sce acute medicine: everything you need to know to pass.

Paper 1

100 best-of-five SBAs · 3 hours · computer-based at Pearson VUE designated test centres

Paper 2

100 best-of-five SBAs · 3 hours · same day, after a 1-hour break

Candidate level

Pitched at the level of a consultant practising in Acute Medicine — basic science, clinical scenarios, current UK guidelines and scoring systems

Sepsis and septic shock — Surviving Sepsis Campaign 2021 bundles, qSOFA vs NEWS2, source control timing, vasopressor sequencing (norepinephrine first-line, vasopressin add-on, hydrocortisone in refractory shock)

Acute coronary syndromes and decompensated heart failure — ESC 2023 ACS guidelines, GRACE score thresholds, four-pillar HFrEF therapy, IV diuretic + nitrate strategies in acute pulmonary oedema

Stroke and intracranial bleed — thrombolysis windows (extended to 9h in selected patients), thrombectomy criteria, BP management thresholds in haemorrhagic stroke, posterior circulation pitfalls

Toxicology — paracetamol nomogram and staggered ingestion rules, salicylate dialysis criteria, sodium-channel blocker overdose, calcium-channel blocker / beta-blocker antidote sequencing

GI bleeding — Glasgow-Blatchford and Rockall scores, terlipressin in variceal bleeding, when to escalate to interventional radiology vs surgery

Care of the deteriorating elderly patient — comprehensive geriatric assessment, anticoagulation in frailty, recognising delirium vs dementia vs depression, ceilings of care discussions

Pulmonary embolism — Wells score, age-adjusted D-dimer, sub-massive vs massive PE management, thrombolysis indications and contraindications

AKI and renal replacement therapy initiation — KDIGO staging, AKI bundles, indications for emergency dialysis (pulmonary oedema, hyperkalaemia, refractory acidosis, uraemia, certain toxins)