Launching in November 2023, the SCA is a new exam format, which has introduced a lot of uncertainty around how to best prepare. The following guidance has been put together from suggestions by Bristol GPST3s who are either preparing for, or who have sat the SCA exam.
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To give some context for the guidance that follows, here is a brief overview of the structure of the exam:
- 12 stations
- 3 mins preparation/reading time before each case
- 12 mins remote consulting time over a virtual platform (mix of video calls and telephone calls)
Please see the SCA page for further guidance and signposting on exam structure.
Do’s and Don’ts:
Study groups
the majority of trainees find that practising in a group was key for their SCA preparation. People tend to arrange study groups according to the date they plan to sit the exam. Reach out to colleagues on the trainee whatsapp groups, or in your small groups at half-day teaching sessions.
Group size
Practise varies here. In general, being involved in each practise case in some capacity is key for learning, so trainees often suggest working in groups of 3-5, with observers giving constructive feedback.
6 minutes history:6 minutes management
Marking is across 3 domains: Data Gathering and Diagnosis (in brief: history taking), Clinical Management and Medical Complexity (CM&C), and Relating to Others. Marks obtained in CM&C receive additional weighting, and so count towards a greater proportion of your overall score. Therefore leaving around 6 minutes to discuss a management plan with the patient is a good target.
Practise back to back cases
We all know consulting is hard work, particularly in a high-stakes exam. It’s a good idea to get used to dealing with a few cases back-to-back, without feedback from study group colleagues in between, and instead do the feedback at the end.
“Be awkward”…
…when simulating scenarios. Not, ideally, when consulting. Actors playing patients in the exam scenarios have required candidates to use negotiation, persuasion, and compromise to come to an agreement about the best way forward. Practise this with colleagues to develop these skills ahead of the exam.
Vary your study resources
See our suggestions here. Resources vary in layout, case mix, difficulty, and depth (think here – psychosocial elements or that constant suspicion of a “hidden agenda”).
Do lots of remote consulting during revision
Use Teams, Zoom, or similar platform to revise, so that you get used to remote consulting.
The BNF
Past candidates have suggested you could use this in the 3 minutes you have to prepare before a consultation. Consider looking at treatment summaries, or drugs, side effects, important considerations in pregnancy, breastfeeding, renal impairment, and so on. Familiarising yourself and using the BNF in revision sessions will help fluency in the exam itself.
That being said: don’t get bogged down in 3rd or 4th line treatment options during revision
All GPs have to look things up, and examiners know this, although it isn’t possible to do this within the exam (other than using the BNF, if necessary). The cases are designed to test working knowledge and problem solving, not an encyclopaedic knowledge of the management of allergic rhinitis.
Compartmentalise and move on if a case doesn’t go to plan
Remember, you still have plenty more to show your abilities on, there is no negative marking and different examiners mark each case.
Whiteboards
Use these during practice sessions, as it’s the only thing you are allowed to use during the SCA for taking notes. Come up with a strategy for how best to employ them ahead of the exam, and stick to it.
Case banks:
There are a number of these – many of which require you to purchase a subscription, although the Pennine VTS cases can be accessed for free.
Recorded Case Examples
- RCGP: Please note (as explained on the RCGP site) that these cases are not graded or judged, therefore the performance of the candidate is for educational purposes only rather than to demonstrate a “model” consultation.
- Bradford VTS (the inspiration for this site) has a bank of SCA videos, some of which come with an examiner’s opinion of the consultation.
- YouTube – Dr Matthew Smith has a series of SCA consultation skills videos.
- Mentor Medicine – Dr Nigel Giam also has a series of SCA consultation skills which you can access for a fee.
Mark Schemes and Consulting Guides
North West Consultation Toolkit (endorsed by RCGP):
- Click here to download the pdf toolkit directly.
- Click here to download the “RAG” (Red-Amber-Green) rating tool – useful as a mark scheme guide.
- See the RCGP page about recommended use of the toolkit
Webinars
These can be helpful to guide preparation and can explain what to expect in the exam:
Mentor Education (free recorded webinar – scroll down page)
Preparation Courses
Every GP trainee is entitled to study budget funding for one SCA preparation course. At the time of writing, the only one funded by the Severn Deanery is the RCGP/Severn Deanery. Details of these courses are regularly distributed by email. Contact Kelly.Bush@rcgp.org.uk if you have not received these.
Some Bristol VTS trainees have given positive feedback on Mentor Medical Education SCA courses, run by Dr Nigel Giam. At the time of writing these will not be approved by Severn Deanery School of Primary Care for funding from study budget, and would need to be self funded.
Please note that trainees who have been unsuccessful in their SCA attempt are entitled to further support. Please see the SPEX pages for more information.
See also:
Page last reviewed: 18 April, 2024