Clinical Skills Assessment

Please click here for the document 'CSA Information for Candidates'

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’. A PowerPoint presentation about the CSA is available here.

GPStRs will be eligible to take the CSA when they are in ST3 (the third and final year of their GP specialty training).

The CSA is offered at least three times a year: dates for the forthcoming year are shown in the table below. 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.

Format of the assessment

Each candidate is allocated a consulting room and has 13 consultations, each of 10 minutes, all of which are assessed. 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.

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.

The pass mark is created using the borderline group method which establishes the pass mark for each different daily mix of cases. As well as marking the domain scores, the examiners will also separately rate the candidate as a pass, a fail or a borderline, overall. For each case the overall numerical case marks of the candidates in the borderline group are averaged. These averaged scores are then aggregated across all the 13 cases to create the “cut score”, ie the approximation between a passing and a failing score.

The CSA tests mainly from 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 co-morbidity 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.

The CSA will also test:

Clinical Practical Skills - demonstrating proficiency in performing physical examinations and using diagnostic/therapeutic instruments.

Applying to sit the CSA

GP trainees who have registered with the RCGP and are eligible to sit the CSA (i.e. they are in ST3) can apply online for a morning or afternoon assessment on a particular date. Dates will be offered until fully booked, after which further dates will be made available. Fees must be paid at the time of applying.

Re-sitting the CSA

Trainees who fail the CSA may apply to re-sit in a subsequent series, but would need deanery approval for any extension of training that might be needed. Fees for re-sits are the same as for first assessments.

Assessment dates 2010-2011

Please note that in most instances the assessment dates shown in the table below will be offered in reverse chronological order, with the later dates being made available first. Further dates will be released according to demand.

Candidates wishing to change or cancel their booking should refer to the cancellations and refunds policy that applies to MRCGP. Applications are confirmed in an automatically generated email.

Before sitting the CSA, candidates should read the document 'CSA Information for Candidates'. Please note in particular the requirements for arrival times (9.30 for morning assessments; 12.45 for afternoon assessments) and identification documents (valid passport or photo-card driving licence).

Disabilities and reasonable adjustments

Candidates have the opportunity at the application stage to register any disability and request a reasonable adjustment. The assessment centre is DDA compliant, but additional appropriate arrangements will be made for candidates with disabilities or special needs, as far as these are needed and can be accommodated. The CSA will comply with all relevant UK legislation in this respect, but candidates should notify the RCGP of any special requirements at the earliest possible opportunity.

Equipment

Candidates are required to bring to the CSA their normal doctor’s bag.  Full details can be found in the document ‘Information for Candidates’, which can be viewed or downloaded from the link above.

Video recording

Consultations may be recorded as part of quality control and for training purposes for both assessors and role players.  They are not used to assess performance.

Non-disclosure

The CSA assessment material is confidential and copyright to RCGP. By applying to take the CSA candidates agree not to pass on knowledge of any of the cases. In addition, candidates taking the CSA are required to sign a non-disclosure agreement.

Does prior notice of CSA cases help you pass the examination?  For guidance click here.

Results and feedback

The dates on which results will be issued are given in the table above. Results are accessible via candidates’ eportfolios and displayed within the section 'Progress to Certification' as a pass or fail.

Candidates will receive their overall score and the passing score for that day.

Areas of performance identified as deficient by two of more examiners will be flagged in the candidate’s ePortfolio. These statements can be interpreted by reference to the document ‘Candidate feedback: suggestions for improvement’.