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Wear a watch, bring the BNF and eat porridge for breakfast: top tips on passing the CSA

In the final part of her series on how to pass the nMRCGP, Dr Una Coales gives some handy hints to ensure the day of the CSA goes smoothly.

In the final part of her series on how to pass the nMRCGP, Dr Una Coales gives some handy hints to ensure the day of the CSA goes smoothly.

Here I focus on practical CSA tips to round off the series.

• If you choose to stay at a hotel near the exam centre, be aware that the examiners stay at the Croydon Park Hotel. So when you come down for your breakfast, you may be in close proximity of the examiners themselves! It is a delightful hotel with an indoor swimming pool, so bring along your spouse and make a family day of your exam to ease pressures.

• Pack all your equipment and copy of your British National Formulary the night before. Have your CSA bag ready to go. The list of equipment required is on the RCGP website. You would be amazed that some doctors have forgotten their BNF or stethoscope in a panic to get to Croydon. Do not invest in a fancy doctor's bag as you will be supplied a clear plastic bag to carry your belongings on the day and a locker for item storage.

• Eat porridge for breakfast. No food or drink is allowed in the rooms and it has a low glycaemic index and allows you to sustain energy levels over a long period. Each room is supplied with a bottle of sparkling water. If you have diabetes, please inform the invigilator.

• Bring a book. When you arrive, you may be waiting up to an hour in a cordoned room with other candidates, while the actors are being briefed and examiners are preparing. You are permitted to bring reading material for the waiting room.

• Set up quickly. You will be allocated a room on one of the three examining floors. The examiner and actor walk from room to room as a pair. So when you enter your assigned room, quickly empty out your equipment and set up the room, as the bell goes off seconds later!

• Be flexible. The cases differ from day to day and week to week. If you are re-sitting the exam and come across a case that sounds familiar, note that there are often different permutations of the same case. You may be assessed on a completely different focus or angle than before.

• Bring a watch. The clock in the room may not be clearly visible, so here is some practical advice to help you keep to time. Bring a digital wrist watch, remove and place it in front of you. Make a note of what time the bell goes to signal commencement of the role-play and add eight minutes. Yes, I say eight minutes instead of 10, as the CSA is assessing whether you are ready for partnership, to be released into the world as a future practitioner and not as a GP registrar sitting CSA. In real-life, we are required to type up a medico-legal report after seeing the patient within your 10-minute consultation and complete a physical examination.

• Note: If you do not complete in time and the bell goes, the actor will ‘morph' into a zombie. He will stand up, turn his back on you and exit the room in silence. It is a very spooky experience, as real patients offer their ‘thank yous' and ‘goodbyes' before exiting the room. This is another reason to try your best to complete your consultations on time.

• If an actor tells you ‘that is not required for this station', stop examining him! It means the station is not testing your examination skills, but rather another domain.

• If a case requires a chaperone, ask for a chaperone or you will fail. If the examiner does not step forward as a chaperone, follow the GMC guidance on chaperones and assess without a chaperone, only in an emergency situation (e.g. fear of cancer, suspected testicular torsion)

• Control your body language. Some rooms are equipped with video camera recording. So during your two minute interval between cases, please remember you are still being observed… no funny faces, burying your head in your arms etc. The advantage of being allocated such a room is that if there is any impropriety, you may inform the invigilator on the day with hard evidence. Be aware that tapes are erased after two to three days, so best to lodge your complaint on the day and not weeks after.

• Avoid tea and coffee. When you require the loo, you will be accompanied by a ‘warden'. In fact avoid all stimulants, as the exam itself is giving you more than enough of an adrenaline rush and you need to keep calm throughout the day, to perform at your optimum.

This is the last of 10 articles to help GP specialist trainees facing their nMRCGP exams. I would like to thank Pulse for accepting my articles for publication. The complete series of CSA tips is also covered in the first 15 minutes of my CSA revision course.

Dr Una Coales

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