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100+ Free Medical Oncology SCE Practice Questions

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2025: 74.2% UK resident doctors; 58.3% all candidates Pass Rate
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Question 1
Score: 0/0

Which situation best illustrates immortal time bias in an observational oncology study?

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B
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2026 Statistics

Key Facts: Medical Oncology SCE Exam

9 Sep 2026

2026 Exam Date

Federation Medical Oncology SCE page

20 May-17 Jun 2026

Application Window

Federation Medical Oncology SCE page

200

Official MCQs

SCE Regulations and Medical Oncology blueprint

2 x 3h

Official Paper Length

Federation SCE format FAQ and regulations

GBP 700

UK Centre Fee

Federation SCE exam dates and fees

74.2%

2025 UK Resident Doctor Pass Rate

Federation pass rates table and Medical Oncology 2025 report

The 2026 SCE in Medical Oncology is scheduled for 9 September 2026, with applications open 20 May to 17 June 2026 at 8:00am UK local time. The official format is two 3-hour computer-based papers, each with 100 best-of-five MCQs, separated by a one-hour break. From June 2026, UK and international SCEs are delivered in centre. Published 2026 fees are GBP 700 for UK centres and GBP 875 for international centres. The latest official 2025 Medical Oncology report lists a pass mark of 371, equivalent to 61.9% or 122/197, with pass rates of 74.2% for UK resident doctors and 58.3% for all candidates.

