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College launches new clinical exam – the Simulated Consultation Assessment

Published on 27 April 2023

Deep End Developing

The College is delighted to have received approval from the General Medical Council for our new clinical exam - the Simulated Consultation Assessment (SCA) - to replace the Remote Consultation Assessment (RCA) that was introduced as a temporary measure during the COVID-19 pandemic. The first SCA sittings are expected to be in November 2023, subject to the success of a technical pilot this summer.

The SCA is designed to be reflective of ‘real life’ general practice, more convenient for candidates and their trainers, more sustainable and more accessible for GP trainees who rely on adjustments to their work environment. This will significantly reduce the inconvenience and cost for candidates while also reducing the examination's carbon footprint by 4.5 times.

Candidates will complete the SCA in a local GP surgery via an online platform. The majority of consultations will be via video, and the rest will be audio.  In most cases trainees will carry out the exam in their own surgery and the College is working to ensure as many accredited training practices can meet the necessary IT requirements.

Most SCA consultations will be with simulated patients, and in some instances role players may portray a patient’s carer, parent, or other health or social care workers to reflect the various situations a GP may be presented with in everyday practice.

Prof Rich Withnall

The examination itself will consist of twelve simulated consultations each lasting twelve minutes, with an additional three minutes of reading and preparation time between each case. Consultations will examine a GP trainee’s ability to integrate and apply clinical, professional and communication skills. Physical examinations of patients will now be assessed through the Workplace Based Assessment (WPBA).

The SCA will be delivered at least nine months of the year, with trainees receiving their results within a month of the examination. A new examination reservation process is being developed so that candidates are able to plan their examinations up to 12 months in advance.

RCGP Chief Examiner Professor Rich Withnall said: "The SCA is the end product of listening to a huge amount of feedback. It has been developed in close consultation with a wide range of stakeholders across the four UK nations,  including trainees, recently qualified GPs, trainers and examiners. Equality, Diversity and Inclusivity experts have also been involved, along with leading psychometric and assessment specialists.

"It covers the breadth of the RCGP curriculum and will help to maintain the highest standards of clinical practice. Trainees will be able to prepare through everyday consulting."

Dr Margaret Ikpoh

RCGP Vice Chair for Professional Development Dr Margaret Ikpoh said: "It’s important that specialty GP training evolves to reflect both changes in healthcare and society. The SCA takes into consideration the diverse needs of GP trainees, including accessibility for candidates with a disability. At the same time, it prepares GP trainees for the challenges of modern general practice, including delivering high quality complex care in growing areas of need, such as mental health, and optimising the use of new technology in primary care.

"The development of the SCA has required a huge amount of time and effort from teams right across the College and I would like to thank everyone involved. We are confident that we will deliver a truly excellent examination from November."

The College is publishing a range of resources to help trainees prepare, along with information on how and when to apply and SCA policies and procedures, on its SCA webpages.

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From September, the SCA will be the only assessment available for first-attempt candidates. Retakes of the RCA will be still be possible in September 2023, or candidates can attempt the SCA instead.