If you've passed MRCP Parts 1, 2, and PACES, you might think the exam treadmill is over. It isn't. Before you can be awarded a CCT in most medical subspecialties, you need to pass the relevant Specialty Certificate Examination (SCE) — and for most SCEs, the preparation resources range from thin to nonexistent.
What SCEs are
SCEs are written exams administered by the Federation of Royal Colleges of Physicians. They test knowledge at the level expected of a doctor approaching the end of higher specialty training — deeper and more specialty-focused than MRCP, but still covering general internal medicine.
Each SCE consists of two papers of 100 best-of-five (BOF) questions each, sat on the same day (total: 200 questions, 5 hours). The content is mapped to the relevant specialty curriculum and tests both specialty-specific knowledge and its application to clinical scenarios.
From 2026, SCEs are returning to computer-based testing at Pearson VUE centres, moving away from the remote online proctoring that caused significant disruption in 2025.
The full list of SCEs
SCEs exist for the following specialties: Acute Medicine, Cardiology, Clinical Genetics, Clinical Pharmacology and Therapeutics, Dermatology, Endocrinology and Diabetes, Gastroenterology, Geriatric Medicine, Haematology, Immunology (Allergy), Infectious Diseases, Medical Oncology, Nephrology, Neurology, Palliative Medicine, Rehabilitation Medicine, Renal Medicine, Respiratory Medicine, Rheumatology, and Tropical Medicine (among others — the exact list is published by JRCPTB).
Some specialties share SCE content or have combined examinations. Check the JRCPTB website for the current list specific to your training programme.
The resource problem
Here's the uncomfortable reality: for most SCEs, there is no dedicated question bank.
The exceptions are limited. StudyPRN offers SCE-specific banks for a handful of specialties (Rheumatology, Acute Medicine, and a few others) — they're small but targeted. Pastest and PassMedicine offer MRCP Part 1/2 content that overlaps with SCE content but isn't calibrated to the SCE level or specialty focus. BMJ OnExamination has some SCE-adjacent material.
For the majority of SCEs — Nephrology, Neurology, Cardiology, Dermatology, Palliative Medicine, Infectious Diseases — candidates are essentially assembling preparation from: MRCP question banks (partial overlap), specialty textbooks (comprehensive but not exam-format), and informally shared past questions (variable quality and currency).
This is a genuine market failure. Each SCE has 100–500+ candidates per year. Candidates are registrars with income and strong willingness to pay for quality resources. Yet no platform serves most of them.
How to prepare when resources are scarce
Step 1: Map the curriculum. Download the specialty curriculum from JRCPTB. This is the exam blueprint. Every question on the SCE should map to a curriculum learning outcome. If you can't find your weak areas from the curriculum alone, work through a general medicine qbank and flag every question in your specialty domain.
Step 2: Use MRCP resources as a foundation. MRCP Part 1 and Part 2 question banks cover the general medicine core that constitutes 20–30% of most SCEs. This is your baseline. Don't skip it — many candidates fail SCEs not on specialty content but on the GIM component.
Step 3: Supplement with specialty-specific sources. For each specialty, there's usually a "bible" textbook: Harrison's for GIM, Rook's for dermatology, Oxford Textbook of Medicine subspecialty chapters, etc. Read the chapters relevant to your exam, then convert key facts into practice questions (or use AI tools to generate them).
Step 4: Use AI to fill the gap. This is where tools like iatroX genuinely help. The AI clinical search can answer specialty-specific clinical queries with guideline references, and the quiz engine covers the general medicine foundation. For generating practice questions on specific topics ("Generate 10 SBAs on lupus nephritis management"), AI tools provide volume practice that doesn't exist elsewhere for most SCEs.
Step 5: Form a study group. For niche SCEs, your co-registrars are your best resource. A group of 4–5 registrars each writing 20 practice questions and sharing them creates a 100-question bank at zero cost. The act of writing questions is itself high-yield revision.
Which SCEs are hardest?
Pass rates vary by specialty and sitting, but consistently challenging SCEs include: Neurology (broad curriculum, complex localization questions), Dermatology (visual recognition plus management), Medical Oncology (rapidly evolving evidence base), and Clinical Pharmacology (detail-oriented, calculation-heavy).
The SCEs with the highest pass rates tend to be in larger specialties where more candidates have had broader training exposure: Acute Medicine, Respiratory Medicine, and Geriatric Medicine typically have higher pass rates, partly because the content overlaps more heavily with general internal medicine.
The bottom line
SCEs are a necessary final hurdle in medical specialty training. The lack of dedicated resources for most of them is a genuine problem that forces candidates into creative preparation strategies. The most successful approach combines: MRCP-level foundation, specialty textbook depth, practice question generation (AI-assisted or peer-created), and systematic curriculum mapping.
The market will eventually catch up — dedicated SCE qbanks will emerge for all major specialties. Until then, the registrars who prepare most systematically will outperform those who rely on passive reading.
iatroX covers general internal medicine and primary care content that forms the foundation for all SCEs. AI clinical search and UK qbank available now.