Dip PEC Guide 2027: Format, Blueprint and How to Pass
The Dip PEC(SA) is the Diploma in Primary Emergency Care of the College of Emergency Medicine of South Africa, examined by the Colleges of Medicine of South Africa (CMSA). It is written as two online papers: Paper 1, a multiple-choice question (MCQ) paper, and Paper 2, a Visually Aided Question (VAQ) paper of MCQs. It tests broad emergency care.
Unlike the fellowship primaries, the Dip PEC is not a registrar-entry exam. It is a diploma for doctors who want to be sharper and more confident in the emergency centre: community service doctors, medical officers, doctors in district and rural hospitals, and doctors between posts who want a recognised emergency qualification on their CV. This guide covers what the exam involves, what Paper 1 tests, the references worth your time and a 12-week plan that fits around clinical work.
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Try 5 free Dip PEC questions →Dip PEC(SA) key facts
Here is everything the CMSA states about the Dip PEC(SA) on one screen.
| Official name | Diploma in Primary Emergency Care of the College of Emergency Medicine of South Africa, Dip PEC(SA) |
|---|---|
| Run by | Colleges of Medicine of South Africa (CMSA) |
| Papers | 2 online written papers |
| Question format | Paper 1: MCQ paper. Paper 2: Visually Aided Question (VAQ) paper of MCQs |
| Questions | Set by the CMSA; see the Dip PEC(SA) regulations and candidate information leaflet |
| Duration | See the CMSA Dip PEC(SA) regulations and candidate information leaflet |
| Fee | R16,800 |
| Eligibility | 12 months supervised training at a teaching or CMSA-approved hospital, or a completed portfolio with supervisor letter |
| When it's written | In the CMSA's two written-examination semesters each year; first-semester papers are usually in February/March and second-semester papers around July/August |
| Official page | CMSA Dip PEC(SA) page |
Last checked: 1 October 2026. Certiva is independent and not affiliated with the CMSA.
What is the Dip PEC exam format?
The Dip PEC(SA) is examined in two online written papers, both built from multiple-choice questions.
- Paper 1 is an MCQ paper. This is the paper Certiva's question bank covers.
- Paper 2 is a Visually Aided Question (VAQ) paper of MCQs.
All CMSA examinations have been written on an online platform since 2021. For the length of each paper and the rules on the day, use the official Dip PEC(SA) regulations and candidate information leaflet linked from the CMSA Dip PEC(SA) page.
What does the Dip PEC cover?
Dip PEC Paper 1 spans the whole of undifferentiated emergency care, from resuscitation and trauma to the medical, surgical, paediatric and obstetric emergencies you see on a busy shift.
The CMSA publishes the official Dip PEC(SA) blueprint (PDF), and that is the document to plan from. The table below shows how Certiva's Dip PEC Paper 1 question bank is organised: 25 sections and 400 questions. The counts describe Certiva's bank, not the official weighting of the paper, but they give you a sense of how broad the content is.
| Section | Sample subtopics | Questions |
|---|---|---|
| Cardiovascular | Acute coronary syndrome, ECG interpretation, arrhythmias, cardiogenic shock | 48 |
| Respiratory Emergencies | Acute asthma, tension pneumothorax, pulmonary embolism, airway foreign body | 42 |
| Trauma | Primary survey, head injury and GCS, chest and pelvic trauma, burns, massive transfusion | 42 |
| Toxicology and Environmental Emergencies | Toxidromes, paracetamol and TCA overdose, envenomation, hypothermia, drowning | 26 |
| Neurology | Altered consciousness, subarachnoid haemorrhage, status epilepticus, stroke | 24 |
| Infectious Disease Emergencies | Malaria, meningococcal disease, HIV emergencies, sepsis, tetanus, rabies | 24 |
| Paediatric Emergencies | Neonatal resuscitation, croup, bronchiolitis, dehydration and fluids, choking | 24 |
| Orthopaedics and Musculoskeletal | Fractures and dislocations, compartment syndrome, septic joint | 22 |
| Critical Care & Resuscitation | Adult and paediatric life support, 4Hs and 4Ts, post-ROSC care, shock | 18 |
| Gastrointestinal Emergencies | Acute abdomen, GI haemorrhage, pancreatitis, perforated ulcer | 12 |
| Endocrine and Metabolic Emergencies | DKA, HHS, hyperkalaemia, sodium derangements, Addisonian crisis | 12 |
| Obstetric and Gynaecological Emergencies | Ectopic pregnancy, postpartum haemorrhage, eclampsia, delivery | 12 |
| Psychiatry | Acute psychosis, suicide risk assessment, managing aggression | 10 |
| ENT, Ophthalmology, Geriatrics, Genitourinary, Clinical Practical Skills, Prehospital and EMS, Ethics and Medicolegal | Epistaxis, chemical eye injury, delirium, testicular torsion, RSI, triage, consent and declaration of death | 8 each (56) |
| Applied Basic Science, Dermatology, Haematology and Oncology, Research and EBM | Acid-base physiology, SJS/TEN, neutropenic sepsis, sensitivity and specificity | 6 each (24) |
| Teaching, Management and Leadership | Emergency centre leadership, clinical handover, triage management | 4 |
Two things stand out. First, the "big three" (cardiovascular, respiratory and trauma) make up about a third of the bank. Second, the long tail matters: ethics, prehospital care, research and leadership are small sections, but they are easy marks to lose if you have never studied them formally.
