This is for the higher specialty trainee revising SCE Acute Medicine around a full acute-take rota who wants BMJ OnExamination's dashboard to tell them something honest. It addresses the written knowledge component only. The principal limitation is simple: a rising home-screen percentage on a bank you have partly seen before measures familiarity with that bank, not your standing against 200 unseen best-of-five questions on exam day.
What BMJ OnExamination offers for SCE Acute Medicine right now
BMJ OnExamination publishes a dedicated SCE in Acute Medicine module. The figures below are vendor-reported and last checked on 20 July 2026; confirm the live numbers on the product page before you buy, because counts and prices change between diets.
| Attribute | Vendor-reported detail (checked 20 July 2026) |
|---|---|
| Question volume | 315+ best-of-five items, mapped to the JRCPTB Acute Internal Medicine curriculum |
| Question format | Best of five (single best answer), one correct option of five |
| Access periods | 1 to 12 months |
| Price (GBP) | 1 month £69.99; 2 months £89.99; 3 months £109.99; longer terms up to roughly £209.99 |
| Mock tests | Timed mocks curated by the BMJ editorial team against recent exam themes |
| Analytics | Per-question feedback, peer comparison, self-selected difficulty, revision planning |
| Adaptive/AI | No proprietary adaptive-difficulty algorithm is advertised on the product page |
| Free access | 10 free questions per day without subscription |
Two honest points before you read any chart. First, the 315+ item pool is smaller than the specialty banks that market themselves as SCE-first, so completion arrives quickly and repeat exposure inflates your accuracy faster than you might expect. Second, there is no verified adaptive engine here. What candidates experience as "adaptive" is largely the difficulty filter you set plus the platform steering you back to flagged and previously wrong items. That is a useful revision loop, but it is not a hidden model predicting your result.
The exam you are actually sitting
The SCE in Acute Medicine follows the standard Federation of Royal Colleges of Physicians format. It is two papers of 100 best-of-five questions each, 200 questions in total, three hours per paper, sat in one day on a computer at a test centre (Surpass). Each correct answer scores one mark and there is no negative marking, so an unanswered question and a wrong question cost you the same. The structure never changes between specialties; only the blueprint does. The Acute Medicine exam is delivered roughly every nine months, and preparation is anchored to the JRCPTB Acute Internal Medicine curriculum.
The published blueprint distributes those 200 questions approximately as follows. Use it as the reference standard against which every practice statistic is judged.
| Domain | Questions | Share |
|---|---|---|
| Gastroenterology and hepatology | 20 | 10% |
| Cardiovascular medicine | 20 | 10% |
| Neurology and ophthalmology | 20 | 10% |
| Respiratory medicine | 20 | 10% |
| Medicine in the elderly | 18 | 9% |
| Diabetes and endocrine medicine | 14 | 7% |
| Infectious diseases | 14 | 7% |
| Musculoskeletal system | 12 | 6% |
| Cancer, palliative care and haematology | 10 | 5% |
| Clinical pharmacology and poisoning | 10 | 5% |
| Critical care medicine | 10 | 5% |
| Renal medicine | 10 | 5% |
| Other (allergy, genetics, dermatology, immunology, patient safety, psychiatry, public health) | 22 | 11% |
The striking feature of Acute Medicine is how cross-specialty it is: no single domain exceeds 10%, and the exam is essentially general internal medicine viewed through an acute lens. That matters for how you audit your practice data.
Every metric on the dashboard, defined
Before you act on a number, name it. First-attempt accuracy is the percentage correct the first time you see an item, and it is the only accuracy figure that approximates unseen performance. Repeat accuracy is your score on items you have answered before; it climbs toward 90%-plus with exposure and tells you almost nothing about readiness. Peer comparison is BMJ OnExamination's percentile-style metric, ranking you against other subscribers who attempted the same items; it is only as representative as that self-selected cohort. A predicted score or pass-probability figure, where any platform shows one, is a model built on prior candidate behaviour, not a guarantee; I could not confirm BMJ OnExamination publishes a formal predicted SCE score, and if you see one, treat it as a soft prior rather than a verdict. Coverage is the proportion of the pool you have attempted, which measures completion, not competence. Difficulty here reflects the filter you selected or the item's historical facility index. Time per item is your pace against the roughly 108 seconds per question the real paper allows.
