A decade on: the SCE in endocrinology and diabetes (2022)

Exams are a fact of life – rarely pleasant at the time, but often an essential requirement if you want to get on, especially in a discipline such as medicine. Up until recently, most physicians could comfort themselves in the knowledge that, once they had successfully navigated Parts I & II of MRCP(UK), they wouldn’t need to face another exam, before taking up an appointment as a consultant (unless they chose to do so). But then things changed…

In 2008, the Federation of Royal Colleges of Physicians (UK), in conjunction with the relevant specialist societies (in our case, the Society for Endocrinology and the Association of British Clinical Diabetologists) launched the Specialty Certificate Examinations (SCEs), leading to the award of MRCP(UK) (Specialty).1

Interestingly, the MRCP(UK) website promotes the SCE programme as an opportunity to ‘broaden your horizons’, although how many trainees view the exam in that light while preparing to sit it could be debated!

However, it is undoubtedly the case that, over the last decade, the SCE has established itself as one of the most respected international postgraduate qualifications. It is in effect a ‘quality stamp’, providing objective evidence that a specialist trainee has sufficient knowledge of their discipline to practise safely and competently as a consultant.

Perhaps the strongest endorsement of the SCE programme has come from colleagues in other European countries, who are seeking to collaborate with their UK counterparts and build on the expertise and quality of the SCEs. The European Specialty Examination in Gastroenterology and Hepatology is already up and running, and Endocrinology and Diabetes is not far behind. In 2018, the European Society of Endocrinology, in collaboration with the European Union of Medical Specialists (UEMS), will hold the first pan-European Examination in Clinical Endocrinology, Diabetes and Metabolism.


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(Video) Specialty spotlight - endocrinology and diabetes

The SCE in Endocrinology and Diabetes runs once a year, typically in early summer. It is a single exam, consisting of two papers, each containing 100 questions. Candidates are allowed 3 hours per paper with a 1-hour break in between. The examination is delivered electronically at designated test centres.

Each question (or ‘item’) is presented in a standard format (see Example question), with the majority of items based around a brief clinical scenario (the ‘stem’), followed by the question (the ‘lead-in’), and then a list of five possible answers (the ‘options’).

Importantly, these options are the ‘best-of-five’; i.e. each of the options should be plausible for the clinical context described, but one should be clearly better than the others. This is very different to the historic multiple-choice question papers that many of us sat in the past, when the candidate was often presented with a list of true/false options – several of which were often completely implausible!

Importantly, most of the 200 items seek to test the application of knowledge rather than simple factual recall, thereby attaining the second level of George Miller’s classic framework for clinical assessment (Figure), now commonly referred to as ‘Miller’s triangle’.2 In essence, the candidate who successfully navigates the SCE will have demonstrated that they know how to apply the core knowledge relating to their discipline.

(Video) High Yield Endocrine Diabetes Concepts, Quick Revision for SCE, EBEEDM&MRCP &Endocrine board exams-1

Inevitably, critics of such an approach may say that, by settling for an applied knowledge test, the examiners cannot be sure that competence in the SCE inevitably translates into successful/safe clinical practice. However, such criticism fails to acknowledge the broader context in which the SCE exists. No trainee is granted a Certificate of Completion of Training (CCT) simply by virtue of passing the SCE. Instead, the SCE is now a compulsory component of the CCT, but satisfactory progression through the ARCP (Annual Review of Competence Progression) process remains the vehicle through which trainees are required to demonstrate their attainment of the higher levels of Miller’s triangle (Figure). The SCE seeks to ensure that the underpinning knowledge and its application are secure.

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As a senior examiner in both the undergraduate and postgraduate arenas, I not infrequently hear candidates complaining that a particular question in an exam wasn’t fair, or that the correct answer wasn’t included in the five options. My response is usually to smile, politely reassure the concerned students/trainees that the latter is very unlikely, and raise the possibility that perhaps they haven’t quite remembered the question properly!

(Video) Shirisha Avadhanula, MD | Cleveland Clinic Endocrinology, Diabetes & Metabolism

I can do this based on an understanding of just how much time and effort have gone into the creation of each question. Indeed, understanding this process is vital to reassuring candidates that the exam they are about to sit is a high quality assessment, devoid of errors or ambiguity.

The Question Writing Group

Trainees are often surprised to learn just how much time and rigour are involved in perfecting individual questions and in creating an exam containing 200 high quality items. The process begins with individual clinicians being asked to draft questions, which are then subjected to scrutiny by their peers during a 2-day face-to-face meeting.

Such meetings are not for the faint-hearted! It can be quite uncomfortable, watching a question that you are proud of being slowly dismantled. However, if the question survives it almost always emerges a better/more robust item.

In the decade since 2008, the SCE question bank has expanded significantly and many of the items now carry performance data from previous diets, which helps inform the creation of future exams.

