MRCGP Clinical Skills Assessment (CSA)

MRCGP 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

Clinical Skills Assessment (CSA) format

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 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
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.

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.

Candidate information on the use of iPads in the CSA

More about the format and content of the CSA [PPT]

More about the GP curriculum 

Examination Regulations

You should ensure that you’re familiar with the relevant sections of the MRCGP Examination Regulations before applying to sit the CSA, particularly with respect to eligibility and the number of attempts permissible.

MRCGP regulations, reviews, complaints, 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.

When the CSA can be sat

You can sit the CSA during or after ST3 stage of your GP specialty training. There are currently three CSA sessions per year shown in the table below.
A maximum number of four attempts will be permitted for those who have entered ST3 on or after 1st August 2010.

CSA assessment dates 2013-2014

  November 2013

  February 2014

  May 2014

Apply via college website 

  17 - 25 September 2013    

  4 - 12 December 2013

  21 - 28 March 2014    

Week 1

  8 - 9 November 2013 

  30 January - 1 February 2014   

  8 - 10 May 2014

Week 2

  11 - 14 November 2013* 

  3 - 6 February 2014**

  12 - 17 May 2014***

Week 3

  18 - 23 November 2013

  10 - 15 February 2014 

  19 - 24 May 2014

Week 4


  24 February - 1 March 2014 


Week 5


  3 - 8 March 2014 


Week 6  

  10 - 12 March 2014


Results published

  4 December 2013

  20 March 2014 

  4 June 2014

*Please note that we will not be holding examinations on Friday 15 and Saturday 16 November 2013.

**Please note that we will not be holding examinations on Friday 7 and Saturday 8 February 2014.

***Please note that we will not be holding examinations on Friday 16 May 2014.

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

How to apply for the CSA

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

CSA booking procedure

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.

Preparing for the CSA

CSA candidate information document

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

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.

CSA: on the day

Dress Code

You’ll be expected to adhere to a dress code.


Information about the equipment you’ll need to bring to the examination 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 examiners and role players). They will not used to assess your performance.

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.

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.

Contact us

Tel: 0203 188 7660


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