RCA

The RCA is a summative assessment of a doctor’s ability to integrate and apply clinical, professional, communication and practical skills appropriate for general practice. It uses pre-recorded video or audio consultations to provides evidence from a range of encounters in general practice relevant to most parts of the curriculum and also provides an opportunity to target particular aspects of clinical care and expertise.

The aim of the RCA is to test a doctor’s ability to gather information and apply learned understanding of disease processes and person-centred care appropriately in a primary care context, make evidence-based decisions, and communicate effectively with patients and colleagues. Being able to integrate these skills effectively is a key element of this assessment 

– 13 consultations (any combination of audio, video or face to face consultations) undertaken by the candidate in their own current working environment and submitted to the FourteenFish RCA Platform.
– Sat during the ST3 year or beyond of training and recordings will be made during this time. Submitted recordings can be taken up to six months prior to the deadline for submission.
– Cases submitted should be of an appropriate level of challenge for an ST3 trainee to demonstrate safe and independent practice.
– There are 8 mandatory cases – child under 16, female/reproductive health, patient over 65, urgent/acute case, long term health condition (e.g disability, multimobidity and cancer), mental health and minimum of two cases showing (or if remote describing) examination.
– No more than two cases should be from one topic area
– In cases where the patient is examined, it should not show the swimsuit area (the area covered by the bikini in women and trunks in men).
– The cases will be assessed by trained and calibrated examiners who are experienced GPs. Each consultation will be viewed independently by at least one examiner who will make a global judgement of that consultation, attributing marks in three domains and blind to other marks the candidate receives for that or any other consultation.

1. Record everything! Whilst they won’t initially be submission worthy, it is useful to watch yourself and find areas to improve on and habits you’ve picked up that you need to change. You will also be able to guage what cases are submission-worthy after recording a few.
2. Have set recording clinics and before them, go through your patient list to try and guage topics that will come up. Then have a read of NICE/RMS guidance or have the tabs open and ready for you to refer to if needed during the consultation.
3. Make use of your trainer. Tutorials can be a great opportunity for you to watch your cases with your trainer. They will be able to pick up on bad habits, body language, missed cues and repetitions you say so you can work on improving those areas.
4. Similarly, getting a buddy to watch your recordings and critique them can be useful. As can reviewing their recordings.
5. Try to stay within 10 minutes. Aim to be at the top of the hill (think consultation model) at around 6 minutes, so you have ample time for shared management, checking understanding, follow up and safety netting. You can submit videos longer than 10 minutes but the examiner will not watch passed 10 minutes from after you’ve consented the patient.
6. Avoid typing and scrolling with your mouse where possible, it can be distracting when watching back. Instead, have catch up slots after your recording to document/do housekeeping.

Click here for exam resources and other useful links.