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From February 2020 the SCE Nephrology and the European Certificate in Nephrology merged into ESENeph — the GMC-mandated knowledge assessment for UK renal trainees. Full curriculum coverage, KDIGO and UKKA guidance, and an AI-adaptive question bank with embedded histology and electrolyte interpretation modules.
100 best-of-five SBAs · 3 hours · delivered via MRCP(UK) online portal or in-centre (in-centre from June 2026)
100 best-of-five SBAs · 3 hours · same day, after a 1-hour break · includes histology images and electrolyte panels
Most items are clinical case vignettes. Some carry biopsy histology, radiology or ECG. SI units in the question stem with conversion to conventional units available
GMC-approved mandatory summative assessment for CCT in Renal Medicine in the UK. Open to candidates worldwide.
2026/01 sitting: 9 September 2026. Application window: 20 May–17 June 2026. Reasonable adjustment deadline: 25 June 2026. Results released approximately 6 weeks after the exam. From June 2026 sittings are delivered in centre.
Approximate question distribution across the UEMS Renal Section curriculum and JRCPTB Renal Medicine syllabus. Used to drive iatroX adaptive sequencing.
Drawn from current KDIGO guidelines, UKKA position statements and item density in iatroX.
Glomerular disease — IgA nephropathy (MEST-C scoring, targeted-release budesonide [Nefecon], sparsentan), lupus nephritis (belimumab, voclosporin), ANCA vasculitis (avacopan, rituximab vs cyclophosphamide induction)
AKI — KDIGO 2012/2024 staging, AKI bundles, contrast-induced nephropathy controversy, hepatorenal syndrome terlipressin + albumin, indications for emergency RRT (refractory hyperkalaemia, fluid overload, uraemia, acidosis, intoxications)
CKD-MBD — calcimimetics (cinacalcet, etelcalcetide), active vitamin D, phosphate binders (iron-based, calcium-based, sevelamer, lanthanum), parathyroidectomy indications
Anaemia in CKD — Hb targets per KDIGO/NICE, HIF-PHi agents (daprodustat, roxadustat) vs ESAs, IV iron protocols, hyporesponsiveness workup
Transplant immunosuppression — tacrolimus + MMF + steroids standard, belatacept vs CNI long-term, recognising acute T-cell rejection (Banff classification) vs antibody-mediated rejection
Complement-mediated disease — atypical HUS (eculizumab, ravulizumab), C3 glomerulopathy (iptacopan), classical HUS-STEC, TMA differential
Pregnancy and kidney disease — GFR adaptation, pre-eclampsia BP targets per NICE NG133, lupus flare management, transplant pregnancy timing
Inherited disease — ADPKD tolvaptan eligibility (TKV, eGFR), Fabry agalsidase/migalastat, Alport screening for relatives, genetic testing pathways
Observations from UK renal trainees and recent ESENeph candidates. Verify against current KDIGO and UKKA guidance.
Candidate-reported observations — not official guidance.
A pragmatic phased approach used by recent UK passers in ST4–ST6 renal medicine.
A live item from the iatroX bank. Try it before launching a full session.
A 43-year-old woman with lupus nephritis is on maintenance mycophenolate 1 g BD, hydroxychloroquine 200 mg OD, and prednisolone 7.5 mg. She develops herpes zoster (shingles) affecting the T4 dermatome. She is started on oral valaciclovir. Regarding her immunosuppression, what is the recommended approach?
Why iatroX is built differently for ESENeph (Nephrology Specialty Exam).
Every iatroX item is tagged to a blueprint topic, so your performance dashboard mirrors the structure of the exam itself.
The engine surfaces your weakest topics first, in real time, instead of marching you through a static syllabus.
Incorrect items return at increasing intervals to interrupt the forgetting curve and lock knowledge into long-term memory.
Timed full-length simulations that mirror the official exam structure under realistic conditions.
One iatroX subscription includes the ESENeph (Nephrology Specialty Exam) bank plus every other premium iatroX exam bank.
Cancel anytime · 30-day money-back guarantee on annual
From February 2020 the UK SCE in Nephrology and the European Certificate in Nephrology (UEMS Renal Section / ERA-EDTA) merged into a single exam: the European Specialty Examination in Nephrology (ESENeph). It is the GMC-approved mandatory summative knowledge assessment for UK renal medicine trainees as a requirement for CCT.
The next UK sitting is 9 September 2026. Application window: 20 May to 17 June 2026. ESENeph is delivered every 9 months globally, so additional international sittings may run outside the UK cycle. Confirm dates on the MRCP(UK) website.
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 designated test locations. Most questions are clinical case vignettes; some carry biopsy histology, electrolyte panels, ECG or radiology.
The UEMS Renal Section advises UK trainees dual-accrediting in General Internal Medicine and Nephrology to sit ESENeph during ST5 to allow time for up to 3 attempts before CCT. Single-accreditation candidates may sit in ST4. EU candidates typically take it towards the end of specialisation.
No. Candidates who have already passed the legacy SCE in Nephrology are not permitted to apply for ESENeph. The legacy SCE pass is sufficient for CCT purposes.
For candidates sitting in ESBGH/ESENeph member, associate member and observer countries the fee is €800. UK fee is £700; international fee is £875. Fees are non-refundable after the application closing date.
Yes. A single iatroX subscription (£29/month or £99/year for UK users; $29/$99 elsewhere) includes the ESENeph bank alongside every other premium iatroX exam bank. No add-ons or per-exam fees.
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Reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP · Last reviewed 12 May 2026
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