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5 Mistakes to Avoid when taking the MRCGP RCA Assessment

If you are preparing for MRCGP RCA (Recorded Consultation Assessment) this blog is for you!

The RCA (recorded consultation assessment) replaced the CSA exam in 2020 during the Covid-19 pandemic. The RCA asks you to submit 13 cases (including certain mandatory ones) to demonstrate your breadth of knowledge and skills appropriate for General Practice.

For our comprehensive RCA All-in-One Pass Package click here

To register for our next free RCA Booster webinar click Free RCA Webinars

To watch back our latest free RCA Booster webinar click Past RCA Webinars

For all of our short RCA consultation skills videos click here

Despite the high pass rate, some trainees unfortunately fail the RCA and below are the most common reasons from our experience. For more details on what the RCA is, read out blog here.

1. Lack of time to prepare

Many trainees inevitably want to get their exams over and done with – and so try to take the RCA as soon as possible. Submitting 13 recorded consultations with real patients however, is no simple process! It takes time to get enough recordings that a) you’re happy with and b) to display a breadth of clinical knowledge – and it also takes time to develop an appropriate consultation style. 

You need to familiarise yourself with the 3 main domains that examiners will be marking you on – Data Gathering, Interpersonal Skills and Clinical Management. Everyone eventually develops their own consultation style and it’s important you have a style that enables you to demonstrate certain skills in these three domains – for each case – to pass the RCA. Hence taking the RCA too early may mean that you either may not have developed your consultations skills enough to gain the necessary marks to pass, or recorded a breadth of cases to display your knowledge across the GP curriculum.

2. Lack of structure in your consultations

There are a huge variety of consultation models out there and sometimes it is hard to adhere to these models in real life – for example when a patient presents with multiple problems, you’re running behind or being interrupted in your consultation. However for the RCA you need to ensure that you remain calm and have a model that you loosely stick to. If your gut feeling is that a case ‘lacks structure’, do not submit as its likely that an assessor will feel the same.

A chaotic consultation makes it difficult for the examiner to see that you have the necessary skills to become an independent GP, as you may not have been able to demonstrate a controlled data gathering or management plan (whilst also likely impacting your interpersonal skills as well). 

Take your time to practice consultations with colleagues and ask your trainer to feedback on your consultation style – and don’t miss the opportunity to carefully watch back and self-critique your own recording (I know this can be cringeworthy at times!). These will all help you to improve and enhance your own consultation style. A quick video focusing on getting the structure right is here.

3. Technical issues – resulting in a poor submission

The RCA is submitted using the FourteenFish platform. It is vital that you familiarise yourself with the platform as well as the equipment that you are using for recording. Sometimes trainees submit cases which may have been high scoring consultations, but have poor sound or video quality. Whilst this can be frustrating for an assessor, it is also difficult for the examiner to truly assess your abilities if they’re not able to hear clearly or watch your non-verbal actions. The platform has a number of videos helping you avoid these errors, and it is always worth doing a few test runs with the equipment before officially starting recording for the exam.

4. Poor choice of cases

Although a trainee may have all the competencies to be a great GP, ultimately the examiners only have these 13 cases to assess your capabilities. It is therefore important that you choose a wide range of cases with appropriate difficulty. The MRCGP RCA page has a useful grid explaining the right balance of complexity to ensure that you choose the right cases. 

An example case may be an acne consultation where you initially feel you could get sufficient marks in all 3 domains. However if all you managed to do is assess the acne, ask a few questions and prescribe a topical treatment – this would likely be classed as a low challenge case. Expanding data gathering however – for example opening up about impact, confidence mood, ICE etc, you would have more issues to manage than clinical alone. Alternatively you may choose a very complex case and then try to manage it all in 12 minutes – usually running out of time and demonstrating a lack of interpersonal skills in trying to complete so much. 

Before submitting your cases it is worth sitting down with your trainer and going through the cases to get a second opinion if they too feel you have chosen the right range of complexity. For a full breakdown of cases and how to approach them, subscribe to our RCA-90 online course (also available as part of our RCA Gold Pass Package).

5. Playing to the camera

It is natural in an exam situation to be more focussed about passing the exam, rather than continuing with the day job. Sometimes in an effort to ensure that we score marks in each domain, we may expand out or exaggerate things that are not necessary eg. in clinical management, whilst safety netting we may give advice such as calling 999 – whereas in reality the consultation was about a simple nappy rash (for a really quick video on safety-netting watch here!). 

During your consultations try to provide clear explanations for examinations and advice for management that is only appropriate for that particular situation – don’t try and elaborate or ‘pad’ the case to score more (you may end up scoring less!). You are much more likely to score highly by being yourself and consulting naturally rather than playing to the camera. The confidence to leave things out will come with practice – but is an important skill to develop and demonstrate.

And finally…

There are many other common mistakes that trainees make with RCA, but as with the above 5, most will be ironed out over time as you record more and more cases. Unlike the CSA where the complexity and range of cases were decided for you, it takes some time to develop the ability to choose the cases that allow you to demonstrate appropriate skills and competencies. 

Take time to ensure that your whole practice is on board to help you find the right cases, and give yourself plenty of time to record your cases. As always if you need any extra help feel free to get in touch with us. All the best!


For our comprehensive RCA All-in-One Pass Package click here

To register for our next free RCA Booster webinar click Free RCA Webinars

To watch back our latest free RCA Booster webinar click Past RCA Webinars

For all of our short RCA consultation skills videos click here

About us

Dr Aman Arora is a GP who is now 100% committed to transforming medical education, helping doctors across the globe to ace their exams and enhance their careers. He is proud to hold FRCGP (Fellow of Royal College of General Practitioners). Previous roles include:

  • GP Training Programme Director
  • NHS GP Appraiser
  • GMC PLAB 2 Examiner
  • GP Recruitment Examiner
  • GP Recruitment Question-writer
  • HEWM IMG Board Member
  • HEWM Advanced MRCGP AKT Trainer

Dr Pooja Arora is a GP with a background in Medical Politics, passionately focusing on improving the opportunities and working conditions for junior doctors. Previous roles include:

  • Vice Chair Birmingham LMC
  • BMA Council Member
  • BMA General Practitioners Committee elected representative 
  • BMA Sessional GP Committee elected representative 
  • BMA National Deputy Policy lead for working at scale
  • HEE GP Ambassador
  • HEE GP Stage 3 Assessor
  • RCGP Midland Faculty AiT representative

* Blogs written by Dr Aman and Dr Pooja Arora are not for professional, financial or medical advice. Please seek appropriate professional, legal or financial advice where appropriate *

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