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New RCGP Exam: Everything you need to know about the SCA…

A new exam is set to replace the recorded consultation assessment (RCA) this Autumn. Here is everything you need to know…

In March 2023, the RCGP submitted a proposal to the GMC for the replacement of the RCA with a new examination format. The RCA was originally rolled out in July 2020 as a temporary measure in response to the Covid-19 pandemic. Here the RCA replaced the previously existing clinical skills assessment (CSA), providing candidates with an opportunity to pass the exit examination during the pandemic.

The RCGP has had much success piloting the new examination format, the Simulated Consultation Assessment (SCA). The new format has been described as a hybrid model of both the RCA and CSA. The Vice Chair for Professional Development for RCGP, Dr Margaret Ikpoh, has provided some key insight into the development of the new SCA format:

“The new exam is being developed in consultation with a range of key stakeholders, including trainees, trainers, examiners and patients, and has taken on feedback from both the RCA and its predecessor, the Clinical Skills Assessment. The new exam is likely to retain elements of both exams”

The new examination will require a different strategy for both the candidate and trainer, here is everything you need to know about the latest examination changes.

Aims of the SCA assessment:

Demonstrate candidates’ ability to:

- Manage risk, medical complexity and uncertainty

- Manage patients concerns

- Exhibit appropriate attitudes and behaviours

- Adapt treatment and consultation styles to different types of illnesses and patients

- Keep patients safe

SCA format

The SCA will be delivered via an online platform, involving real-time simulated consultations performed by trained actors. The candidate will be assessed across twelve cases and have an allocated twelve minutes per consultation. Each candidate will be allocated three minutes of reading time before the consultation begins to gain basic knowledge of the patient. The cases will take the form of video or telephone-based consultations, within the candidate's local surgery or a nearby surgery. A major reason for the retention of the virtual component was a reduction in travel costs, coupled with the creation of a less artificially constructed consultation- this was one of the largest criticisms of the CSA.

When can the assessment be taken?

ST3 training year

When could the first SCA take place?

The RCGP remains committed to providing a six-month notice period for any changes related to RCGP examinations thereby, changes are due to roll out in late 2023.

What types of cases to expect?

Cases will reflect prevalent conditions encountered within a GP’s daily practice. Cases will be calibrated and standardised to meet these requirements, with actors instructed to respond in accordance with the individual candidate in real time. Commonly, the actors will take the form of a patient however, there will be instances when the actor may present as a patient’s carer or other health care worker (e.g. social worker).

The types of cases explored within the SCA pilot included:

- Young people and children

- Long-term conditions

- Elderly care

- Mental health- including substance misuse

- Urgent care

- Gender, sexual health, LGBTQ, reproductive health

- Safe prescribing

- Inclusivity, ethnicity and diversity

- Health disadvantages and vulnerabilities

What does this mean for the March and April RCA submissions?

Despite the transition from the RCA to the SCA the college remains committed to ensuring candidates can take one last sitting of the RCA. The last examination date for the RCA will be May 2023, after this date, the RCA will no longer be able to be taken. It is advised for all candidates wanting to undertake the RCA that they apply for the March 2023 diet, as the May 2023 diet will have a tight submission number of 1250 candidates maximum. It is important to note that candidates will not be able to submit for both March and May submissions. It is advised to discuss your educational plans with your educational supervisors as soon as you can if you are wanting to take the RCA.

What about resits?

For those candidates who require an RCA resit, there will be an Autumn 2023 RCA diet open specifically for these candidates.

Best way to prepare for the SCA

SCA and WBPA assess similar capabilities:

An important change to the format of this exam is that the SCA will assess candidates against a sample of capabilities strongly associated with the WPBA. The main reason for this is to place a larger emphasis on clinical management and less emphasis on the candidate's interpersonal skills.

What is the SCA designed to assess:

- Clinical management

- Making a diagnosis

- Data gathering and interpretation

- Communication skills

- Fitness to practice

- Maintaining an ethical approach

- Managing medical complexity

- Working within a team

- Practising holistically

- Safeguarding

- Community orientation

Practice, practice, practice

The RCGP advises that the best way to practice for the SCA is through everyday consulting, indicating that the more practice candidates can get the better. One of the best ways- in our experience of training thousands of doctors- is to study consultations from experienced GPs and practice implementing some of their structure and communication skills in your everyday consultations. Here at Hippocratix, we have a plethora of video-based consultations targeting both RCA and SCA examinations, check out our membership programme to learn more.

What are the next steps?

The GMC is currently undertaking a rigorous quality assurance process, reviewing changes to the assessment and the curricula- this review process can take up to three months. To keep up-to-date with the latest MRCGP examination news check out our Hippocratix blog page, or give us a follow on LinkedIn.


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