Achieving Your MRCGP

Becoming a GP

Postgraduate Medical Education & Training Board (PMETB) has merged with the GMC to ensure that training standards are met, approve training programmes and ensure that they adhere to twelve Domains.

The duties of a doctor and guidance on providing good clinical care are accessible on the GMC website.

It is worth familiarising yourselves with the website as throughout your training and career ensuring patient safety is of paramount concern. A snapshot is shared here:

The Duties of a Doctor Registered with the General Medical Council (GMC)

Patients must be able to trust doctors with their lives and health.  To justify that trust you must show respect for human life and you must make sure your practice meets the standards expected of you in four domains:

Knowledge, Skills & Performance

  • Make the care of your patient your first concern
  • Provide a good standard of practice and care
  • Keep your professional knowledge and skills up to date
  • Recognise and work within the limits of your competence

Safety & Quality

  • Take prompt action if you think that patient safety, dignity or comfort is being compromised
  • Protect and promote the health of patients and the public

Communication, Partnership & Teamwork

  • Treat patients as individuals and respect their dignity
  • Treat patients politely and considerately
  • Respect patients’ right to confidentiality
  • Work in partnership with patients. 
  • Listen and respond to their concerns and preferences
  • Give patients the information they want or need in a way they can understand 
  • Respect patients’ right to reach decisions with you about their treatment and care 
  • Support patients in caring for themselves to improve and maintain their health
  • Work with colleagues in the ways that best serve patients’ interests

Maintaining Trust

  • Be honest and open and act with integrity
  • Never discriminate unfairly against patients or colleagues
  • Never abuse your patients’ trust in you or the public’s trust in the profession

You are personally accountable for your professional practice and must always be prepared to justify your decisions and actions.

Information taken from the General Medical Council website 05.08.2016

GMC link

GP Curriculum

The GP Curriculum sets out what’s required to practise as a GP in the NHS and helps prepare GPs for a professional life of development and change. The curriculum forms the basis of GP training and assessment across the UK, and is relevant to GPs throughout their career, including preparation for revalidation. 

The Royal College of General Practitioners publishes a full version of the curriculum, as well as a super condensed guide under “Alternate Versions”. The latest versions can be found using the green button below.

To achieve Membership of the Royal College of GPS and a Certificate of Completion of Training, a Trainee must successfully pass the Applied Knowledge Test (AKT) exam which can be taken from ST2, the Simulated Consultation Assessment (SCA) in ST3 as well as successful completion of the portfolio and required Workplace Based Assessments (WPBA) for each post throughout training.

The Local GPST Faculty is responsible for ensuring that the GPST programme is such that it will enable you to meet specific competences required in any given year through your GPST curriculum.  The local programme is thus mapped to the national GPST curriculum.

The purpose of the curriculum is to describe the competences to be attained in specialties relevant to General Practice in terms of the specific knowledge, skills and attitudes to be acquired.

The objectives are to:

  • have clinicians who are able to practice in a professional, ethical, and patient focussed manner in accordance with Good Medical Practice (
  • have clinicians who demonstrate an ethical stance of respect and inclusivity of race, class, culture, gender, sexual orientation, age, disability and religion.
  • spend a minimum of one year in hospital specialties thought most appropriate and relevant to future careers in General Practice. 

How You Complete the GPST Curriculum

This GPST curriculum is competency based and leads to acquisition of knowledge, skills and attitudes needed to progress to Specialty Training. 

You will be supported during your time at Royal Surrey NHS Foundation Trust by your Programme Directors and allocated Educational Supervisor and Clinical Supervisors, all of whom will give you regular feedback about your progress.  You should never be in any doubt about your progress and what you can do to improve this.  Evidence that you have completed the GPST curriculum and achieved competence is assessed through your ePortfolio entries at ARCP.

RCGP Curriculum

Workplace Based Assessments and the ePortfolio

The GP ePortfolio is hosted by the FourteenFish Platform. More information and support on this can be found here.

Review periods in the ePortfolio are generated in six month blocks. After six months there will be an interim ESR (Educational Supervisor Report) and after twelve months a Full ESR.

Throughout training the following WPBA’s are required pro rata (signed off by ST4 grade doctor or above):

  • Learning Logs – 3 per month (36 per year) covering the breadth of the curriculum (read more here).
  • Case Based Discussions (CBD) – 4 per year (2 per 6 months)
  • Mini Consultation Evaluation Exercise (MiniCEX) – 4 per year (2 per 6 months)
  • Consultation Observation Tool (COT) – replaces MiniCEX in GP placements
  • Quality Improvement Project (QIP) – 1 in a GP placement
  • Quality Improvement Activity (QIA) – 1 each year without a QIP (Total 2)
  • Clinical Examination and Procedural Skills (CEPS) – 5 mandatory and 7 advised throughout training
  • Multi-Source Feedback (MSF) – 1 per year
  • Patient Satisfaction Questionnaire (PSQ) – 1 in ST3 only
  • Leadership MSF – 1 in ST3 only
  • Prescribing Assessment – 1 in ST3 only
  • Educational Supervisor Report – interim ESR at 6months, full ESR each year

The following videos were designed by the Guildford Training Scheme sharing how to effectively record a reflective log (this was based on the old MRCGP ePortfolio) and doing a Cased Based discussion.

AKT: Applied Knowledge Test

The AKT exam cannot be taken before the ST2 year, and typically requires about 3 months of preparation time. The Training Programme Director Lead for the AKT runs a local focus group for candidates who have applied for each sitting and can direct trainees towards available resources suited to exam preparation.

The recommendation from analysis of successful and unsuccessful candidates is to use a combination of techniques, not just practice questions, to adequately prepare to pass.

Learning should be undertaken according to your individual style (the four core learning styles include visual, auditory, reading and writing, and kinesthetic) but mapped to the RCGP Curriculum.

All trainees in the Guildford scheme are strongly encouraged to complete a dyslexia assessment tool to identify if there are additional ways to support. More and more doctors find the first hurdle for underlying neurodiversity is postgraduate examinations. This is particularly relevant if you have found past examinations time-pressured, find difficulty with linguistic aspects of reading or interpreting questions, or trained as an international medical graduate.

Suggested Resources include (but are not limited to):

  • NICE Clinical Knowledge Summaries provide general practitioners with a readily accessible summary of the current evidence base and practical guidance on the common conditions and presenting problems encountered in primary care.
  • British National Formulary (BNF) a pharmaceutical reference book that contains essential information on prescribing for drugs available in the NHS.
  • GP Self-Test an RCGP accredited learning needs assessment tool which can be used to identify areas of knowledge needing improvement. It provides a breakdown of your performance across the RCGP curriculum.
  • e-Learning for Healthcare delivers free and searchable online education modules for doctors on a wide variety of topics.

SCA: Simulated Consultation Assessment

The SCA is a summative assessment of a doctor’s ability to integrate and apply clinical, professional, communication and practical skills appropriate for general practice. It replaces the CSA and RCA and comprises 12 simulated (actor) consultations, each lasting 12 minutes. These scenarios will be based on a range of encounters from general practice relevant to most parts of the curriculum and also provides an opportunity to target particular aspects of clinical care and expertise.

The following resources that were prepared by a trainee for the RCA assessment may still be useful for SCA preparation: Tabulated version of the 2021 mark scheme to consider how to gain marks. Consultation flowchart as a prompt for the important parts of the consultation.