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RCGP outlines details of new trainee assessment replacing the CSA

The RCGP has confirmed details of how the replacement to the CSA exam will be implemented.

The RCA (Recorded Consultation Assessment) will take place in lieu of the CSA, to accommodate the impracticalities posed by coronavirus (Covid-19).

After a period of trainees and trainers alike seeking clarity, the RCGP has announced that candidates can complete their assessment via any combination of phone consultations, video calls and face-to-face interactions.

They are able to use their own smart devices to capture consultations, and marks will be given in three domains - data gathering, clinical management and interpersonal skills.

Those who fail the RCA before 30 September will be granted another go, in addition to the four attempts that are normally permitted. This is in acknowledgement of the ‘disruption’ to training in recent months, that ‘may impact’ performance during this season.

The first session of the RCA will only be available to trainees to due to obtain their Certificate of Completion of Training on or before 30 September. Their prioritisation will be coordinated by local deanery and LETB GP education teams.

Trainees were notified of a recorded assessment replacing the CSA on 6 May, but the College has stressed that some details remain pending.

In a letter to colleagues, Dr Michael Mulholland, vice chair (professional development) of the RCGP, said: ‘We are now in a position to begin to share details of the Recorded Consultation Assessment (RCA), which will be offered in place of the CSA during the period of disruption caused by Covid-19.

‘The RCA is a summative assessment of a doctor’s ability to integrate and apply clinical, professional, communication and practical skills appropriate for general practice. It will require candidates to submit 13 recorded consultations, which may be any combination of audio, video or face-to-face encounters.

‘These consultations will be recorded directly onto, or submitted onto a single central digital platform - this is currently being developed by FourteenFish following a competitive tendering process.'

Dr Mulholland said that the RCA 'will be undertaken by candidates in their current working environment, which may include home working'.

He said this 'will provide an objective assessment of their real-life practice, recognising that this will have changed significantly in recent months'.

He added: ‘The RCA has been designed to test the same competencies and curriculum areas as the CSA and will be assessed at the same standard. As you will be aware, there are strict legal regulations in place around the standards necessary to allow entry onto the GP register.

'The college and RCA Core Group has therefore worked with the GMC to ensure that the RCA displays the necessary reliability and validity to be approved as the equivalent to the CSA.’

Dr Anthony James, chair of the RCGP's AiT community, told Pulse: ‘It’s only natural that a new assessment will trigger some anxiety amongst trainees, particularly given the time pressure many are under to submit recordings.

‘I hope my fellow trainees are reassured that the RCA has been designed to test the same skills as the CSA and aims to provide a fair judgement of how they currently practice, recognising that this will have changed considerably in recent months.

‘The decision to not hold any unsuccessful single attempt at either the RCA or AKT until 30 September against a trainee's overall number of exam attempts is very fair and I know will be welcomed by all trainees currently trying to prepare for these assessments. It has been great to see the college and others move so quickly to develop this assessment; a process that would normally take months to years has been achieved in weeks.

‘This degree of agility is not something that the college has traditionally had a reputation for, but this is clearly changing and represents the strength of the teams uniting on this.’

Dr Janet Rutherford, head of GP school at Health Education England, also urged those who are unable to consult with patients in a way that would help to prepare for the RCA to discuss this now with their educational supervisor.

A reduced capacity Applied Knowledge Test (AKT) is due to take place on 15 July, for up to 450 candidates at approximately 50 test centres throughout the UK. A further AKT is now scheduled for 19 August.

Pressure had been mounting on the RCGP to deliver clarity to the 1,500 trainees affected, but Dr James welcomed the original announcement earlier this month as hopefully ‘helpful’ for them.

Readers' comments (16)


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  • I think I read the costs are going to be the same to the trainees...if true that would be completely unjustified. Would PULSE be able to clarify this point?

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  • Hancocks told them to pass them all and get them in pre-influenza. If they're not already disillusioned.

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  • Wasnt this the previous way of doing it? I remember being fleeced nearly £2K for the CSA. Still leaves a bitter taste in my mouth. No idea why it had to be done in Central London. Really the BMA should demand a breakdown of costs and value of money for trainees.

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  • How come the cost is same as CSA? They don’t have to pay actors, trainees will be searching for the the‘right’ patients who can help them complete each recording in 10 minutes!

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  • If the cost is the same it only confirms what everyone has known for a long time,these and other exams (eg PLAB)are just there to spin revenue for these organisations-they give a toss for training, standards and trainee wellbeing.

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  • Those were the days John. The new doctors these days are worse in many ways pandering to the pen pushers.

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  • We certainly live in interesting times

    Presumably,this could be marked by Alexa,if so,one imagines she could also produce the consultation,using two different voices.

    Certainly local trainers should be able to vet any recordings prior to submission,raising the question as to who has failed and their motives for doing so.

    As JG Munro points out things used to be somewhat different,though
    there is a paucity of evidence they were worse.

    Where is the evidence that scores in these assessments correlate with;

    actually being a GP 10 yrs later

    not having a nervous breakdown

    not killing people

    not being struck off

    Amazingly,should a serious error arise,the college holds no liability,despite being the validating body.

    The NHS is one of the worst kind of institutions in that it begets institutions,and the RCGP is one of it's worst creations

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  • If these stressed young people still want to be GPs after the s**tshow of the last 3 months, they should be waived through and given an honorary membership without any more gaffing about. If retired and burned out GPs can be brought back to triage patients before passing them to me to triage them again, then these worthy padawan should welcomed.

    I know plenty of college members who are complete buffoons, particularly the ones that graduate into sitting on CCG boards. And conversely lots of great GPs who never joined the club

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  • Wouldn't give the RCGP the steam off my weewee let alone any £££.

    Self-important, self-indulgent, self-deluding twatocrats.

    Otherwise great idea and implementation chaps - tally ho.

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