Updated 14 September 2020
This guidance is offered to encourage candidates to demonstrate their skills across a breadth of the curriculum and General Practice which would normally be selected for you in the CSA. It is not an exclusive list, nor do you have to consult with every example listed. However, the best way to ensure you demonstrate your skills across a breadth of the curriculum is by including a wide range of different consultations.
Mandatory Case selection criteria for RCA from November 2020
In response to trainee feedback requesting further guidance on case submission, and learning from the emergency Recorded Consultation Assessment (RCA) diets, mandated and recommended case criteria have been developed. A wider range of clinical topics allows a better review of candidates’ global capability and therefore provides better evidence on which to make a judgement of their readiness for independent practice as a GP. It is easier for candidates to gain marks and for the examiners to see candidates’ level of skill if a range of cases of a suitable, but not overly complex nature is submitted.
Read our guidance on case submission
We would suggest where possible you utilise new patient contacts rather than follow up patients as these are more likely to allow you to demonstrate your competence in consultation skills. Whilst it is recognised that many of the patients will have been triaged before the consultation begins, you should at the very least check with the patient whether your understanding of that triage process and its outcome aligns with theirs. Patients' stories and/or their needs frequently change between triage and consultation.
Your workbook will help you check the variety in your submission, for example:
The 2018 GP curriculum and topic guides can be found on the RCGP website.
For reference please review the clinical topic areas as set out in the curriculum.
Topic guides about professional issues:
- Consulting in general practice
- Equality, diversity and inclusion
- Evidence-based practice, research and sharing knowledge
- Improving quality, safety and prescribing
- Leadership and management
- Urgent and unscheduled care
Topic guides about life stages:
- Children and young people
- Reproductive health and maternity
- People living with long-term conditions including cancer
- Older adults
- People at the end of life.
Topic guides about clinical topics:
- Allergy and immunology
- Cardiovascular health
- Dermatology
- Ear, nose and throat (ENT), speech and hearing
- Eyes and vision
- Gastroenterology
- Genomic medicine
- Gynaecology and breast
- Haematology
- Infectious disease and travel health
- Kidney and urology
- Mental health
- Metabolic problems and endocrinology
- Musculoskeletal health
- Neurodevelopmental disorders, intellectual and social disability
- Neurology
- Population health
- Respiratory health
- Sexual health
- Smoking, alcohol and substance misuse.
You should use the full breadth of the curriculum topic guide areas in preparing recordings for submission. However, the RCA handbook currently contains only the clinical topic guide headings. If your consultation does not match one of these headings, there is the option to choose ‘other’. Please ensure you enter a short description of the case.
Low challenge cases are unlikely to give you the opportunity to demonstrate your consultation skills fully and will make it difficult for examiners to find evidence to meet the required performance criteria.
Examples of low challenge consultations might include simple lower urinary tract infections, straightforward skin conditions such as viral warts, uncomplicated upper respiratory tract infections and some follow up consultations.
However, any of these apparently low challenge cases can become more complex if, for example, significant psychosocial factors become apparent during the consultation. In general, more complex consultations are likely to give you the opportunity to demonstrate your consultation skills fully and meet the performance criteria required.
Examples of complex consultations might include consultations with patients who are new to you, those with a significant psychosocial component, patients presenting with more than one problem, patients with multimorbidity, and consultations with more than one person.
Please note:
- It is the responsibility of the candidate to be aware of the deadline for submission of cases and to work within this to make their submission in good time.
- It is the candidate's responsibility to ensure the consultation recordings submitted are of good quality in sound and picture.
- It is preferable in video or face to face consultations that the face of both the patient and the doctor are visible.
Clarification on examination of patients in Recorded Clinical Assessment (RCA) submissions - good medical practice. From 1 September 2020
The RCGP reminds candidates submitting cases for the MRCGP Recorded Clinical Assessment (RCA) about the importance of the dignity of patients and good medical practice.
A consultation in which clothing equivalent to vest top and shorts, or the ‘swimsuit area’, is removed and captured on a visual recording must not be submitted for assessment.
If a consultation is submitted, where this guidance is breached, examiners have been advised that they should not continue to watch or assess it, and no marks will be awarded for that consultation.