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100+ Free Palliative Medicine SCE Practice Questions

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A patient with metastatic cancer asks whether palliative radiotherapy could help focal painful bone metastasis. What is the best answer?

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2026 Statistics

Key Facts: Palliative Medicine SCE Exam

The Federation lists Palliative Medicine SCE 2026/01 for 16 September 2026, with applications from 27 May to 24 June 2026, reasonable adjustment deadline 2 July 2026, results six weeks after the exam, and certificates eight weeks after results release. The 2027/01 diet is listed for 16 June 2027, with applications from 24 February to 24 March 2027. The SCE/ESE regulations state that the exam is an in-centre computer-based two-paper test; each paper lasts three hours and contains 100 best-of-five questions. The 2026 fees page lists GBP 700 for UK centres and GBP 875 for international centres.

Sample Palliative Medicine SCE Practice Questions

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

1A hospice patient with metastatic cancer is bedbound, taking only sips and has Cheyne-Stokes breathing. What is the best clinical interpretation?
A.The patient is likely in the dying phase and priorities should shift to comfort-focused anticipatory care
B.Escalate to routine outpatient chemotherapy review
C.Start long-term parenteral nutrition immediately
D.Withhold all symptom-relief medication until death is certified
Explanation: The combination of profound functional decline, minimal intake and altered breathing pattern is consistent with dying; care should focus on comfort, communication and anticipatory prescribing.
2A dying patient has noisy respiratory secretions causing family distress but no evidence of pulmonary oedema. What medication class is most appropriate?
A.Antimuscarinic antisecretory medication such as glycopyrronium or hyoscine butylbromide
B.High-dose loop diuretic as first-line therapy
C.Routine broad-spectrum antibiotics
D.Long-acting beta agonist inhaler
Explanation: Terminal secretions are commonly managed with repositioning, communication and antimuscarinic antisecretory drugs when symptoms are distressing.
3A patient in the last days of life can no longer swallow modified-release morphine. What is the safest prescribing principle?
A.Convert to an appropriate continuous subcutaneous opioid dose with breakthrough doses available
B.Crush modified-release tablets and give them sublingually
C.Stop all opioid because oral intake has stopped
D.Double the previous total daily opioid dose without calculation
Explanation: Loss of oral route should prompt calculated conversion to a suitable subcutaneous opioid regimen plus breakthrough medication.
4A dying patient develops intermittent agitation after urinary retention and constipation have been excluded. What is a common first-line drug for terminal agitation?
A.Midazolam by subcutaneous route when non-drug causes have been addressed
B.Oral bisphosphonate
C.Inhaled corticosteroid
D.Warfarin loading dose
Explanation: After reversible causes are considered, benzodiazepines such as midazolam are often used for terminal agitation, sometimes with antipsychotics depending on the syndrome.
5Family members ask why clinically assisted hydration is not being started automatically in a dying patient. What is the best response?
A.Benefits and burdens should be assessed individually and reviewed with the patient or those close to them
B.Hydration is legally forbidden in the last days of life
C.Hydration always prevents delirium and secretions
D.Hydration must be continued indefinitely once started
Explanation: Hydration decisions in the dying phase are individualized; potential benefits, burdens and uncertainty should be discussed and reviewed.
6A patient near death has persistent breathlessness despite oxygen saturation of 96% on room air. What treatment is most appropriate?
A.Low-dose opioid with non-pharmacological measures such as positioning and airflow
B.Escalation to oxygen solely because breathlessness is present
C.Routine thrombolysis
D.Fluid restriction as the only intervention
Explanation: Subjective breathlessness in advanced illness can respond to low-dose opioids and non-drug measures even when hypoxaemia is absent.
7A dying patient has severe pain but relatives worry that morphine will intentionally shorten life. What is the most accurate explanation?
A.Appropriately titrated opioid is used to relieve pain and breathlessness, not to cause death
B.Morphine is illegal in the dying phase
C.Opioids should never be escalated near death
D.Only placebo analgesia should be used when prognosis is short
Explanation: The doctrine of proportionate symptom relief supports careful opioid titration to relieve distressing symptoms; intent and proportionality matter.
8A patient with an implantable cardioverter-defibrillator is recognised to be dying. What device issue should be addressed urgently?
A.Discuss deactivation of shock therapy to prevent distressing shocks while maintaining comfort care
B.Increase defibrillator sensitivity to deliver shocks earlier
C.Remove all analgesia because the device is present
D.Arrange routine annual device follow-up only
Explanation: ICD shock therapy can cause distress in the dying phase; deactivation should be discussed and arranged while pacing functions may be handled separately.
9A dying patient lacks capacity and has no advance refusal. What should guide decisions about burdensome observations and blood tests?
A.Best interests, proportionality and whether tests will change comfort-focused management
B.A requirement to continue all routine monitoring until death
C.The family vote alone regardless of clinical judgement
D.Automatic transfer to intensive care for all abnormal observations
Explanation: When capacity is absent, decisions should be made in best interests and proportionate to goals; routine tests should be avoided if they do not improve care.
10A patient in the final hours of life has dry mouth. What intervention is usually most helpful?
A.Frequent mouth care with moistening and attention to comfort
B.Large-volume intravenous fluid boluses for every patient
C.Avoid all oral care because aspiration is possible
D.High-dose diuretics to reduce secretions
Explanation: Dry mouth is common near death; careful mouth care is often more beneficial and less burdensome than routine parenteral fluids.

