MRCGP CSA Exam

Clinical Skills Assessment

For full information, please refer to the RCGP webiste.

The aim of the CSA is to test a doctor’s ability to gather information and apply learned understanding of disease processes and person-centred care appropriately in a standardised 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

You can sit the CSA during or after ST3 stage of your GP specialty training.
A maximum number of four attempts will be permitted for those who have entered ST3 on or after 1st August 2010.

The CSA is a high-fidelity skills assessment based largely on the familiar and well-proven OSCE format providing an external, objective assessment of clinical skills at a standardised, pre-determined level of challenge. The validity of the CSA resides in its realistic simulation of real-life consultations. Patients are played by trained and calibrated role players, and cases that are written and assessed by working GPs. The format of the assessment also allows for systematic sampling from the curriculum, using a selection blueprint.

Each candidate is allocated a consulting room and has 13 ten minute consultations.

The CSA focuses on testing the following areas of the GP curriculum:

  • primary care management: recognition and management of common medical conditions in primary care
  • problem solving skills: gathering and using data for clinical judgement, choice of examination, investigations and their interpretation and demonstration of a structured and flexible approach to decision making
  • comprehensive approach: demonstration of proficiency in the management of co-morbidity and risk
  • person-centred care: communication with patients 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 and therapeutic instruments

A paediatric case has routinely been included in the daily case mix (palette) of the CSA since its inception. This has hitherto only been achieved through a third party, usually a parent presenting with concerns about their child.

Cases involving child role players, accompanied by their parents, have recently been piloted and these can now be included in the palette selection process with effect examinations in November 2013. Although there will be a paediatric case each day, this will not necessarily involve the use of a child role-player on every occasion.

Some new cases will test paediatric examination. There will be no need for candidates to prepare in a different way as the learning outcomes are unchanged.

Additionally, please note that the British National Formulary (BNF) for Children has now been added to the list of equipment that candidates are required to bring into the CSA examination.

You should bring your doctor’s bag containing the usual diagnostic equipment with you, including:

  • BNF
  • BNF for children
  • Stethoscope
  • Ophthalmoscope
  • Auroscope
  • Thermometer
  • Patella hammer
  • Tape measure
  • Peak flow meter and disposable mouthpieces (N.B. These must be EU standard)

Please note that there is no need to bring a sphygmomanometer

Each case is marked by a different examiner. The examiner marks each case on three domains or areas - data gathering, clinical management and interpersonal skills. This creates an overall numerical mark for the case. Each domain carries the same number of marks. The marks for each case are added to create a final mark. Each of the 13 cases contributes equally to the overall score.

The pass mark is created using the borderline group method, which establishes the pass mark for each different daily mix of cases.

The result of your examination along with any formative feedback will published in your ePortfolio on the date given to you when you applied for the exam.

For full information, please refer to the RCGP webiste, where you will find a list of exam dates and a link to the online application for applying for the exam.