The Clinical Skills Assessment (CSA) is an essential component of the MRCGP, and is ‘an assessment of a doctor’s ability to integrate and apply clinical, professional, communication and practical skills appropriate for general practice’.

The CSA can only be taken during the ST3 stage of specialist training.  A pass in the CSA prior to 1 August 2010 is valid for 3 years, passes after this date have non “expiry date” however from 1 August 2011 candidates will be permitted a maximum of 4 attempts to pass the CSA.  The CSA is offered at least three times a year- usually in November, February and May.  You are advised to discus with your trainer when the best time for you to sit the exam will be prior to applying for it.

The assessment centre is located at Number 1 Croydon and has been created by fitting out three floors of the building specifically for the purpose.

Additional attempts may be allowed in very exceptional circumstances if mitigating circumstances can be proved (see section 10 of CSA examination rules on RCGP website).  You will be required to provide proof of these circumstances eg death certificate, flight details, doctor’s certificate if appropriate, and these things MUST be entered into your eportfolio at the time.  You must either withdraw from the exam in advance or supply evidence to the RCGP in writing within 2 days of the exam.

Format of the assessment

Each candidate is allocated a consulting room and has 13 consultations, each of 10 minutes. Twelve of these are assessed; the 13th is a pilot case. Patients are played by role-players who have been trained and calibrated to perform their role in a consistent manner. A description of the type of cases used in the CSA and sample cases can be seen here. Candidates’ performance on each consultation is graded Clear Pass, Marginal Pass, Marginal Fail or Clear Fail by assessors who observe the consultations. Assessors are also trained and calibrated.

The CSA tests the following areas of the curriculum

  • Primary Care Management: recognition and management of common medical conditions in primary care.
  • Problem Solving Skills: gathering and using data for clinical judgment, choice of examination, investigations and their interpretation. Demonstration of a structured and flexible approach to decision making.
  • Comprehensive Approach: demonstration of proficiency in the management of comorbidity and risk.
  • Person‐centred Care: communication with patient and the use of recognised consultation techniques to promote a shared approach to managing problems.
  • Attitudinal Aspects: practising ethically with respect for equality and diversity, with accepted professional codes of conduct.
  • Clinical Practical Skills: demonstrating proficiency in performing physical examinations and using diagnostic/therapeutic instruments.

The three domains on which you will be marked are

  • Data Gathering, Technical & Assessment skills: Gathering & using data for clinical judgement, choice of examination, investigations & their interpretation. Demonstrating proficiency in performing physical examinations & using diagnostic and therapeutic instruments
  • Clinical management skills: Recognition & management of common medical conditions in primary care. Demonstrating a structured & flexible approach to decision‐making. Demonstrating the ability to deal with multiple complaints and comorbidity. Demonstrating the ability to promote a positive approach to health
  • Interpersonal skills: Demonstrating the use of recognised communication techniques to gain understanding of the patient’s illness experience and develop a shared approach to managing problems. Practising ethically with respect for equality & diversity issues, in line with the accepted codes of professional conduct.