Sample Medical Oncology SCE Practice Questions

Try these sample questions to test your Medical Oncology SCE exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which statement best describes an actionable driver mutation in a solid tumour?
A.A somatic alteration that predicts benefit from a matched targeted therapy
B.A germline variant found in every normal cell
C.Any mutation with a high variant allele frequency
D.A mutation that proves the tumour is metastatic
Explanation: An actionable driver mutation is a tumour alteration that contributes to malignant behaviour and can guide a specific treatment, trial, or diagnostic pathway. Examples include EGFR mutations in non-small cell lung cancer and KIT mutations in GIST.
2A colorectal cancer shows loss of MLH1 and PMS2 on immunohistochemistry. What is the most immediate implication?
A.The tumour should be assessed as mismatch repair deficient and Lynch syndrome or MLH1 promoter methylation considered
B.The tumour is confirmed to be RAS wild type
C.The patient cannot receive immune checkpoint inhibitors
D.The finding is diagnostic of familial adenomatous polyposis
Explanation: Loss of MLH1 and PMS2 suggests mismatch repair deficiency. In colorectal cancer this has treatment, prognostic, and familial implications; reflex testing often distinguishes sporadic MLH1 promoter methylation from possible Lynch syndrome.
3Which example is a predictive, rather than purely prognostic, biomarker?
A.HER2 amplification predicting benefit from trastuzumab
B.Tumour stage predicting survival
C.Performance status predicting treatment tolerance
D.High grade predicting relapse risk
Explanation: A predictive biomarker estimates likelihood of benefit from a specific therapy. HER2 amplification predicts benefit from HER2-directed therapy, whereas stage, grade, and performance status mainly estimate prognosis or treatment risk.
4In lung cancer pathology, what does a PD-L1 tumour proportion score measure?
A.The percentage of viable tumour cells showing membranous PD-L1 staining
B.The percentage of lymphocytes staining for CD8
C.The total number of tumour mutations per megabase
D.The proportion of necrotic tumour in the biopsy
Explanation: PD-L1 tumour proportion score is the percentage of viable tumour cells with partial or complete membranous PD-L1 staining using an approved assay. It may guide immune checkpoint inhibitor choices in non-small cell lung cancer.
5Why can BRCA1 or BRCA2 loss make a tumour sensitive to PARP inhibition?
A.Homologous recombination repair is impaired, making PARP-mediated repair dependence therapeutically exploitable
B.PARP inhibitors directly block oestrogen receptors
C.BRCA loss causes universal microsatellite instability
D.PARP inhibitors reverse all platinum resistance
Explanation: BRCA1/2 are central to homologous recombination repair. When this pathway is defective, PARP inhibition can create synthetic lethality by preventing repair of DNA damage that the cancer cell cannot otherwise resolve.
6Which HER2 result is usually considered positive for standard HER2-directed therapy in breast cancer?
A.IHC 3+ membranous staining or ISH-amplified disease
B.IHC 0 only
C.Any ER-positive tumour
D.Ki-67 above 10 percent
Explanation: HER2-positive breast cancer is generally defined by strong complete membranous HER2 staining on IHC 3+ or gene amplification by in situ hybridisation. This identifies tumours likely to benefit from HER2-directed treatment.
7Under RECIST 1.1, what best defines a partial response in target lesions?
A.At least a 30 percent decrease in the sum of diameters from baseline
B.Any visible shrinkage in one lesion
C.Complete disappearance of non-target lesions only
D.A 20 percent increase in the sum of diameters
Explanation: RECIST 1.1 partial response requires at least a 30 percent decrease in the sum of diameters of target lesions, taking baseline as reference. It is a standardised radiological response rule used in trials and practice.
8What is the best general use of circulating tumour DNA in advanced cancer care?
A.To identify tumour genomic alterations when tissue is unavailable or to monitor molecular disease in selected contexts
B.To replace all diagnostic histology
C.To prove a patient is fit for chemotherapy
D.To calculate radiotherapy dose
Explanation: ctDNA can help identify actionable genomic alterations when tissue is limited and can support monitoring in selected cancers. It complements, rather than replaces, histology, imaging, clinical assessment, and multidisciplinary review.
9Before starting palliative chemotherapy, which action is most central to valid consent?
A.Discussing realistic benefits, material risks, alternatives, and the option of no anticancer treatment
B.Asking the patient to sign a form without a consultation
C.Explaining only the most common side effect
D.Delegating all discussion to a family member because treatment is palliative
Explanation: Consent requires a patient-centred discussion of expected benefits, material risks, alternatives, uncertainty, and no-treatment options. A signed form records but does not replace the consent conversation.
10A patient receiving chemotherapy phones with fever and rigors 7 days after treatment. What is the safest first principle?
A.Treat as possible neutropenic sepsis and arrange urgent assessment and empiric antibiotics
B.Advise paracetamol and routine clinic review next week
C.Delay action until neutrophil count is known from the next scheduled blood test
D.Start oral iron because fever after chemotherapy is usually anaemia
Explanation: Fever after chemotherapy is neutropenic sepsis until proven otherwise. The priority is urgent assessment, blood tests and cultures, and prompt empiric broad-spectrum antibiotics according to local acute oncology policy.

About the Medical Oncology SCE Exam

The Specialty Certificate Examination in Medical Oncology is the UK knowledge-based assessment for higher specialty training in medical oncology. It is a once-yearly, in-centre computer-based SCE covering the JRCPTB Medical Oncology curriculum and a 200-question blueprint across tumour sites, scientific basis of malignancy, systemic anticancer therapy, acute oncology, professional skills, clinical research, supportive care, palliative care, survivorship, and SACT governance.

Assessment

In-centre computer-based test delivered as Paper 1 in the morning and Paper 2 in the afternoon. Each paper lasts 3 hours and contains 100 best-of-five MCQs, with a one-hour break between papers.

Time Limit

6 hours testing time across two 3-hour papers, plus a one-hour break

Passing Score

Equated, criterion-referenced pass standard; 2025 Medical Oncology SCE pass mark was 371 (61.9%, 122/197). Future diets can require a different percentage correct.

Exam Fee

GBP 700 UK centre fee; GBP 875 international centre fee (The Federation of the Royal Colleges of Physicians of the UK / MRCP(UK))

Medical Oncology SCE Exam Content Outline

14/200

Breast cancer

Early and metastatic breast cancer, receptor-directed therapy, HER2 treatment, endocrine therapy, triple-negative disease, genetics, bone metastases, and survivorship.

