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Jokes aside, the CSA is truly painful

With regard to Dr Copperfield's entertaining rant, the clinical skills assessment is a component of the MRCGP.

Each component tests a different attribute not tested elsewhere – in this case communication skills – against academically validated criteria. As Dr Copperfield pointed out, it is a painful and expensive procedure.

I would question whether the LMC leaders referred to in the same edition have ever seen a CSA consultation. I would suggest to Dr Copperfield that this is a more worrying issue than those he lists.

Consider a trainee surgeon demonstrating his technical skill to 1) open a patient, 2) remove appendix, 3) close patients, with each attribute demonstrated independently, on different patients, all of whom die because the surgeon does not bother with the other two attributes on each patient. The surgeon, however, passes with distinction – academically validated distinction.

LMC leaders give us sound, reasonable, technically correct guidance – but should be aware the RCGP requires the opposite.

From Dr Tom Robinson

Penarth, Wales