MRCGP Clinical Skills Assessment (CSA)

What is the Clinical Skills Assessment(CSA)

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

Format of the CSA

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.

CSA consulatations

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

Use of children in the CSA:

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.

Introduction to the CSA cases

Clinical Skills Assessment walkthrough video

Clinical Skills Assessment walkthrough

Dr Kamila Hawthorne and Dr Richard Jones walk trainees through what to expect as they prepare to take their CSA exam


Delivery of the CSA / Use of iPads

The CSA is delivered in a paper-light format. Candidates have electronic patient lists and case notes and examiners record their marks electronically. Please consult the following document before you attend your examination.

CSA booking procedure

Please note that as there are a limited number of spaces available for each session and applications will be accepted on a first come-first served basis. Therefore you should make your booking at your earliest opportunity.

The procedure for booking CSA examinations has now changed and is part of a wider system development for more efficient delivery of the examination at the RCGP’s new premises. It ensures that those who in the past have felt disadvantaged by applying later within the booking window will have the same chance as others to take their examination during the more popular days or weeks.

Regrettably we cannot allow you to choose a specific date for your examination. We will assume that you’re available to attend on each of the dates published, but if you foresee insurmountable problems in attending on any particular days, or at a specific time, you should state these when completing your application and we will try to accommodate your request. We cannot however guarantee that this will be possible in every instance.

It is possible that we may not hold examinations on each of the dates published, as the scheduling will depend entirely on the number of candidates who have applied.

After you apply

You’ll get an email with the time and date of your exam as indicated in the confirmation email you will receive after you have made your application. Please do not contact our Exams Office before this time: scheduling won’t be completed until all applications have been received and processed.

Slots are allocated randomly, after the application window has closed - so there’s no advantage in applying early.

Fees must be paid when you apply.

Dates for applications for CSA examinations and publication of results

Eligibility for the CSA

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.

CSA assessment dates 2014-2015

With effect from October 2014 there will be eight separate CSA sessions each year, of six, nine or 12 days duration as shown in the table below.

Please note that as there are a limited number of spaces available for each session and applications will be accepted on a first come-first served basis. Therefore you should make your booking at your earliest opportunity.

All dates may be subject to change. Appropriate notice of any changes will be given at the earliest opportunity.

October 2014 November 2014 December 2014 January 2015 February 2015 March 2015 April 2015 May 2015
Apply via website 22 - 27 August 2014 29 September 2014 -
3 October 2014
27 - 31 October 2014 5 - 10 December 2014 12 - 16 January 2015 9 - 13 February 2015 9 - 12 March 2015 30 March - 2 April 2015
Week 1 2 - 4 October 2014 3 -8 November 2014 1 - 6 December 2014 19 - 24 January 2015 23 - 28 February 2015 16 - 21 March 2015 13 - 18 April 2015 18 - 22 May 2015
Week 2 6 - 8 October 2014   N/A   N/A 26 - 31 January 2015   N/A 23 - 25 March 2015 20 - 22 April 2015 27 - 30 May 2015
Week 3   N/A   N/A   N/A   N/A   N/A   N/A   N/A   N/A
Results published 14 October 2014 13 November 2014 11 December 2014 5 February 2015 5 March 2015 31 March 2015 28 April 2015 2 June 2015
Suggested date for re-sitting December 2014 January 2015 February 2015 March 2015 April 2015 May 2015 May 2015    -

Apply for the CSA

Apply online during one of the booking periods shown in the table above.

Please note that as there are a limited number of spaces available for this session and applications will be accepted on a first come-first served basis. Therefore you should make your booking at your earliest opportunity.

Declaring a disability or requesting special adjustments

Please refer to the relevant sections of the Examination Regulations in the first instance and complete the relevant section below. Appropriate arrangements will be made for those requiring reasonable adjustments. You should complete a Reasonable Adjustment Request Form if you are seeking a reasonable adjustment in the AKT. Please email the completed form to

Notify the RCGP of a disability 

Frequently Asked Questions about reasonable adjustments

Preparing for the CSA

CSA candidate information document

All candidates should read the full candidate information pack before sitting the CSA.

Candidate Briefing

Before the start of your examination you will receive a briefing from the Senior Marshal. Below is the presentation that will be presented on the day.