How many questions are in the Dip PEC Paper 1?
The CMSA sets the number of questions in each paper, so check the current Dip PEC(SA) regulations and candidate information leaflet for the official figure.
What we can tell you is how Certiva practice is structured: 400 Paper 1 questions across 25 sections, plus two timed mocks. That is enough to cover every section of the bank more than once when you count the revision rounds.
When is the Dip PEC written?
The Dip PEC(SA) is written in one of the CMSA's two written-examination semesters each year.
First-semester written papers are usually in February/March and second-semester papers around July/August. Exact dates are published in the CMSA written examination timetable, so confirm your sitting there before you count back your study weeks.
Who can write the Dip PEC?
According to the CMSA, you qualify with 12 months of supervised training at a teaching or CMSA-approved hospital, or with a completed portfolio and a supervisor letter.
That makes the Dip PEC accessible to a wide group of South African doctors: community service doctors finishing a year with emergency exposure, medical officers covering casualty, and doctors in smaller hospitals who build up a portfolio over time. If you are unsure which route fits your training, ask the CMSA before you apply. The examination fee listed by the CMSA is R16,800.
Are there Dip PEC past papers?
No. CMSA examinations have been written online since 2021, and past papers are no longer published because questions stay in a secure bank.
Any older recalled questions you come across will not reflect current guidelines or the current blueprint. A question bank mapped to the blueprint, with explanations and references you can check, is the practical alternative.
Which textbooks should I use?
Keep it small: one core handbook, the current resuscitation algorithms and a few trusted online references.
These are the references used in Certiva's bank:
- Oxford Handbook of Emergency Medicine, 5th edition. The backbone of the bank, used across almost every section from respiratory and trauma to paediatrics, obstetrics and ethics.
- Resuscitation Council of Southern Africa (RCSA) algorithms. The 2025 Basic Life Support, Advanced Cardiac Arrest, Post-ROSC, Newborn Resuscitation and Choking algorithms, the 2023 Trauma Cardiac Arrest algorithm and the 2026 Organophosphate/Carbamate Poisoning algorithm.
- Life in the Fast Lane (LITFL). The ECG Library, plus Critical Care Compendium entries on topics such as malaria, diabetic ketoacidosis, compartment syndrome and massive transfusion.
- The Dip PEC(SA) regulations. Useful for the scope of the EMS, ethics and medicolegal, and management content.
Learn the algorithms until you can draw them from memory. Resuscitation content runs through cardiovascular, trauma, paediatric and toxicology questions, not just its own section.
How should I study for the Dip PEC?
Give yourself about 12 weeks: ten weeks working through the content in proportion to its size, then two weeks of timed mocks and targeted revision.
