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An insider view of the CSA

GP registrar, Dr Satpal Shekhawat was a candidate in a pilot of the new CSA exam earlier this year. Here he shares his learning points

GP registrar, Dr Satpal Shekhawat was a candidate in a pilot of the new CSA exam earlier this year. Here he shares his learning points

When the RCGP contacted me to see if I would participate in a pilot clinical skills assessment exam I was immediately interested as I am going to sit the exam for real in February.

Once they confirmed my seat for the exam I started to gather information relevant to the exam. As the exam is still evolving, I found the RCGP's website the most helpful.

The information I received from the organisers was also very useful. They told me to bring my doctor's bag with me on the day and explained the exam would have five stations with scenarios posing clinical problems we see everyday in our surgeries.

My course organiser helped me formulate a preparation plan and also advised me to get hold of a DVD produced by the Wessex faculty. This DVD contains nine scenarios acted out by GPs and role players closely resembling the exam. The best feature of the DVD was the information booklet; it contains all the needed info for the structure and marking pattern of the exam. Each scenario is explained with the blueprint provided to candidates. The expected answers are divided into three categories:

1. Data gathering

2. Clinical management skills

3. Interpersonal skills

The DVD really made it clear to me what the examiners expected and what I needed to do to score more.

As the scenarios are marked as clear pass, clear fail or marginal pass, I could also learn what to avoid in my consultations in order to pass the stations.

Practising scenarios

I also utilized my half day VTS release to practice similar scenarios within my group [check] with one of us role playing, one of us being the examiner and me being the candidate. This helped me as I got different point of views for every single clinical dilemma's and also helped me fine tune my consultation skills.

One of my exam colleagues told me he found doing videos in the practice helpful. He used the video marking grid and discussed these videos with his trainer.

Actual exam

As you would expect I was bit nervous on the day of the exam. The venue was an education centre in a university college. After registering we were given a brief presentation orientating all of us to the structure of the exam and how the exam circuits are organised. We were all made to sign copyright agreements in order to maintain the confidentiality of the exam and scenarios.

After morning coffee we were divided in groups and taken to the room that would be our mock surgery for the day. There were folders in the rooms with blueprint information about the ‘patients' I was about to see. I was provided with basic equipment including prescriptions, sick notes, peak flow meters, sphygmomanometer and stethoscope. I also had my doctor's bag with me as a fallback option. The role players knocked on the door and entered into the rooms and after a whistle blew the examiner would come into the room.


I must say I never once felt that I was not dealing with a real patient, I was impressed with the hard work these simulators had put into their role playing.

The rooms were appropriate size, well lit and I was not distracted by any noises from outside or from my neighbouring registrar. The atmosphere was very quiet and serene making it ideal for this kind of exam. All the examiners sat in periphery of your eyesight, never made direct eye contact with you and were completely unobtrusive. This was very crucial for me to feel comfortable and get cracking with the tasks ahead. We were given coffee break at the right time and I found myself actually enjoying the experience.

At the end of the day we were all asked to give feedback in order bring any changes in the organisation of the examination; it was a very open and healthy discussion.

Dr Satpal Shekhawat is a GP registrar in Scunthorpe, Lincolnshire

A typical desk in the CSA consulting room A typical desk in the CSA consulting room How a consultation might look in one of the consulting rooms How a 'consultation' might look in one of the consulting rooms Corridor of CSA 'consulting' rooms. On the day of their exam candidates will be given a room number and corresponding locker key to lock away items that are not allowed in the 'consulting' rooms.

Corridor of CSA 'consulting' rooms A typical room in the new CSA centre A typical room in the new CSA centre

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