About the Palliative Medicine SCE Exam

The Specialty Certificate Examination in Palliative Medicine is the Federation SCE for physicians training in palliative medicine and equivalent candidates. It assesses applied clinical knowledge and judgement across end-of-life care, symptom control, cancer and non-malignant disease palliation, emergencies, pain, pharmacology, legal decision-making and multidisciplinary rehabilitation.

Assessment

Computer-based Specialty Certificate Examination in Palliative Medicine with 200 best-of-five questions across two 3-hour papers. The blueprint covers care of the dying patient, concurrent clinical problems, legal issues, emergencies, palliation of life-limiting disease, secondary symptoms and clinical problems, pain, pharmacology and therapeutics, practical procedures, and rehabilitation.

Time Limit

Two 3-hour papers with a one-hour break

Passing Score

Criterion-referenced standard setting; no fixed current percentage is listed on the reviewed current specialty page.

Exam Fee

GBP 700 UK centre fee for 2026; GBP 875 international centre fee (Federation of Royal Colleges of Physicians of the UK)

Palliative Medicine SCE Exam Content Outline

20/200

Care of the dying patient

Recognition of dying, anticipatory medicines, communication, hydration, secretion management, breathlessness and terminal phase decisions.

20/200

Concurrent clinical problems unrelated to progressive illness

General medical problems encountered in palliative patients, including infection, heart failure, renal disease, diabetes, thrombosis and delirium.

15/200

Legal issues

Mental capacity, advance decisions, lasting powers of attorney, DNACPR, deprivation of liberty, coroner referral and controlled-drug governance.

20/200

Management of emergencies

Spinal cord compression, superior vena cava obstruction, hypercalcaemia, sepsis, seizures, haemorrhage, opioid toxicity and acute agitation.

20/200

Palliation of life-limiting disease

Principles of cancer, neurodegenerative, cardiovascular, respiratory, frailty, multimorbidity, inflammatory and young-adult palliative management.

48/200

Other symptoms and clinical problems secondary to life-limiting disease

Gastrointestinal, skin, respiratory, genitourinary, metabolic, neurological, psychiatric and treatment-induced complications.

15/200

Pain

Cancer pain, neuropathic pain, bone pain, incident pain, opioid titration, adjuvant analgesia and interventional approaches.

35/200

Pharmacology and therapeutics

Opioid conversion, renal and hepatic impairment, syringe drivers, antiemetics, corticosteroids, sedatives, antisecretory medicines and drug interactions.

5/200

Practical procedures

Common palliative procedures including ascitic drainage, pleural interventions, syringe-driver set-up and safe procedural decision-making.

2/200

Rehabilitation

Functional goals, fatigue management, equipment, therapy input and realistic rehabilitation in advanced disease.

How to Pass the Palliative Medicine SCE Exam

What You Need to Know

  • Passing score: Criterion-referenced standard setting; no fixed current percentage is listed on the reviewed current specialty page.
  • Assessment: Computer-based Specialty Certificate Examination in Palliative Medicine with 200 best-of-five questions across two 3-hour papers. The blueprint covers care of the dying patient, concurrent clinical problems, legal issues, emergencies, palliation of life-limiting disease, secondary symptoms and clinical problems, pain, pharmacology and therapeutics, practical procedures, and rehabilitation.
  • Time limit: Two 3-hour papers with a one-hour break
  • Exam fee: GBP 700 UK centre fee for 2026; 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

Palliative Medicine SCE Study Tips from Top Performers

1Map revision to the official blueprint so that pharmacology, symptom control and end-of-life care receive proportionate time.
2Practise clinical judgement questions where more than one option is plausible and the task is to choose the best immediate action.
3Review national guidance, local controlled-drug governance, mental capacity law and common prescribing conversions.
4Use difficult cases from hospice, hospital support and community palliative care to rehearse ethical and communication decisions.

Frequently Asked Questions

Is the Palliative Medicine SCE still current?

Yes. The Federation lists current Palliative Medicine SCE diets for 2026/01 and 2027/01 and states that the examination is delivered every nine months.

How many questions are on the official Palliative Medicine SCE?

The SCE format is 200 best-of-five multiple-choice questions split across two 3-hour papers taken on the same day.

What is the Palliative Medicine SCE blueprint?

The 200-question blueprint weights care of the dying patient, concurrent clinical problems, legal issues, emergencies, palliation of life-limiting disease, secondary symptoms, pain, pharmacology and therapeutics, practical procedures and rehabilitation.

Are there entry requirements?

The Federation specialty page states that there are no entry requirements, although UK trainees normally sit the SCE in their penultimate year of higher specialty training.

What post-nominal is awarded?

Successful candidates may use the post-nominal SCE (Palliative Medicine).