More resources for CSA candidates

It’s also helpful to review sample cases, guidance on how the CSA is marked and other resources.

Non disclosure agreement

CSA examination material is confidential and copyright to RCGP. By applying to take the CSA, you agree not to pass on information about any of the cases you will encounter. You’ll also be asked to sign a non-disclosure agreement when you arrive at the centre. It is advisable that all candidates read the non-disclosure agreement carefully prior to their examination. Please click here to view the document.

In any case, knowledge of leaked material is unlikely to help you. The following document describes why this is so as well as giving advice on how to prepare for the examination.

Arrival and departure times

The CSA normally lasts approximately 3 hours. A morning exam is scheduled to start at 10am and an afternoon session at 2pm. The RCGP aims to follow these times as closely as possible, however delays, whilst regrettable, are sometimes unavoidable and you should take this into account, particularly when making travel arrangements for return journeys.

Travel to the venue may be slow especially in the morning rush hour and taxi or bus services can be very busy. It is your responsibility to ensure that you arrive in time for the candidate briefing.

Morning Session:-

Entrance to the exam centre will not be permitted before 8.15am. You should not arrive later than 9.00am in order to allow time for checking in.

Afternoon Session:-

Entrance to the exam centre will not be permitted before 11.45am. You should not arrive later than 12:30pm in order to allow time for checking in. For the security of the examinations, you will not be admitted to the session if you arrive later than 12:45pm, when the morning session ends.

Please refer to your confirmation letter or e-mail to be sure which of these sessions you have been allocated to attend.

N.B. Once you have checked in, you will not be permitted to leave the candidate reception and briefing area and mobile phone use is strictly no longer permitted.

Missing the briefing before your exam may leave you at a disadvantage, so we strongly recommend that you allow enough time to arrive by the times stated above. Candidates who arrive after the start of the briefing will only be admitted to the examination under exceptional circumstances.

The CSA will commence when everyone present has been shown to their consulting room and settled in, but not before the stated start times. In the event of an emergency on the day and if you think you may be late, please contact a member of the RCGP Examinations Department by phoning 0203 188 7660.

Equipment required on the day


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
CSA Information for Candidates

Dress Code

You'll be expected to adhere to a dress code when you attend your CSA Examination.
The Dress Code is available as guidance to postgraduate doctors undertaking licensing assessments as part of the MRCGP examination. It has been written in conjunction with Deanery guidance, and applies also to situations of recruitment to GP training, work based training itself and assessment. Please ensure you are familiar with this before sitting the exam. 

Candidate Briefing

Before the start of your examination you will receive a briefing from the Senior Marshal. Below is the presentation that will be presented on the day.

CSA marking

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.

Video Recording

Video recording

Consultations may be recorded as part of quality control and for training purposes (for both examiners and role players). They will not used to assess your performance.

Frequently Asked Questions about the role of video in MRCGP Clinical Skills Assessment

CSA Results and feedback

The result of your examination along with any formative feedback will published in your ePortfolio on the date given in the table above.

CSA Summary Reports from September 2010 to May 2014

Please bear in mind that the nature of the training cycle means that candidate cohorts differ considerably. The results for a particular diet should not therefore be used to draw any conclusions about the likely pass rates for other cohorts.

May 2014 CSA Summary Report [PDF]

January/February/March 2014 CSA Summary Report [PDF]

November 2013 CSA summary report [PDF]

May 2013 CSA summary report [PDF]

January/February/March 2013 CSA summary report [PDF]

November 2012 CSA summary report [PDF]

May 2012 CSA summary report [PDF]

February/March 2012 CSA summary report [PDF]

November 2011 CSA summary report [PDF]

September 2011 CSA summary report [PDF]

May 2011 CSA summary report [PDF]

February/March 2011 CSA summary report [PDF]

November 2010 CSA summary report [PDF]

September 2010 CSA feedback on performance and summary report [PDF]

Complaints, Reviews and Appeals

View the MRCGP regulations and procedures for complaints, reviews, and appeals.

The Academy of Medical Royal Colleges and the General Medical Council have set expectations about the currency of national professional examinations and the number of attempts permissible. This guidance can be found here.

Contact us

Tel: 0203 188 7660


The item has been added to your basket.

Continue shopping

Go to basket

This item is out of stock.

Continue shopping

The item is out of stock.

Yes Continue shopping