GP Registrars working to become newly qualified GPs in 2019 and 2020 will be working towards or perhaps already sitting their MRCGP examinations.
As a quick reminder we're sharing the RCGP's exam deadlines and we'd also, whilst on the subject of exams, like to share our confidence boosting tips when working towards the CSA element of the examinations.
2019/20 Applied Knowledge Test Exam Dates as set by the RCGP
2019/20 Clinical Skills Assessment Exam Dates as set by the RCGP
The Clinical Skills Assessment of the MRCGP examinations is considered by some GPs as the most nerve wracking and hardest to study for element of the examinations.
The examination assesses
- communication skills
- clinical knowledge
and the ability to apply these appropriately to general practice.
"When talking to candidates who have passed their MRCGP it’s always the CSA element that they reflect most on," comments Jason Dunn, GP BDM at Prospect Health.
‘Being put in ‘real-life’ situations and knowing you’re being assessed is a totally different scenario to sitting and getting your head down to pass a written exam… your every move is monitored, from making eye contact with your patient to correctly completing a prescription… it’s tough and you need to plan for it.”
We hope that by sharing our knowledge we will give you the confidence to approach the examination positively and view it as simply the last hurdle before life as a fully qualified GP begins…
- Understand what you will be asked to do in the exam
You will be faced with a number of cases, a couple of which will involve children and some will test your prescribing knowledge. Expect to be given a couple of minutes to review the cases before the consultations and know that the examiner will be present with the patient.
The examiner will be assessing 3 areas:
- data gathering
- clinical management
- interpersonal skills
- Prepare in advance and with others
Be prepared to start studying ideally 9 months before the exam, there is no telling the scenarios you’ll be presented with so the more time you have to practice the better.
Bring together a study group and take it in turns to play the role of patient, doctor and examiner so that you can get used to being observed … be imaginative and play out different types of patients/cases – young or old etc.
Seek opportunities to get feedback where and when you can. This can come from your trainer or other GPs in your surgery. Video yourself and watch particularly for your body language and non-verbal cues from the patient.
- Learn from others
You don’t always have to be the one being watched… you can sit in with more senior GPs or advanced nurse practitioners at your surgery, this is particularly useful if they run specialist clinics.
You can observe how they describe particular conditions or demonstrate using specific remedies such as inhalers for asthmatic patients. Mimicking how your colleagues perform isn’t the goal here but taking their expertise and adapting it to your own style will give you confidence.
- Practice being professional
Some cases can cause your patient embarrassment, upset and distress. You have to be prepared for whatever may walk through your door and you have to be able to talk to your patient in a knowledgeable, compassionate and most of all professional manner. If there are topics that are unfamiliar to you or areas of conversation that you feel awkward discussing practice and research them. You have a responsibility to your patients to be able to support them with whatever they may be facing so make sure you have the skills and knowledge to approach these subjects with tact and diplomacy.
The examination demands that you use 2 minutes to read your case notes and 10 minutes to consult. Ten minutes can feel like 30 seconds or a lifetime depending on what you’re faced with but either way your pass mark will reflect your ability to keep to the time allocated. Three months before the exam try and get in the habit of working to the structure of the exam.
If you’re given longer time slots at your surgery use the minutes afterwards to write up your notes. In the exam many of the elements which take up time in ‘real life’ are eliminated (typing up/referrals/investigation) so use the 10 minutes in your ‘real life’ consultations and the extra time for your admin.
- Be specific
This applies to all areas of your consultation. When data gathering ask specific questions about your patient’s condition and history, don’t be vague… show the examiner you understand the condition and you know exactly what you need to determine the necessary next steps. This will also give you time to make a diagnosis and discuss clearly and specifically the next course of action… don’t use phrases such as ‘urgent’ give specific time frames, ’24 hours’ or ‘two weeks’ – a big difference between the two but either could be considered ‘urgent’.
Always be prepared to examine. Examination is only required in two or three stations (usually MSK/ENT/cranial nerves) but be prepared to examine the patient as normal and the examiner will give you the results. If you don’t state that you are going to examine the patient the examiner won’t give you the results.
You can get through any scenario if you follow a clear structure. Having a structure will also give you confidence and help you offer a patient-centred service.
The BradfordVTS website has a good list of books to help with this and is a comprehensive resource for guidance for the CSA exam.
- Keep going
Just like in your day-to-day practice don’t let one bad case ricochet and affect your work on the next. Take your time in those two minutes before meeting your next patient to re-group, catch your breath and do the best job for the next person to walk through the door. Remember if you don’t completely finish a scenario you can still pass, get through as much as you can as you can still score well even if you don’t finish.
Here at Prospect Health we’re always on hand to discuss your career aspirations and what opportunities could be out there for you, regardless of your experience.
We work with GPs at every stage of their career and you can be safe in the knowledge that you can talk to us in confidence.
If you feel ready to start discussing a possible move and would like to look at some options please call our GP team on 01423 813 454 or email firstname.lastname@example.org