In days gone by, MRCP PACES was the final exam hurdle in the race to become a Consultant. But most specialties have now introduced an additional specialist knowledge test, sometimes referred to as an exit exam. The Specialist Certificate Examination (SCE) in Respiratory Medicine is set at the level of a newly appointed Consultant and is compulsory for all trainees whose specialist training began in or after August 2007. With success comes the satisfaction of proving you have the knowledge that is necessary to justify the title ‘Respiratory Specialist’ and some extra letters to add after your name “MRCP (UK) (Resp Med)”. Failure in the exam does not impede progress through training, but a CCT cannot be awarded without it. It is therefore recommended that trainees consider taking the SCE in their third or penultimate year of training (ST5 or ST6).

SCE format

The SCE consists of 200 questions in 2 x 3-hour papers taken on a single day. The questions are in ‘best of five’ multiple-choice format so for each question there are five options – one correct answer and four distractors which are closely related to the preferred option but less correct.

There is only one diet of the exam per year so plan ahead! Registration for the exam is online, and is usually open between July and September, with the exam taking place in October.  Exams take place in external centres such as Pearson Vue centres, which are also used for theory driving test exams. Be warned that the centres follow strict protocols, which include preventing candidates from taking anything into the exam room (even water).

The SCE is designed to assess knowledge of the natural history and pathogenesis of respiratory disorders, the basic scientific principles and evidence base underpinning current clinical practice, in addition to knowledge of how to diagnose and manage everyday clinical problems. The blueprint provides information on the weighting of different subjects - extremely useful for planning your exam preparation.

SCE preparation

Information on the SCE is provided by BTS, the JRPCTB and MRCP(UK). The cost is currently £665 (as of 2016). A factsheet on the rationale behind this cost is published by the MRCP.  There is an annual SCE Preparation Course before the Summer BTS each year, which is designed to cover ‘difficult’ or ‘hot’ topics. Slides from previous courses are made available on the BTS website along practice questions and 2 mock exams. A mock exam is also available on the MRCP(UK) website, which better reflects the scope and format of the actual exam, but includes fewer questions.

Everyone works differently, but one successful strategy is to ‘buddy-up’ with another trainee, agree a revision schedule, and then test each other on specific areas. Comparing answers from an online mock exam can also be very helpful, as discussing why you don’t agree often leads to deeper understanding.

Dr John Mucklow, Associate Medical Director for the SCE advises that “knowledge necessary to pass the SCE cannot be acquired from clinical practice alone, however diligent. As at every stage of one’s continuing medical education, clinical experience has to be complemented by directed reading and private study.”

See the Forum for resources trainees have found useful in preparing for the SCE, including books, apps, review articles and websites.