SCE Acute Medicine: question practice and revision.

Choose a topic for focused revision and check your plan against the official specification.

• Cardiovascular medicine
• Gastroenterology and hepatology
• Neurology and ophthalmology
• Respiratory medicine
• Medicine in the elderly
• Diabetes and endocrine medicine
• Infectious diseases
• Musculoskeletal system
• Other (allergy · clinical genetics · dermatology · immunology · patient safety · psychiatry · public health)
• Cancer, palliative care and haematology
• Clinical pharmacology and poisoning
• Critical care medicine
• Renal medicine

Drawn from the Federation blueprint, current UK acute medicine guidelines, and item density in iatroX.

• 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)

Observations from acute physician examiners and recent candidates. Verify against current NICE and Federation guidance.

Candidate-reported observations — not official guidance.

1. The "Other" category (22 questions, 11%) is the largest single block in the blueprint — under-prepared by candidates who focus only on the major organ-system topics. Allergy, immunology, clinical genetics and patient safety items recur every paper.
2. Toxicology numerical thresholds — paracetamol nomogram cut-offs at 4h vs staggered ingestion, salicylate level for dialysis, ethylene glycol management. Commonly muddled under time pressure.
3. Distinguishing the unwell post-take patient from the dying post-take patient — RESPECT / ReSPECT framework, capacity assessment in delirium, IMCA referrals, escalation vs ceiling-of-care decisions.
4. NEWS2 score components and triggers — the role of CRT, supplemental oxygen, and chronic NEWS users (e.g. type 2 respiratory failure targets) is examined directly.
5. Critical care interface — when to refer to ITU vs ward-based care, indications for vasopressors outside ITU, non-invasive ventilation thresholds in COPD and pulmonary oedema.
6. Pacing across two papers — candidates report under-finishing Paper 2 after a strong Paper 1. Both papers are equally weighted; deliberate timed practice on the second paper is essential.
7. Public health and patient safety — duty of candour, never events, reporting frameworks, statutory infection notification. Small block but consistently tested.

A pragmatic phased approach used by recent passers in their penultimate AIM training year.

1. Weeks 1–4

   Foundation pass across all 13 blueprint topics. 30–40 questions/day with the iatroX adaptive engine. After ~400 attempts, the diagnostic dashboard identifies your weakest three topics. Read the Oxford Handbook of Acute Medicine alongside.

2. Weeks 5–8

   Targeted weak-area drilling using spaced repetition. Cross-reference current NICE guidance on sepsis (NG51), acute heart failure (NG106), stroke (NG128), AKI (NG148) and DKA. Daily ECG and ABG interpretation practice.

3. Weeks 9–11

   Two timed 200-SBA mock exams under exam conditions — Paper 1 + Paper 2 each week. Review every incorrect answer in detail; flag recurrent themes. Practise the second paper under fatigue.

4. Week 12

   Bookmark review only. Light reading on toxicology thresholds and patient safety frameworks. Confirm Pearson VUE booking and admission documentation. Sleep, hydrate, do not learn new material.

Dedicated SCE Acute Medicine question practice with answer explanations, guided Tutor review and study planning.

• Focused question practice — Choose the relevant bank and use your answers to identify what to study next.
• Guided reasoning — Explore a difficult answer with Tutor, then apply the distinction independently.
• Review and timed practice — Return to important mistakes and choose a timed practice set where available.

Choose the relevant bank and use the official exam guidance to plan your preparation.

Use the dedicated SCE Acute Medicine bank for question practice and answer explanations. Choose a practice set to see its available count and timing, then use the official specification to plan your wider preparation.

Next SCE Acute Medicine sitting: 5 May 2027. Applications: 13 January 2027–10 February 2027. Applications open and close at 08:00 UK local time. Confirm booking and delivery arrangements with the Federation.

Two papers of 100 best-of-five SBAs each, three hours per paper, sat on the same day with a one-hour break between. Total 200 questions across the day. Both papers are computer-based at Pearson VUE designated test centres.

No. From June 2026 all UK and international SCEs are delivered in-centre at Pearson VUE test centres. Remote Online Proctoring (ROP) has been discontinued. Confirm your assigned centre with the Federation after application.

Cardiovascular medicine, gastroenterology and hepatology, neurology and ophthalmology, and respiratory medicine — each contributing 20 questions (10% of the paper). Medicine in the elderly contributes 18 questions (9%). Together these five categories account for 49% of the exam.

UK fee is £700; international fee is £875. Candidates transferring from UK to international centres after applying pay the £175 differential. Fees are non-refundable after the application closing date.

Full SCE Acute Medicine bank access is included in all-access. Up to 10 new sample questions per day are shared across exams, with no account required. A verified free account includes one guided Tutor session; continued Tutor use is included in all-access.