The SCE Gastroenterology is delivered as the European Specialty Examination in Gastroenterology and Hepatology (ESEGH), jointly administered with UEMS. The format is identical to other SCEs — 200 best-of-five questions across two papers — but the European collaboration means some questions reflect pan-European practice. The exam typically sits once per year in June.
The single annual sitting and the breadth of content — spanning luminal gastroenterology, hepatology, biliary and pancreatic disease, nutrition, and interventional endoscopy — make preparation strategy critical.
Topic weighting
Hepatology is the single largest domain, accounting for roughly 20 per cent of questions. This covers cirrhosis and its complications (portal hypertension, variceal bleeding, ascites, hepatic encephalopathy, HCC surveillance), NAFLD/MASH (renamed — the exam uses current nomenclature), viral hepatitis B and C (including direct-acting antivirals), autoimmune hepatitis, PBC, PSC, Wilson's disease, haemochromatosis, drug-induced liver injury, and acute-on-chronic liver failure. EASL clinical practice guidelines are the primary reference for hepatology questions.
IBD accounts for 15 to 18 per cent — Crohn's disease and ulcerative colitis management, biologic sequencing (infliximab, adalimumab, vedolizumab, ustekinumab, and newer agents), surgical indications, dysplasia surveillance, and pregnancy in IBD. BSG and ECCO guidelines are both relevant.
Upper GI (GORD, Barrett's oesophagus, oesophageal cancer, peptic ulcer disease, H. pylori) accounts for 10 per cent. Colorectal disease (polyp management, CRC screening, diverticular disease) accounts for 8 per cent. Biliary and pancreatic disease (gallstone complications, acute and chronic pancreatitis, cholangiocarcinoma, IgG4-related disease) accounts for 8 per cent.
Small bowel and malabsorption (coeliac disease, small bowel bacterial overgrowth, Whipple's disease), GI bleeding (variceal and non-variceal, obscure GI bleeding), nutrition, motility, functional GI disorders, endoscopy standards, and GI pharmacology make up the remainder.
The hepatology emphasis
Many gastroenterology registrars are more comfortable with luminal GI than hepatology. The exam does not share this bias — hepatology accounts for a fifth of all questions. If your clinical exposure to hepatology has been limited, you need to compensate with dedicated revision. EASL guidelines for cirrhosis, HBV, HCV, NAFLD/MASH, AIH, PBC, and PSC should be read alongside BSG/NICE guidelines for UK-specific management.
IBD biologic sequencing
IBD management questions frequently test biologic selection and sequencing. You need to know the mechanism of action, positioning, monitoring requirements, and NICE technology appraisal access criteria for each agent. The distinction between induction and maintenance dosing, primary versus secondary non-response, and therapeutic drug monitoring is tested at a level that assumes you make these decisions in clinical practice.
Revision strategy
Start four months before the June sitting. Dedicate the first month to hepatology — it is the largest single domain and the area where candidates most frequently have knowledge gaps. Month two should cover IBD, upper GI, and colorectal disease. Month three should cover biliary, pancreatic, small bowel, and the remaining topics. Month four is for mock exams and targeted weak-area revision.
iatroX's SCE Gastroenterology bank contains over 1,500 questions aligned to the JRCPTB GI curriculum, BSG guidelines, NICE, EASL, and ECCO. The adaptive algorithm ensures hepatology receives appropriate emphasis if your performance data shows it as a weak area. All included at £29 per month or £99 per year.