Top 10 tips for the Simulated Consultation Assessment (SCA)

Exams can be daunting and preparing for them stressful, to say the least! Passing the November 2023 RCGP Simulated Consultation Assessment (SCA), in the first ever diet of it being run, doesn’t make me an expert. But this is an attempt to provide future candidates with a snapshot into the lived experience of someone who prepared for this exam, sat it and came out happy at the other end, with some tips to share.

As with anything in life, preparation is key - ‘Plan your success to ensure success of your plan’. So here are my 10 to win for the SCA:

1. Is this the right time?

Plan the exam when other major life events are not on the horizon. Make sure you discuss plans with your supervisors to get a perspective on how exam-ready you might be, or how soon you might get there.

2. Secure your slot

Make sure you reserve your slot well in advance. Then you can then forget about this step and focus on preparing as the exam nears. Read the key policies and regulations in advance; if something goes wrong, you need to know what to do. 

Reasonable adjustments need to be applied for in advance and you should understand scenarios for appeals and mitigating circumstances. This could be the difference between passing and failing for some.

3. Practice, practice and practice

Practice in the surgery. Practice in front of the mirror - speak loudly so you can hear yourself. Practice with lay friends. 

Not all courses out there are useful, so be careful what you sign up to. The RCGP website highlights available courses you can explore. 

Video yourself during daily consults so that you can see yourself talk, and dissect the videos with your trainers during tutorials. Be open to change and take all the feedback you can get to improve. Defensive thoughts make it trickier to take on feedback, so deep-dive into your thoughts as you receive feedback. This might be even more applicable if you are an International Medical Graduate (IMG) like me, as we don’t have as much OSCE practice as UK medical graduates.

4. Make changes to consultations slowly

Don’t change it all in one go. Try one new phrase in every other consult for a few days, so you are not thinking too much about it or your consultation style. In all consultations think of red flags, ICE, differentials, explaining conditions in a couple of sentences, safety netting and follow-up plans. Think wide and holistically. Think work, driving, fit notes, duty of candour, etc. If needed, hold a template in your mind that works and which can be adapted to the various consults.

5. Timer for timing

Set a timer (a kitchen timer works well) when you start your consults in surgery and attempt to close consults in 12 minutes. Consults that don’t flow take longer to complete. Although there is no set consultation structure used to assess you in the exam, it is worth practicing using a model that you find easy to navigate through. Complete your consults to your satisfaction within the time available.

6. Remember to recharge and reset

Some days of exam practice are worse than the others (just like real life consults). Remember that your strengths will always hold, so take a break from practice, reset and start trying again.

7. Use the month before the exam to prepare the team

Be aware of the exam dates and the dates for the booking window. Plan leave or exam study leave with your rota coordinator, and ensure the staff know what to expect on the day.

Book your exam room in the surgery and discuss a backup plan for any unexpected room or technology problems. Ideally pick a quiet place in the practice with reliably good internet connection.

8. Use the days before the exam to sort out the specifics

Keep an eye on your email inbox for the virtual connection check instructions, which come in approximately four weeks before the exam. Then, onboard with the RCGP exam link using the same kit as you intend to use on the day. The RCGP is not responsible if you turn up with insufficient computer specifications and you may not get your fee back!

Approximately two weeks before your exam, expect an email with your exam login details, to have at hand for your exam day.

Plan your clothes for the day. Scrubs are absolutely fine. 

Prepare the note you wish to stick on the door of your room (such as “Exam in progress. Please contact [name] if urgent”) on the date of your exam. Make staff are aware that you are not to be disturbed on that day. 

Prepare the room in line with exam specifications laid out. Some might do this on the day of the exam, so give yourself plenty of time for this on the day if needed. 

Ensure you read the exam day guide as it provides important information, including what to do if there is a rerun.

9. Prepare yourself – the exam day can seem long!

Food and drink are allowed into the room, depending on your practice policy, so have some handy. Then, prepare to wait... and wait. The time between you joining the link and the first patient scenario can seem like the longest ever, but the exam moves quick when you are in the thick of it. 

Remember that the SCA is a simulated assessment and is not a like-for-like replication of GP practice. So just go along with the case, read the notes carefully, and listen to the story. Do not be too risk averse.

The cases are structured so you can usually complete the consultations without need for examination findings. If an examination is necessary, remember to discuss what post-examination plans might look like. 

The role players are trained actors, however, don’t over-focus on their actions or behaviours. 

Most importantly, do not fear re-runs. These are commonplace in OSCEs. The invigilator will let you know if you need one (most don’t need any). Use the opportunity to be better prepared for that case if a rerun is needed. 

If something isn’t right, contact the invigilator.

10. Patience is a virtue

If you have just been through all the above, then give yourself a pat on the back. Remember to apologise to all the people you have been snappy to during your stressed phase. 

Now relax, unwind and wait for your College to upload your results. You've got this!

More information

Check out more resources to prepare for the SCA.