The plan below groups the 25 sections of Certiva's bank into roughly equal weekly loads of 32 to 48 questions. Read the relevant Oxford Handbook chapters first, then do that week's questions and read every explanation, whether you were right or wrong.
| Week | Focus | Bank questions |
|---|---|---|
| 1 | Critical Care & Resuscitation, Applied Basic Science, Clinical Practical Skills. Learn the RCSA algorithms. | 32 |
| 2 | Cardiovascular, with daily ECG practice | 48 |
| 3 | Respiratory Emergencies | 42 |
| 4 | Trauma | 42 |
| 5 | Orthopaedics and Musculoskeletal, ENT, Ophthalmology | 38 |
| 6 | Toxicology and Environmental, Dermatology, Haematology and Oncology | 38 |
| 7 | Neurology, Psychiatry, Geriatrics | 42 |
| 8 | Infectious Disease, Endocrine and Metabolic | 36 |
| 9 | Paediatric Emergencies, Obstetric and Gynaecological Emergencies | 36 |
| 10 | Gastrointestinal, Genitourinary, Prehospital and EMS, Ethics and Medicolegal, Research and EBM, Teaching and Leadership | 46 |
| 11 | Timed mock 1, then revise your three weakest subtopics | Mock |
| 12 | Timed mock 2, final pass through weak areas and algorithms | Mock |
Make the plan work around shifts
- Little and often beats marathons. Six or seven questions a day after a shift covers a 45-question week.
- Use your patients. When you see DKA, a snakebite or a tension pneumothorax at work, do the matching questions that night. Clinical memory sticks.
- Track subtopics, not your average. Seventy percent overall can hide 40% in toxidromes. Spend weeks 11 and 12 on the gaps.
- Rehearse timing. Sit both mocks in one go, under exam-like conditions, so pacing is not a surprise on the day.
How Certiva helps
Certiva gives you a Dip PEC Paper 1 question bank built around the way you will actually revise: topic by topic, then under time pressure.
- 400 questions across 25 sections, from cardiovascular and trauma to ethics and prehospital care.
- Explained and referenced answers. Every question has a teaching explanation and the source it is based on, so you can go back to the Oxford Handbook or the RCSA algorithm.
- Smart revision and a weakness tracker that highlight the subtopics worth revisiting.
- Two timed mocks to rehearse the full paper.
- A free 5-question sample with no account and no card.
- A refund or more time. On an eligible Exam Pass, if you complete the full bank and every timed mock before your sitting and do not pass, you can claim a refund or an extra access period within 30 days of your result. See the exam refund conditions.
See what is included on the Dip PEC exam prep page and compare access periods on the pricing page. Two free extras help beyond revision: the free CV maker for when you list your new diploma and apply for posts, and free ethics CPD courses.
Frequently asked questions
Is the Dip PEC a registrar exam?
No. The Dip PEC(SA) is a diploma of the College of Emergency Medicine of South Africa, examined by the CMSA. It is not a fellowship or a registrar-entry exam. Doctors write it to formalise and strengthen their emergency care skills, and it is a recognised qualification to list on a CV.
How much does the Dip PEC(SA) cost?
The CMSA lists the Dip PEC(SA) examination fee as R16,800. Fees can change, so confirm the current amount on the official CMSA page before you enter.
Are Dip PEC past papers available?
No. CMSA examinations have been written online since 2021 and past papers are no longer published; questions stay in a secure bank. A question bank mapped to the Dip PEC(SA) blueprint is the practical alternative.
What is the difference between Paper 1 and Paper 2?
Paper 1 is an MCQ paper. Paper 2 is a Visually Aided Question (VAQ) paper of MCQs. Both are written online. Certiva covers Paper 1.
How long are the Dip PEC papers?
The CMSA sets paper durations in the Dip PEC(SA) regulations and candidate information leaflet. Check those documents for the current timing before your sitting.
Can I write the Dip PEC without working in an emergency centre for a year?
The CMSA lists two routes: 12 months of supervised training at a teaching or CMSA-approved hospital, or a completed portfolio with a supervisor letter. Confirm which route applies to you with the CMSA.
How long should I study for Dip PEC Paper 1?
A structured 12-week plan works well alongside a clinical job: ten weeks working through the topics, weighted towards the largest areas such as cardiovascular, respiratory and trauma, then two weeks of timed mocks and targeted revision.
Can I try Certiva's Dip PEC questions for free?
Yes. You can try five Dip PEC Paper 1 questions with full explanations and references, with no account and no card.
Try 5 free Dip PEC questions
See how Certiva explains and references every answer, then explore the full Dip PEC Paper 1 question bank.
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