‘Trainees are often surprised to learn just how much time and rigour are involved in perfecting individual questions and in creating an exam containing 200 high quality items.’

The Exam Board

Each SCE exam is mapped against the SCE Endocrinology and Diabetes blueprint3 which covers the breadth of the Specialty Training Curriculum as published by the Joint Royal Colleges of Physicians Training Board (JRCPTB).4

Potential questions for inclusion are reviewed by the Exam Board (comprising at least 10 practising clinicians) at a 2-day meeting. During this review, questions are either accepted in their current format, revised through minor modifications or rejected/returned to the Question Writing Group for more significant revision.

(Video) OCDEM - Oxford Centre for Diabetes, Endocrinology and Metabolism

The Standard Setting Group

Once the papers have been finalised, the baton is passed to the Standard Setting Group (SSG) whose job it is to determine the pass mark for the exam. The SSG includes examiners who have been involved at each step of the process, but also includes ‘new faces’ who can bring a fresh perspective/ critical eye. Ultimately, the final pass mark for the exam is reflective of the judgements of the SSG examiners, linked to the actual performance of the candidates in the exam.

Post-exam analyses

A rigorous psychometric process is followed after each exam, to ensure that the performance of each item and of the exam as a whole is at the expected level, and to allow decisions to be made about poorly performing items.

Inevitably, this takes time, which can be frustrating for candidates who expect a computer-based test to be turned around in a matter of days, if not hours. However, it is vital that these post-examination analyses are completed properly to ensure that the reputation of the SCE as a whole is maintained.

‘The fact that significant numbers of European trainees are now keen to sit a ‘Europe-wide SCE’ based on the UK model/exam speaks loudest for the success of the project.’


In 2009, when the first SCE in Endocrinology and Diabetes ran, none of us could be quite sure whether the project would be a success and deliver on its stated aims and objectives. As we approach the 10th anniversary, it appears that the SCE is in good health.

Most trainees now accept that achieving the SCE is an important part of establishing their credentials as a bona fide specialist in the field. Indeed, some are keen to point out that they have a badge which many of their seniors don’t!

The fact that significant numbers of European trainees are now keen to sit a ‘Europe-wide SCE’ based on the UK model/exam speaks loudest for the success of the project – it seems UK Endocrinology and Diabetes has created a badge worth having!

(Video) Ask a Consultant: Dr. Taz Babiker | Diabetes & Endocrinology and General Medicine

Mark Gurnell, Exam Board and Standard Setting Group, Endocrinology and Diabetes SCE

PS Dr Gurnell is happy to provide the correct answer to the example question for anyone who isn’t sure…


  1. MRCP(UK) 2018 Specialty Certificate Examinations www.mrcpuk.org/mrcpuk-examinations/specialty-certificate-examinations.
  2. Miller GE 1990 Academic Medicine 65 (9 Supplement) S63–S67.
  3. MRCP(UK) 2014 SCE in Endocrinology & Diabetes Blueprint www.mrcpuk.org/sites/default/files/documents/sce-endocrinology-and-diabetes-blueprint_0.pdf.
  4. Joint Royal Colleges of Physicians Training Board 2017 Specialty Training Curriculum for Endocrinology & Diabetes Mellitus www.jrcptb.org.uk/sites/default/files/2010%20Endo%20Diabetes%20curriculum%20%28amendments%202017%29_1.pdf


How do I prepare for SCE endocrinology? ›

Preparation for the SCE requires a wide breadth of knowledge around the curriculum and should involve reading of textbooks, journals and guidelines. Experience of the MRCP(UK) examination provides an excellent background to the format of the examination.

What is SCE exam? ›

About the Specialty Certificate. Examination. The SCE is a summative assessment of your scientific and clinical knowledge, as well as your problem-solving ability. It covers all areas of knowledge that you should have acquired during your specialty training.

How do I become a diabetologist UK? ›

The Route To Becoming An Endocrinologist/Diabetologist

ACCS is commonly chosen by trainees interested in acute care in medical specialities. Upon completion of core training, trainees sit the MRCP (Membership of the Royal College of Physicians) exam.

What is SCE in endocrinology? ›

Best of Five MCQs for the Endocrinology and Diabetes SCE is a dedicated revision guide designed to assist candidates in preparing for the Endocrinology and Diabetes Specialty Certificate Examination (SCE).

Is Mrcp eligible for DM? ›

Simply put, MRCP UK is a recognized qualification in India as well. In March 2017, the Medical Council of India recognized MRCP in the UK as equivalent to DM, MS, or MD in India.

Is SCE equivalent to MRCP? ›

The SCEs comprise 12 different specialty examinations, each taking the form of a KBA in a multiple-choice, BOF format. The MRCP(UK) diploma is based on the UK curriculum for core medical training,3 and each SCE is based on the relevant UK specialty curriculum.

