✍ What is the RCA/CSA❓

✍ Technical aspects of RCA/CSA 

✍ Key areas of testing

✍ What cases should you submit❓

✍ When and where can you take the RCA exam❓ 

✍ Preparatory media 

✍ How is it marked❓ 

✍ Results 

✍ Summary

What is the RCA❓

The Recorded Consultation Assessment (RCA) is currently the temporary replacement for the Clinical Skill Assessment (CSA) which is one of the three parts of the MRCGP qualification required to complete GP training in the UK 🌍. 

It is a collective assessment of a doctor’s capacity to combine and apply professional, clinical, practical skills and communication, suitable for general practice. The assessment makes use of submitted pre-recorded cases to provide evidence from a range of past consultations in general practice 🏨 which are relevant to most parts of the curriculum. 

Technical Aspects of the RCA

The RCA requires the submission of 13 consultations which will provide an objective assessment from real life settings by the candidate from their normal working environment. These consultations can be in any combination of video 🎦, audio 🎤 or face to face scenarios. 

The candidate’s chosen cases are to be submitted on the FourteenFish RCA platform, which will then be assessed individually by different trained examiners (experienced GPs 🏨). The cases submitted should be of a certain level of challenge for an ST3 trainee to exhibit safe and independent practice. 

The candidates are also required to obtain consent from the patients under the usual guidance for training and within GDPR and this can be done on the FourteenFish RCA platform where the recordings can be made directly or on paper/electronic or verbally on camera (this will not add to the time of assessment).

The submitted recordings for the RCA will be deleted from the central IT platform after results have been published, whilst uploaded but not submitted recordings will be deleted after 26 weeks. 

Candidates are responsible for the recording quality as the recordings need to be continuous and should not be edited or turned off during the consultation. To maintain dignity of patients and good medical practice 🏨 , consultations in which patients clothing in intimate areas are removed and recorded will not be assessed as this is a breach of guidance. Examiners are advised to discontinue assessment if this occurs, so it is important to pay attention to these aspects of the consultation before submission. 

Key Areas of testing

The RCA focuses on testing the same areas as the CSA. The aim is to test the ability of a doctor 🏨  to collect information and apply understanding of disease processes in a primary care context and person centered care to make evidence based decisions. Specifically the following: 

Your clinical Knowledge 

✍ Clinical examination 

✍ Data collection 

✍ Interpretation of findings to come to a diagnosis 

✍ Decision making principles and applying evidence based approach 

✍ Structured approach to clinical management 🏨 

✍ Clinical care to a range of patients of all backgrounds and ages 

How you relate to others: 

✍ Treating others with respect and compassion 

✍ Behaviours expected of a good doctor 🏨

✍ Establishing a good rapport with patients, carers and families and maintaining the relationship 

Long term and complex care 

✍ Managing patients with long term conditions 

✍ Effective management of care for patients with complex needs 

✍ Managing concurrent health issues in a patient 

Caring for the whole person and the wider community 

✍ Understanding your role in the health service and supporting people through individual experiences 

✍ Having a holistic mindset of a generalist medical practitioner  

What kind of cases should you submit❓

Candidates are advised to demonstrate their skills across a breadth of general practice 🏨 by including a wide range of different consultations with no more than two cases from one curriculum area.

It is also encouraged to aim for new patient contact rather than follow up patients as candidates have room to demonstrate competency in consultation skills 🏨 (even in the case of triaged patients, it is best to check with the patient if the triage process and outcomes align with the patients current needs).

Candidates should also avoid low challenge cases as they do not allow the opportunity to demonstrate consultation skills 🏨 to its full extent and risk examiners not being able to find evidence to meet the required performance criteria. 

When and where can you take the RCA❓

The RCA should be taken during the ST3 year or beyond of training and the recordings should be made during this time. The dates of application can be found on the MRCGP exam applications under the RCA section.  

Preparatory Media 

I-medics offer various preparatory materials that are tailored to suit each individuals needs. Below are currently available on the I-medics website: 

Gold Standard CSA/RCA Consultation Videos: 170+ videos of perfect GOLD standard consultations with CSA actors for the MRCGP CSA/RCA Exam. These videos teach you how to tackle any case/topic/issue in the CSA/RCA, with a proven step-by-step formula. There are over 20 hours of high quality CSA/RCA revision. Minute by minute CSA/RCA video consultation breakdown, of a passed CSA candidate. In the video, all the high scoring techniques, tips, methods and systems are explained. Full examiners mark sheets and practice cases also included:

https://i-medics.co.uk/MRCGPCSAvideos 

How to Pass the MRCGP CSA/RCA exam course: 4.5 hours of CSA/RCA exam tips and techniques. Learn everything you need to know to Pass the RCA/CSA exam 1st time using our online video course:

https://i-medics.co.uk/MRCGPCSAcourse 

Podcast Library: 350+ UK 🌍 NICE CKS guideline summary using the latest UK 🌍 medical guidelines useful for revision for the following exams: RCA/CSA. 

https://i-medics.co.uk/podcasts

FREE Revision Flash Cards: Library pack of high yield gloss flash cards with must know daily information for GP trainees.

https://i-medics.co.uk/flashcards

59 CSA Cases & Mark Sheets: Doctors information sheet, actors script, full MRCGP mark scheme with scoring system explained. Breakdown of 3 key MRCGP RCA/CSA domains with a broad range of realistic cases from RCGP curriculum:

https://i-medics.co.uk/CSAcases

MRCGP CSA/RCA A1 Poster: All the vital information for the MRCGP CSA exam that you need to know in an easy to digest A1 Poster format. 

https://i-medics.co.uk/CSAposter

CSA/RCA Mocks (One to One): Online ? Practice:  Intensive Zoom/Skype CSA mock for GP trainees who want to maximise their chances of passing the RCA/CSA exam. Candidates will get to practice high yield CSA cases with UK 🌍 RCGP registered doctor. 2 hour ⏱ (6 cases) with immediate feedback at the end of each case. 3 hours ⏱ (10 cases) with immediate feedback at the end of each case. You will get a personalised breakdown assessment: data gathering, management and communication skills. Flexible Times/Dates of your choice with Monday-Sunday ⏱ availability. 

https://i-medics.co.uk/CSAskypecoaching

How is the RCA marked❓ 

Each of the recorded consultations 🏨 will be viewed by at least one examiner who will assess and give marks based on three domains; data gathering, clinical management and interpersonal skills. They will grade it based on a clear pass/ pass ✅ or clear fail/ fail ❌. The timing will not include any time for requesting consent from the patient but will include time taken to perform the examinations. 

Results 

Results of the examination will be published in your ePortfolio along with any formative feedback

Summary

As with any assessment test, an early start with effective preparation and planning is key. It is also important to note a few tips: 

2) Have a list of the curriculum areas so you can check which ones you have recorded and which ones need to be done. 

3) Try to record all your sessions, they may not all be ready for submission but will help you notice areas where improvement is needed. 

4) Review your recordings with your trainer and look out for weaknesses in interpersonal skills. 

5) Practice with fellow colleagues to review each others recordings. 

6) Practice staying within ten minutes ⏱.