The SCE Rheumatology tests the full JRCPTB Rheumatology curriculum at consultant level. It covers inflammatory arthritis, connective tissue diseases, vasculitis, crystal arthropathy, osteoarthritis, metabolic bone disease, soft tissue rheumatology, and the pharmacology of DMARDs and biologics. The exam sits once per year, typically in June.
What makes rheumatology distinct
Rheumatology is a classification-heavy specialty. The exam expects you to know and apply the ACR/EULAR classification criteria for RA (2010), SLE (2019), ANCA-associated vasculitis, systemic sclerosis, idiopathic inflammatory myopathies, and gout. These are not the same as diagnostic criteria — classification criteria are designed for research homogeneity and have specific sensitivity/specificity trade-offs. Questions often test the distinction between classification and diagnosis, and between criteria sets from different eras.
Autoantibody interpretation is another pillar. You must know the clinical associations, sensitivity, and specificity of anti-CCP, RF, ANA (including patterns — homogeneous, speckled, centromere, nucleolar), anti-dsDNA, anti-Sm, anti-Ro/La, anti-Scl-70, anti-Jo-1, anti-centromere, ANCA (PR3 and MPO), and anti-PLA2R. Questions frequently present a clinical scenario with an autoantibody panel and ask you to identify the most likely diagnosis or the most appropriate next investigation.
Topic weighting
Rheumatoid arthritis accounts for roughly 15 per cent of questions — diagnosis, disease activity assessment (DAS28), treat-to-target strategy, DMARD and biologic sequencing, and comorbidity management (cardiovascular risk, interstitial lung disease). SLE and antiphospholipid syndrome account for 12 per cent. Vasculitis (giant cell arteritis, GPA, EGPA, PAN, IgA vasculitis, Behçet's) accounts for 10 per cent. Spondyloarthropathy and psoriatic arthritis account for 10 per cent.
Crystal arthropathy (gout and pseudogout) accounts for 8 per cent — including urate-lowering therapy targets, colchicine dosing, and the distinction between acute and chronic management. Systemic sclerosis, myositis, and Sjögren's syndrome account for 10 per cent collectively. Osteoarthritis, metabolic bone disease, and soft tissue rheumatology account for 10 per cent. DMARD and biologic pharmacology — mechanism of action, monitoring, side effects, and NICE access criteria — accounts for 12 per cent.
Biologic access pathways
The exam tests your knowledge of NICE technology appraisals governing biologic access. You need to know the eligibility criteria (usually DAS28 thresholds after failure of two conventional DMARDs), the sequence of biologic classes (TNF inhibitors, IL-6 inhibitors, B-cell depletion, JAK inhibitors, co-stimulation modulators), and the specific monitoring requirements for each. BSR guidelines on biologic prescribing and monitoring are essential reading.
Revision strategy
Three to four months. Start with RA and SLE — they are the two largest domains and the most densely tested. Cover vasculitis in the second month, which is a high-failure topic because the classification is complex and the management varies significantly between subtypes. Spend the third month on crystal arthropathy, SpA, and the remaining connective tissue diseases. Dedicate specific sessions throughout to autoantibody interpretation and classification criteria — these are discrete, memorisable knowledge sets that yield reliable marks.
iatroX's SCE Rheumatology bank contains over 1,500 questions aligned to BSR, EULAR, and NICE guidelines. Autoantibody interpretation and classification criteria questions are tagged for focused practice. Adaptive learning ensures vasculitis and the less common connective tissue diseases receive attention proportional to their exam weighting. All included at £29 per month or £99 per year.