How do I apply for SCE exam? ›

Apply for attending the test via the web page specified for engineers on the SCE website.
  1. A valid membership with the Saudi Council of Engineers (SCE)
  2. A valid ID.
  3. Pay 1500 SR - exam fees (there are additional fees required for NCEES)
  4. Select the desire exam discipline.

How do I prepare for acute medicine SCE? ›

Preparation for the SCE requires a wide breadth of knowledge around the curriculum and should involve reading of textbooks, journals and guidelines. Experience of the MRCP(UK) examination provides an excellent background to the format of the examination.

Is endocrinology a good career? ›

It is a thriving medical specialty in India with career growth in academics, hospitals, public and private sectors. Endocrinology is diverse field subspecialties that include diabetes and metabolism, nuclear medicine, neurosurgical endocrinology, reproductive endocrinology, pediatric and thyroid disease.

How much do endocrinologists make UK? ›

The average consultant endocrinology salary in the United Kingdom is £93,990 per year or £48.20 per hour. Entry level positions start at £90,126 per year while most experienced workers make up to £99,281 per year.

How many years does it take to become a diabetologist? ›

Diploma in Diabetology is a Post graduate level degree lasting for one to three-years. Diploma in Diabetology will have admissions based on the Merit list of the candidate in the MBBS exam.

How do I get an MRCP certificate? ›

In the UK, the MRCP(UK) Diploma is usually taken during the two-year period of general professional training (GPT) in medicine after you have registered with the UK General Medical Council. The SCEs consists of 2 three-hour multiple-choice question papers delivered through computer-based testing throughout the world.

How long does it take to become an endocrinologist UK? ›

After your foundation programme, you then get experience of all medical specialties over three years (internal medicine training). You can then apply for paid specialty training to become an endocrinologist or diabetologist, which will take a minimum of four years.

Which is better DM or MRCP? ›

MRCP (UK) is now considered equivalent to the General Medicine (MD) degree in India. In fact, MRCP provides you with additional benefits than the General Medicine (MD) degree if you plan to settle and work outside of India. The MOST SIGNIFICANT advantage of MRCP is its wide recognition in India and abroad.

Is MRCP worth doing? ›

With the status attached to an MRCP degree, you can get better job offers, more professional benefits, and higher pay. Lastly, successfully passing the MRCP exam boosts your CV for fellowships and other medical ventures. And these benefits alone make this postgraduate degree worth it!

Is MRCP exam difficult? ›

MRCP (UK) exam assesses candidates based on their basic sciences and clinical skills. To clear this exam, advanced hands-on knowledge of applied basic sciences and medical principles is necessary. As a result, MRCP is difficult; there's no doubt in that fact.

What is an SCE higher? ›

The SCE was intended to cater for the increased range of subjects available to pupils since the raising of the school leaving age from 14 to 15. It initially included examinations and awards at both Ordinary Grade ('O-Grade') and Higher Grade ('Higher').

Is SCE valid in India? ›

For those looking to take up teaching appointments in a medical college in India, MRCP(UK) understands that the MRCP(UK) Diploma and SCEs can be considered as equivalent qualification to MD/MS/DM/M.Ch.

Can I work in Australia after MRCP? ›

Doctors who pass the MRCP Exam can apply to jobs in any country that recognizes the degree abroad.

Which is better MRCP or Plab? ›

MRCP is one of the eligible criteria to apply for higher specialty training in medical specialties. MRCP costs more, takes more time, is harder of an exam than PLAB. Even if you get GMC registered with PLAB, in order to pursue your career in medicine you will have to pass MRCP.

Is MRCP equal to FCPS? ›

The MRCP is only equal to an Intermediate Module passed Doctor of the FCPS who after passing the module, goes into his speciality field. The same is the case with MRCP. You attain the degree, and then enter the speciality. You work (for e.g in Cardiology) for 3 years and then you come out as a specialist.

What is SCE in Saudi? ›

The Saudi Council of Engineers (SCE; Arabic: الهيئة السعودية للمهندسين) is a professional body intended to promote the engineering profession and develop and upgrade its standards and those practicing it. It operates under the supervision of Ministry of Commerce and Investment with headquarters in Riyadh.

How long is acute medicine training? ›

While being predominantly based in Acute Medicine Units, training programmes include a minimum of four months Intensive Treatment Unit (ITU) experience and will typically include rotations spending time in relevant acute specialties such as cardiology, respiratory and medicine for the elderly, ensuring a varied ...

What is the difference between acute medicine and emergency medicine? ›

Acute medicine is distinct from the broader field of emergency medicine, which is concerned with the management of all people attending the emergency department, not just those with internal medicine diagnoses.

