Clinical Skills Assessment

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

The Clinical Skills Assessment (CSA) is an essential component of the nMRCGP, 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 for use in training sessions.

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. Twelve of these are assessed; the 13^th is a pilot case. 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. Candidates’ performance on each consultation is graded Clear Pass, Marginal Pass, Marginal Fail or Clear Fail by assessors who observe the consultations. Assessors are also trained and calibrated.

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

Dates for assessments in 2009 have been revised (July 2008) to take account of emerging trends in demand and training requirements as well as to improve re-sit opportunities for candidates who do not pass at the first attempt. An additional examination may be made available in December 2008 exclusively for re-sitting candidates whose training has been extended.

Please note that not all of the dates shown in the table below will necessarily be offered: they will be made available according to demand.

Candidates wishing to change or cancel their booking should refer to the cancellations and refunds policy that applies to nMRCGP. 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.

Results and feedback

Results are provided via candidates’ eportfolios approximately three weeks after the final assessment in the series. Results are given as grades on the twelve assessed cases and an overall pass or fail.

Feedback statements accompanying the results can be interpreted by reference to the document Candidate feedback: suggestions for improvement.