14/200

Colorectal and anal cancer

Colon, rectal, and anal cancer staging and systemic treatment, RAS/BRAF/MMR biomarkers, neoadjuvant rectal strategies, adjuvant chemotherapy, and chemoradiotherapy for anal cancer.

14/200

Lung and thoracic cancer

NSCLC and SCLC diagnosis, staging, molecular testing, PD-L1, targeted therapy, immunotherapy, chemoradiotherapy, pleural disease, and thoracic emergencies.

7/200

Carcinoma of unknown origin

CUP work-up, immunohistochemistry, molecular testing, favourable subsets, symptom-led management, and site-specific versus empirical treatment decisions.

7/200

Ovarian cancer

High-grade serous ovarian cancer, cytoreduction decisions, platinum sensitivity, BRCA and HRD testing, PARP maintenance, relapse assessment, and CA125 limitations.

7/200

Germ cell tumours

Testicular and ovarian germ cell tumours, AFP and hCG interpretation, seminoma versus non-seminoma, cisplatin-based curative treatment, and late toxicities.

6/200

Oesophagogastric cancer

Oesophageal, gastro-oesophageal junction, and gastric adenocarcinoma, perioperative chemotherapy, HER2, PD-L1 and MMR testing, nutrition, and staging.

3/200

Lymphoma

Oncology-haematology overlap, urgent recognition of lymphoma presentations, DLBCL referral, tumour lysis risk, and steroid timing before tissue diagnosis.

3/200

Uterine cancer

Endometrial cancer risk stratification, mismatch repair testing, recurrent disease systemic therapy, immunotherapy, and multidisciplinary gynaecological oncology care.

5/200

Hepatobiliary cancer

Hepatocellular carcinoma, cholangiocarcinoma, liver function assessment, portal hypertension, immunotherapy-bevacizumab, FGFR2 and IDH1 targets, and biliary obstruction.

5/200

Skin cancer

Melanoma, cutaneous squamous cell carcinoma, BRAF testing, anti-PD-1 therapy, BRAF/MEK inhibition, adjuvant treatment, and immune toxicity.

5/200

Sarcoma

Soft-tissue sarcoma, GIST, bone sarcoma, desmoid tumour, specialist sarcoma MDT referral, doxorubicin, imatinib, and biopsy planning.

1/200

Leukaemia

Haematology overlap including urgent recognition of acute promyelocytic leukaemia, coagulopathy, tumour lysis, and need for immediate specialist referral.

3/200

Prostate cancer

Hormone-sensitive and castration-resistant prostate cancer, ADT intensification, AR pathway inhibitors, docetaxel, PARP selection, bone disease, and spinal cord compression.

3/200

Urothelial cancer

Cisplatin eligibility, platinum and immunotherapy pathways, antibody-drug conjugates, FGFR alteration testing, haematuria assessment, and supportive care.

3/200

Cervical cancer

HPV-related disease, staging, concurrent cisplatin chemoradiotherapy, brachytherapy, recurrent disease options, and toxicity management.

2/200

Head and neck cancer

Squamous head and neck cancer, HPV and p16 status, smoking risk, chemoradiotherapy, immunotherapy in recurrent disease, nutrition, and airway risk.

2/200

CNS cancer

Glioblastoma, MGMT promoter methylation, brain metastases, steroids, seizure management, local therapy, and neurologic emergencies.

3/200

Renal cell cancer

Clear-cell RCC, risk stratification, immune checkpoint combinations, VEGF TKIs, cytoreductive nephrectomy decisions, and toxicity trade-offs.

2/200

Endocrine cancer

Thyroid and neuroendocrine tumours, RET alterations, somatostatin receptor imaging, somatostatin analogues, PRRT, and hormonal syndromes.

18/200

Scientific basis of malignancy

Tumour biology, genomics, DNA repair, biomarkers, targeted therapy, immunotherapy mechanisms, pathology interpretation, response criteria, and ctDNA.

14/200

Professional skills

Shared decision-making, consent, capacity, communication, MDT working, training, supervision, quality improvement, patient safety, and ethical practice.