The single most important habit is to separate first-attempt accuracy from blended accuracy. The blended figure on the home screen is the one that quietly rises while your true unseen standing stays flat.
Why the feed flatters you
Any revision loop that keeps returning you to your weak and flagged items will, over weeks, make those items feel easy. That is desirable for learning and misleading for measurement. When you re-drill cardiology because you failed it in week one, your cardiology percentage recovers, but it recovers on the specific stems you have now seen two or three times. The dashboard cannot tell the difference between "understands acute coronary syndromes" and "remembers that this particular troponin vignette wanted a different answer last time." Raw practice percentages are therefore not comparable with a mixed, unseen block, and they are certainly not comparable across candidates who have seen different subsets of the pool. Treat any accuracy above your first-attempt baseline as recognition until proven otherwise.
Blueprint audit before you trust the average
Open your attempted-question distribution and lay it beside the blueprint table above. The question is not "what is my average?" but "have I attempted a representative share of every domain?" A common failure pattern in Acute Medicine is a candidate sitting at 78% overall while having attempted 60 cardiology items and 4 renal items. Their average is dominated by their favourite domain, and the 5% of the paper that is renal, the 5% that is poisoning and the 11% "other" bucket are effectively untested. Build a two-column check: attempted share versus blueprint share, domain by domain. Any domain where your attempted share is less than half its blueprint weight is a blind spot the home-screen average is hiding.
The readiness test
A practice score becomes a readiness signal only when five conditions hold at once. The block must be unseen (items you have never attempted). It must be timed at exam pace. It must be mixed across the whole blueprint rather than one domain. It must be sat with no assistance (no notes, no pausing to look things up). And it must be a sufficiently large sample (at least 80 to 100 items) so that a single lucky or unlucky run does not swing the figure. A 90% on a 20-item single-domain open-book drill is not a signal. A 68% on a 100-item mixed unseen timed block is. Only the second number belongs anywhere near a go or no-go decision.
Override rules for the feed
Because the feed follows your behaviour and the pool is finite, some material will be under-served unless you force it. Manually schedule blocks in the low-volume, high-consequence areas the average will never surface enough: clinical pharmacology and poisoning (TOXBASE-style scenarios, overdose antidotes, drug interactions), critical care, ECG and imaging interpretation, calculations such as anion gap and osmolar gap, and the 11% "other" bucket that quietly contains dermatology, psychiatry, genetics, immunology and patient-safety items. Ethics and patient safety in particular rarely feel urgent in revision and appear on the paper anyway. If a domain is only 5% of the exam, it is still 10 marks, and in a tightly standard-set exam 10 marks decide passes.
Worked dashboard example
Suppose your dashboard reads: overall 76%, first-attempt 64%, coverage 82% of the pool, peer comparison 55th percentile. Attempted by domain: cardiology 70 items, gastroenterology 55, respiratory 40, neurology 20, elderly 18, endocrine 12, infectious diseases 10, everything else in single figures. Read honestly, this is not a 76% candidate; it is a 64% first-attempt candidate with three well-drilled domains and a long tail of near-untested ones.
Next week's quotas follow directly. Cap cardiology and gastroenterology at revision-only (no new volume). Assign new unseen items to the tail: 15 renal, 15 poisoning and pharmacology, 15 critical care, 20 across the "other" bucket, 15 infectious diseases. Close the week with one 100-item mixed unseen timed mock and record only the first-attempt result. No pass prediction is made or needed; the quotas are driven by coverage gaps and the first-attempt figure, not by a reassuring blended average.
A seven-day pattern for busy trainees
The goal is one defined job per tool, no proprietary-algorithm claims on either side. Use BMJ OnExamination as your Acute Medicine coverage-and-explanations engine; use iatroX as your unseen general-medicine measurement layer.
- Days 1 to 5 (20 to 30 minutes each): work BMJ OnExamination in the under-served domains from your blueprint audit. Read every explanation, not just the wrong ones. Flag anything you got right for the wrong reason.
- Day 6: sit one mixed timed block. Alternate diets: one week a BMJ mock, the next week a fresh unseen block in iatroX drawn from its UK/MRCP-level general-medicine bank, so the transfer test uses items neither you nor the specialty pool has shown you.
- Day 7: review only. Send every missed concept into a spaced queue and, for the ones that exposed a reasoning gap rather than a fact gap, open them in the iatroX Socratic Tutor to be questioned rather than told.
