracic.org.uk); StudyPRN and BMJ OnExamination respiratory SCE pages; iatroX, Your Q-Bank Percentage Is Not Your Exam Score; iatroX, The SCE Respiratory Medicine Q-Bank Content-Gap Checklist; iatroX comparison hub.
Run a fresh, timed SCE Respiratory Medicine block in iatroX →