20/200

Acute oncology

Neutropenic sepsis, spinal cord compression, SVC obstruction, hypercalcaemia, tumour lysis, brain metastases, bowel obstruction, immunotherapy emergencies, CRS, and DIC.

8/200

Clinical research, ethics and economics

Clinical trial phases, randomisation, non-inferiority, bias, hazard ratios, Kaplan-Meier analysis, NNT, GCP, adverse event reporting, and consent.

18/200

Systemic anticancer therapy

Chemotherapy, endocrine therapy, targeted therapy, immunotherapy, CAR-T interface, dosing, extravasation, hypersensitivity, pneumonitis, cardiotoxicity, and safe prescribing.

10/200

Supportive therapies and palliative care

Antiemetics, G-CSF, cancer pain, renal impairment, palliative care integration, malignant bowel obstruction, bone metastases, fertility, survivorship, and late effects.

3/200

Standard operating procedures

SACT governance, local protocols, pharmacy review, staff training, toxicity escalation pathways, consent documentation, audit, and implementation of new treatments.

How to Pass the Medical Oncology SCE Exam

What You Need to Know

  • Passing score: Equated, criterion-referenced pass standard; 2025 Medical Oncology SCE pass mark was 371 (61.9%, 122/197). Future diets can require a different percentage correct.
  • Assessment: In-centre computer-based test delivered as Paper 1 in the morning and Paper 2 in the afternoon. Each paper lasts 3 hours and contains 100 best-of-five MCQs, with a one-hour break between papers.
  • Time limit: 6 hours testing time across two 3-hour papers, plus a one-hour break
  • Exam fee: GBP 700 UK centre fee; GBP 875 international centre fee

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

Medical Oncology SCE Study Tips from Top Performers

1Use the official 200-question blueprint to weight revision rather than studying tumour sites equally.
2Practise acute oncology decisions until the first safe action is automatic: neutropenic sepsis, cord compression, SVC obstruction, hypercalcaemia, tumour lysis, immune toxicity, CRS, DIC, and brain metastases.
3Link each systemic therapy to its biomarker, line of therapy, expected benefit, monitoring needs, and stopping rules.
4Revise UK practice through MDT reasoning, consent, capacity, palliative care, clinical trials, GCP, and SACT governance, not just drug names.
5After each timed set, review why the distractors are less correct; the real SCE uses plausible best-of-five options.

Frequently Asked Questions

When is the 2026 Medical Oncology SCE?

The Federation lists the 2026/01 Medical Oncology SCE exam date as 9 September 2026. The application period is 20 May to 17 June 2026, opening and closing at 8:00am UK local time, with a reasonable adjustment deadline of 25 June 2026.

What is the format of the Medical Oncology SCE?

The SCE is a computer-based two-paper test. Candidates sit Paper 1 in the morning and Paper 2 in the afternoon; each paper lasts 3 hours and contains 100 best-of-five MCQs, with a one-hour break between papers.

How much does the Medical Oncology SCE cost in 2026?

The Federation SCE fees page lists a centre fee of GBP 700 for UK sittings and GBP 875 for international sittings. Candidates transferring from a UK to an international location are liable for the GBP 175 difference.

Are there entry requirements for the Medical Oncology SCE?

The specialty page states that there are no entry requirements for the SCE in Medical Oncology. UK trainees would normally take it in the penultimate year of higher specialty training, and the curriculum expects the SCE before CCT.

What is the pass mark for the Medical Oncology SCE?

The SCE uses an equated, criterion-referenced pass standard, so the required percentage can vary by diet. The official 2025 Medical Oncology results report states that the 2025 pass mark was 371, equivalent to 61.9% or 122/197.

What topics are tested?

The official Medical Oncology blueprint totals 200 questions across breast, colorectal and anal, lung and thoracic, CUP, ovarian, germ cell, oesophagogastric, lymphoma, uterine, hepatobiliary, skin, sarcoma, leukaemia, prostate, urothelial, cervical, head and neck, CNS, renal cell and endocrine cancer, plus scientific basis, professional skills, acute oncology, research and ethics, SACT, supportive and palliative care, and SOPs.