Because roughly the whole Acute Medicine blueprint is general internal medicine, iatroX's cross-specialty UK bank overlaps its breadth well and is a fair unseen yardstick. It does not, and should not claim to, replace the acute-specific prioritisation practice the specialty bank gives you.
Continue, supplement, switch or stop
Continue with BMJ OnExamination while your first-attempt accuracy is still climbing and you have un-attempted items in weak domains. Supplement when first-attempt accuracy plateaus but blueprint coverage is uneven, which usually means you need unseen volume and a second source rather than more repeats. Switch your primary bank only if the pool is exhausted well before your diet and you need a larger specialty bank for depth. Stop re-drilling a domain once first-attempt accuracy on genuinely new items is consistently at or above your target and repeat accuracy has stopped moving; further reps there buy recognition, not marks. Make each call on a measurable gap, never on novelty or on the money already spent.
Bottom line
BMJ OnExamination is a credible, editorially sound coverage tool for SCE Acute Medicine, and its mocks and explanations are worth including in the revision stack. Its analytics are honest as far as they go, but they describe your relationship with a bank you have partly seen, not your standing against an unseen paper. Read first-attempt accuracy, audit your attempted distribution against the blueprint, and reserve the word "ready" for a large, mixed, timed, unseen, unassisted block. Everything else is practice data.
Frequently asked questions
Is BMJ OnExamination enough for SCE Acute Medicine on its own? For many well-prepared trainees it is a reasonable single spine, because its 315-plus items (vendor-reported, 20 July 2026) are curriculum-mapped and its explanations are strong. But "enough" depends on your baseline: a candidate with weak first-attempt accuracy or an uneven blueprint spread will exhaust a mid-sized pool into recognition before they are ready, and should add unseen volume from a second source. The pool size, not the platform's quality, is the constraint.
Which SCE Acute Medicine component does BMJ OnExamination not reproduce well? No static best-of-five bank rehearses real-time acute prioritisation, the tempo of escalating a deteriorating patient, or parallel triage across a live take. It can test whether you know the correct next investigation or the right escalation, which is exactly what the written SCE asks; it cannot reproduce the pressured sequencing of the shop floor, and it is not designed to.
How many BMJ OnExamination questions should I complete per day for SCE Acute Medicine? Volume is the wrong target; blueprint-weighted coverage is the right one. A sustainable 25 to 40 well-reviewed items per day, deliberately biased toward under-attempted domains, beats 100 rushed repeats. Track first-attempt accuracy and attempted share by domain rather than a daily count, and stop when review quality drops.
When should I stop using BMJ OnExamination and move to mixed mocks? Move to predominantly mixed, timed, unseen mocks once your first-attempt accuracy has plateaued and your attempted distribution covers every blueprint domain at roughly its exam weight. At that point more single-domain drilling adds recognition, and only mixed unseen blocks will move or confirm your true signal.
How should I combine BMJ OnExamination with iatroX without duplicating practice? Give each a single job. BMJ OnExamination owns Acute Medicine coverage, explanations and specialty mocks; iatroX owns unseen general-medicine measurement and spaced retrieval of your misses, following the two-Q-bank rule so the second source stays clean of items the first has already shown you. iatroX is the cross-specialty UK measurement layer, not an Acute Medicine question bank, and combining them this way keeps your unseen signal honest.
Editorial notes and references
Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 20 July 2026. All BMJ OnExamination question counts, prices and features above are vendor-reported and were correct at the time of checking; verify the current figures on the product page before purchase, as they change between diets. Disclosure: iatroX operates a UK question bank that competes with parts of BMJ OnExamination's offering; this article confines iatroX's role to jobs BMJ OnExamination does not claim, namely unseen cross-specialty measurement and spaced retrieval, and it is not a specialty SCE bank. Corrections are welcome via the feedback route on iatrox.com.
References: the Federation of Royal Colleges of Physicians SCE Acute Medicine specialty and blueprint pages (thefederation.uk); the BMJ OnExamination SCE in Acute Medicine product page (onexamination.com); iatroX, Your Q-Bank Percentage Is Not Your Exam Score; iatroX, the two-Q-bank rule; iatroX, building a blueprint-coverage matrix; the iatroX comparison hub and Socratic Tutor.
Run a fresh, timed unseen block in iatroX and decide whether to learn, retest, simulate or stop →