SCE Medical Oncology: question practice and revision.

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

• Lung cancer — NSCLC (driver mutation testing, IO sequencing), SCLC, mesothelioma
• Breast cancer — HER2, HR-positive, TNBC, CDK4/6, ADCs, neoadjuvant strategies
• GI cancers — colorectal (RAS/BRAF, MSI), gastric/oesophageal, hepatobiliary, pancreatic
• Genitourinary — prostate (ARSI, PARP), renal (IO-TKI combos), bladder (PD-L1, ADCs)
• Gynaecological — ovarian (PARP maintenance), cervical, endometrial (MMR, IO)
• Skin and melanoma — BRAF/MEK, IO combinations, adjuvant, neoadjuvant TIL therapy
• Haematological malignancies — lymphoma overlap, CAR-T, BTKi, BCL2i
• Head and neck cancer — IO in R/M, induction strategies, oligometastatic SBRT
• CNS tumours — glioma molecular classification, temozolomide, leptomeningeal disease
• Sarcoma and rare tumours — GIST (imatinib resistance), MPM, NETs grading
• Oncological emergencies and toxicity management — irAEs, TLS, MSCC, neutropenic sepsis
• Trials, biostatistics, ethics, supportive care, survivorship
• Palliative oncology, symptom control, end-of-life prescribing

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

• NSCLC driver mutations — EGFR (osimertinib first-line, ALK (lorlatinib, alectinib), ROS1, BRAF V600E, RET, KRAS G12C, MET ex14, HER2; testing pathways and resistance mutations (e.g. T790M obsolete, but C797S, MET amplification)
• IO mechanism and irAE management — checkpoint inhibitor classes (PD-1, PD-L1, CTLA-4, LAG-3); irAE recognition (colitis, pneumonitis, hepatitis, hypophysitis, myocarditis); steroid sequencing per ESMO 2022/24 irAE guidelines
• Breast cancer — HER2-low (T-DXd), HR+ early (adjuvant abemaciclib, ribociclib NATALEE), CDK4/6 in metastatic, TNBC (pembrolizumab + chemo in KEYNOTE-522), neoadjuvant strategies, OncotypeDx use
• Prostate cancer — ARSI sequencing (abiraterone, enzalutamide, apalutamide, darolutamide), triplet therapy (PEACE-1, ARASENS), PARPi (olaparib BRCA-mutant) per PROfound, PSMA-RLT (lutetium-177)
• Colorectal cancer — MSI testing, IO in dMMR (pembrolizumab KEYNOTE-177), RAS/BRAF testing, FOLFOXIRI vs FOLFIRINOX, encorafenib + cetuximab in BRAF V600E
• Oncological emergencies — neutropenic sepsis bundles (MASCC score), TLS prevention and rasburicase, MSCC investigation and dexamethasone dosing, SVC obstruction, malignant hypercalcaemia
• Trial design and biostatistics — non-inferiority trials, basket vs umbrella vs platform designs, hazard ratios and OS vs PFS endpoints, ITT vs per-protocol analysis
• Survivorship — late toxicity (anthracycline cardiomyopathy, taxane neuropathy, IO endocrinopathies), second primary risk, fertility preservation discussions

Observations from UK medical oncology trainees and recent SCE candidates. Verify against current ESMO and NICE TA guidance.

Candidate-reported observations — not official guidance.

1. NICE TA vs ESMO divergence — UK access pathways often lag ESMO recommendations. The SCE tests both UK practice (NICE TA-aware) and international standards (ESMO). Knowing where they diverge is critical.
2. irAE grading and steroid dosing — CTCAE grading, when to hold vs permanently discontinue IO, prednisolone equivalent doses for grade 3–4 toxicity. Commonly muddled. Myocarditis is high-yield and lethal.
3. Driver mutation testing in NSCLC — reflex testing for EGFR/ALK/ROS1/BRAF/RET/MET/KRAS/HER2 is standard. Resistance mechanism recognition (C797S in osimertinib, MET amplification, histologic transformation to SCLC) is examined.
4. PARP inhibitor maintenance — distinguishing first-line maintenance vs platinum-sensitive relapse vs treatment in BRCA-mutant disease across ovarian, prostate, breast, pancreatic settings. Easy to confuse trial settings.
5. Bispecific T-cell engagers — talquetamab, teclistamab (myeloma), tarlatamab (SCLC), tebentafusp (uveal melanoma). New class, often tested.
6. Antibody-drug conjugates — T-DM1 vs T-DXd indications and toxicity (ILD with T-DXd), sacituzumab govitecan in TNBC and bladder, enfortumab vedotin in bladder. New class, often tested.
7. Statistics in oncology trials — composite endpoints, surrogate endpoints (DFS as proxy for OS), HRs and confidence intervals, NNT for adjuvant therapies. Routinely tested.
8. Late toxicity recognition — anthracycline cardiomyopathy LVEF monitoring intervals, taxane peripheral neuropathy, IO-induced T1DM and hypophysitis with permanent endocrinopathy.

A pragmatic phased approach used by recent ST5–ST6 medical oncology passers.

1. Weeks 1–6

   Foundation pass across all 13 blueprint topics. 30 questions/day with the iatroX adaptive engine. Read ESMO Clinical Practice Guidelines for each tumour type as you cover it.

2. Weeks 7–11

   Targeted weak-area drilling. Map current NICE TAs for high-volume tumours and the ESMO Magnitude of Clinical Benefit Scale. Practise trial design and biostatistics interpretation daily.

3. Weeks 12–14

   Two timed 200-SBA mock exams under exam conditions weekly. Practise irAE grading and oncological emergency scenarios under time pressure. Review radiology recognition (RECIST/iRECIST).

4. Weeks 15–16

   Bookmark review only. Targeted reading on new ADCs, bispecifics and 2025/2026 ESMO Congress practice-changing trials. Confirm Pearson VUE booking. Sleep, hydrate, do not learn new material.

Dedicated SCE Medical Oncology 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 Medical Oncology 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 Medical Oncology sitting: 8 September 2027. Applications: 19 May 2027–16 June 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. From June 2026 all sittings are in-centre at Pearson VUE locations. Paper 2 is widely reported to include more radiology, pathology and trial-data interpretation items.

Most UK trainees sit during ST5 or ST6 (penultimate year of higher specialty training). There are no formal restrictions on when in training you sit, but CCT requires a pass before completion. International candidates can sit at any time once registered with the Federation.

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.

The SCE is the UK-mandated Federation knowledge assessment for CCT in Medical Oncology. ESMO offers its own examinations (ESMO Examination in Medical Oncology) which are not mandatory for UK CCT but are valuable for European recognition. iatroX content is mapped to both UK and ESMO standards.

Full SCE Medical Oncology 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.