What does acute medicine cover? ›

Acute Medicine (or Acute Internal Medicine – AIM) is the hospital specialty concerned with the assessment, diagnosis and treatment of adult patients with urgent medical needs. It was formally recognised as a specialty in 2009, having previously been a subspecialty of General Medicine.

Is endocrinology in high demand? ›

A recent Medscape report confirms that endocrinologists are among the lowest paid of medical providers.

What makes a good endocrinologist? ›

A doctor who wants to spend time with their patients

Another key indicator of an endocrinologist's quality of care is the amount of time they spend with their patients. Patients can often feel just like a number with practitioners who want patients in and out of their office as quickly as possible.

How many patients does an endocrinologist see in a day? ›

I typically see anywhere from 16-25 patients a day. Long morning. I saw a good mix of cases from diabetes, thyroid cancer, low testosterone and a pituitary tumor.

How much does a endocrinologist make? ›

Endocrinologist Salary

Endocrinologists make $234,132 per year on average, or $112.56 per hour, in the United States. Endocrinologists on the lower end of that spectrum, the bottom 10% to be exact, make roughly $139,000 a year, while the top 10% makes $392,000.

What does endocrinologist mean? ›

Listen to pronunciation. (EN-doh-krih-NAH-loh-jist) A doctor who has special training in diagnosing and treating disorders of the endocrine system (the glands and organs that make hormones). These disorders include diabetes, infertility, and thyroid, adrenal, and pituitary gland problems.

How much do GPs earn UK? ›

2) salaried GPs who are employees of independent contractor practices or directly employed by primary care organisations. From 1 April 2022, the pay range for salaried GPs is £65,070 to £98,194.

What is the proper name for a diabetic doctor? ›

A diabetes specialist is called an endocrinologist. Endocrinologists specialize in the glands of the endocrine (hormone) system. The pancreas is the gland involved in diabetes. The pancreas produces insulin, and problems with insulin are what managing your diabetes is about.

How does an endocrinologist help a diabetic? ›

To help you best manage your diabetes, an endocrinologist will help you by making sure you understand the disease process first. They will then discuss treatment options and how best to manage the disease.

How long is residency for endocrinology? ›

An endocrinologist is first trained in internal medicine, pediatrics, or gynecology before specializing in endocrinology. In the United States, the typical training involves four years of college, four years of medical school, three years of residency, and two years of fellowship.

How do I prepare for respiratory SCE? ›

Advice on preparing for the exam

Work hard. Read the respiratory curriculum. Attend Multi-disciplinary meetings (MDM) in the various specialty blocks. Interpret lung function tests including spirometry, flow volume loops, full pulmonary function tests, exercise physiology and arterial blood gases.

Who is eligible for MRCP? ›

Candidates for the MRCP(UK) Part 1 Examination must have had at least 12 months' experience in medical employment by the date of the examination, i.e. must have completed Foundation Year 1 or equivalent; therefore, candidates will not be admitted to the MRCP(UK) Part 1 Examination until 12 months after the date of ...

What is Mrcp SCE? ›

An MRCP Sce is a 'gold standard' postgraduate qualification for Medicine doctors looking to progress in their sub- specialty . Sces are available in the following sub- specialties : Acute Medicine. Dermatology. Endocrinology and Diabetes.

What is the MRCP exam? ›

The MRCP(UK) Part 1 is the entry-level exam accessible to doctors with a minimum of 12 months' postgraduate experience in medical employment. It covers a broad range of topics to ensure the level of knowledge is appropriate to physicians at the beginning of postgraduate training.

How do I get an MRCP certificate? ›

In the UK, the MRCP(UK) Diploma is usually taken during the two-year period of general professional training (GPT) in medicine after you have registered with the UK General Medical Council. The SCEs consists of 2 three-hour multiple-choice question papers delivered through computer-based testing throughout the world.

How do I become a respiratory specialist UK? ›

How to become a doctor in respiratory medicine. After medical school, you'll join the paid two-year foundation programme where you'll work in six placements in different settings. After your foundation programme, you can apply for General Internal Medicine (GIM) training which lasts for three years.


1. Introduction to SCE
(Endocrine SCE)
2. A Consultant Endocrinologist perspective on Flash | The Flash campaign | Diabetes UK
(Diabetes UK)
3. Cushing's Syndrome Diagnosis- A Case based approach for SCE ENDOCRINE ,EBEEDM AND MRCP(UK)
(Mastering Endocrine& Diabetes with Dr Mazhar Dalvi)
(Mastering Endocrine& Diabetes with Dr Mazhar Dalvi)
5. Dr Susannah Rowles - Consultant (Diabetes & Endocrinology)
6. 01 Diabetes for SCE and EBEEDM Hypoglycemia for SCE 2020
(Elzohry EBEEDM & SCE in Endocrinology Course 2022)

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