SCE Geriatric Medicine: question practice and revision.

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

• Frailty, falls and comprehensive geriatric assessment (CGA)
• Dementia and delirium — diagnosis, 4AT, behavioural symptoms, anti-dementia drugs
• Stroke and TIA — including secondary prevention, post-stroke rehab
• Movement disorders — Parkinson's disease, atypical parkinsonism, drug-induced
• Polypharmacy, STOPP/START, anticholinergic burden, deprescribing
• Continence — urinary and faecal, including post-stroke continence
• Bone health — osteoporosis, fracture liaison, fragility fracture management
• Acute presentations in older adults — sepsis, AKI, AF in frailty, syncope
• End-of-life care, capacity (MCA), DoLS/LPS, advance care planning
• Pressure ulcers, sarcopenia, nutrition, dysphagia, oral health
• Service models — intermediate care, hospital at home, virtual wards, frailty front-door
• Statistics, ethics, professional behaviours

Mapped to the published JRCPTB curriculum and prioritised using item-density signals across the iatroX bank.

• Comprehensive Geriatric Assessment — domains (medical, functional, psychological, social, environmental), evidence base (Cochrane CGA meta-analysis), who benefits most, frailty front-door models
• Delirium — 4AT vs CAM, distinguishing from dementia (acute onset, fluctuating attention), TIME bundle for prevention, antipsychotic use in older adults (risks, indications, monitoring)
• Falls — multifactorial assessment, postural hypotension thresholds, medication review (anticholinergics, sedatives, opioids, antihypertensives), STEADI / NICE CG161 framework
• Anti-dementia drugs — donepezil, rivastigmine, galantamine, memantine — sequencing, side effects, when to stop. Emerging anti-amyloid therapies (lecanemab, donanemab) and ARIA monitoring
• STOPP/START version 3 — anticholinergic burden, deprescribing thresholds, beers criteria differences, polypharmacy reviews
• Parkinson's management — levodopa wearing-off (entacapone, opicapone, safinamide, istradefylline), DBS criteria, psychosis (quetiapine, pimavanserin), end-of-life PD
• Mental Capacity Act — functional test (understand, retain, weigh up, communicate), best interests, DoLS/LPS framework, attorneys (LPA-health-and-welfare) vs deputies
• End-of-life prescribing — anticipatory medications, opioid conversion (oral to subcutaneous, ratio calculations), midazolam for terminal agitation, glycopyrronium for secretions

Observations from UK geriatric trainees and recent SCE candidates. Verify against current NICE and BGS guidance.

Candidate-reported observations — not official guidance.

1. STOPP/START version — STOPP/START is periodically revised (version 3 published 2023). Older revision sources cite version 2 criteria. The newer version includes anticholinergic burden scoring and emerging deprescribing rules.
2. Dementia subtype recognition — DLB (neuroleptic sensitivity, visual hallucinations, REM sleep behaviour disorder, fluctuations), FTD behavioural variant (disinhibition, executive dysfunction), vascular cognitive impairment vs Alzheimer's. Commonly muddled.
3. DoLS vs LPS — the Liberty Protection Safeguards framework began rollout in 2024 and replaces DoLS. Both are examined. Knowing which deprivations require authorisation in domestic vs care home vs hospital settings.
4. Frailty scoring — Clinical Frailty Scale (Rockwood) levels and meaning, electronic Frailty Index for primary care, PRISMA-7, gait speed thresholds. Different scales tested in different domains.
5. Anti-amyloid therapies — lecanemab, donanemab. ARIA-E and ARIA-H monitoring intervals, who is eligible (early symptomatic AD with biomarker confirmation), APOE-ε4 genotyping. Newly tested topic.
6. Continence subtypes — stress vs urge vs mixed vs overflow vs functional. Anticholinergic burden in older adults — mirabegron preferred over oxybutynin/solifenacin where possible.
7. Statistics in geriatric trials — composite endpoints in fall prevention studies, hazard ratios for fracture trials (FREEDOM, ARCH, romosozumab), interpreting Cochrane reviews in CGA.

A pragmatic phased approach used by recent ST5–ST7 geriatric medicine passers.

1. Weeks 1–4

   Foundation pass across all 12 blueprint topics. 30 questions/day with the iatroX adaptive engine. Review current authoritative guidance for dementia, falls and osteoporosis alongside weak topics.

2. Weeks 5–8

   Targeted weak-area drilling. Map every BGS position statement and the STOPP/START v3 criteria. Daily ECG and bone profile interpretation. Practice anticholinergic burden calculations.

3. Weeks 9–11

   Two timed 200-SBA mock exams under exam conditions weekly. Specifically practise end-of-life prescribing dose calculations and capacity assessment scenarios under time pressure.

4. Week 12

   Bookmark review only. Targeted reading on anti-amyloid therapies (lecanemab, donanemab), LPS framework, latest BGS position statements. Confirm Pearson VUE booking. Sleep, hydrate, do not learn new material.

Dedicated SCE Geriatric 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 Geriatric 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 Geriatric Medicine sitting: 21 July 2027. Applications: 31 March 2027–28 April 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. From June 2026 all sittings are in-centre at Pearson VUE locations.

Most UK trainees sit during ST5 to ST7 (penultimate year of higher specialty training is typical). There are no formal restrictions on when in training you sit, but CCT requires a pass before completion. Check the published calendar before arranging clinical and study leave.

The SCE is a Federation/JRCPTB knowledge assessment required for CCT in Geriatric Medicine. BGS (British Geriatrics Society) membership is separate but useful. BGS position statements and educational events are valuable revision tools.

UK fee is £700; international fee is £875. Fees are non-refundable after the application closing date. From June 2026 all sittings are delivered in-centre at Pearson VUE locations.

Full SCE Geriatric 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.