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The MRCGP RCA (Recorded Consultation Assessment): What it is and How to Pass

If you are preparing for MRCGP RCA (Recorded Consultation Assessment) this blog is for you!For our comprehensive RCA All-in-One Pass Package click here.To register for our next free RCA Booster webinar click Upcoming Free Webinars.

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What is the RCA?

The RCA is the temporary replacement for the CSA (clinical skills assessment) – one of the three components of the MRCGP qualification needed to complete GP training in the UK. It aims to test various aspects of General Practice through the form of submitted recorded consultations. Areas tested include clinical, practical, communication and professional skills related to General Practice. It is likely to continue until mid 2023 before a brand new assessment is planned to launch.

How do I take it?

It requires submission of 13 real-life consultations from within your normal working environment.

Consultations can be face-to-face, video or telephone consults and can be recorded from within a Practice or from your own home – depending on how you are currently working.

Chosen cases are submitted to a central platform created by Fourteen Fish and marked by examiners. A different examiner will examine each case.

Cases should be continuous with no breaks or edits. Only the first 12 minutes of the consultation recording (minus time for consent) will be marked.

Booking is via the RCGP website.

Watch this video for 3 mistakes to avoid when preparing for RCA. 

RCGP RCA Dates

RCA gold

November 2022 RCA
Apply: 4th-18th October 2022
Submissions by: 16th November 2022
Results: 15th December 2022

January 2023 RCA
Apply: 13th December-3rd January 2023
Submissions by: 24th January 2023
Results: 23rd February 2023

Which cases should I submit for RCA?

The aim should be to submit cases demonstrating as much breadth of the curriculum as possible, with no more than two cases from a single curriculum area. It is suggested to aim for new presentations (as opposed to follow-ups), choosing cases that demonstrate the level of an ST3 GP trainee.

The RCGP have some mandatory cases:

– A case involving a Younger Person (16 years or younger)
– A case involving an Older Adult (65 years and above)
– A case including a Mental Health concern
– A long-term condition eg cancer, multi-morbidity or disability 
– A case involving an acute problem (urgent investigation or referral)
– A case involving Maternal or Reproductive Health

There are also some ‘recommended’ features including:

– Having no more than two cases in a particular topic area
– Having a variety of spread of clinical areas and complexity

Your educational supervisor will need to verify that it is all your own work prior to submission.

Gaining Consent for RCA

As per the RCGP website, it is the trainee’s responsibility to obtain consent for recording from the patient. This might be directly on the FourteenFish RCA Platform, in written form kept by the practice (paper/electronic) or verbally (on camera, the timing of which will not be counted as part of the assessed time). You would need to a) gain consent before the consultation begins, as well as b) confirm after the consultation as well.

How is the RCA marked?

Watch this video for 3 mistakes to avoid when preparing for RCA. 

The RCA tests core aspects taken from the RCGP Curriculum, specifically:

– Knowing yourself and relating to others
– Applying clinical skill and knowledge
– Managing couples and long-term care
– Caring for the whole person and wider community

Each case is marked across three domains, with each domain gaining a CLEAR PASS, PASS, FAIL or CLEAR FAIL outcome. The three domains are:

– Data gathering.
– Clinical management.
– Interpersonal skills.

All 3 are focused on heavily in our All-in-One RCA Gold Pass Package.

Data gathering assesses your ability to first gather, and then utilise data from various sources. These include relevant history taking and examination skills, as well as interpretation of results and clinical letters. Data gathering is not restricted to clinical issues – understanding the patient’s thoughts, as well as impact on their psychosocial life is also part of understanding key issues of the case. Being efficient, relevant and systematic is important as time can quickly add up – leaving enough time for management is key to using the data effectively.

> Takes a focussed history to allow for a safe assessment to take place
> Elicits and develops relevant new information
> Rules in or out serious or significant disease
> Considers and/or generates any appropriate diagnostic hypotheses
> Explores where appropriate the impact and psychosocial context of the presenting problem
> Plans, explains and where possible, performs appropriate physical/mental examinations and tests
> Appears to recognise the issues or priorities in the consultation

Clinical management assesses your ability to use the data that you have elicited, both in terms of managing the clinical problem AS WELL AS managing the situation as a whole. Clinical decision-making, managing patient expectations, health promotion and effective use of resources may feature here.

> Appears to make a safe and appropriate working diagnosis/es
> Offers appropriate and safe management options for the presenting problem
> Where possible, makes evidence-based decisions re prescribing, referral and co-ordinating care with other health care professionals
> Makes appropriate use of time and resources whilst attending to risks
> Provides realistic safety netting and follow up instructions appropriate to the nature of the consultation

Interpersonal skills run throughout the ten-minute consultation, assessing your ability to communicate effectively and with a patient-centered approach. It is not simply ‘being nice to the patient’ – adapting techniques for different situations is key – done so in a fluid, non-rehearsed way. It also focuses on areas such as ethics, equality and diversity, explanations and attitude.

> Encourages the patient’s contribution, identifying and responding to cues appropriate to the consultation
> Explores where appropriate, patient’s agenda, health beliefs & preferences
> Offers the opportunity to be involved in significant management decisions reaching a shared understanding
> When undertaken, explains and conducts examinations with sensitivity and obtains valid consent
> Provides explanations that are relevant, necessary and understandable to the patient

I have found that trainees often worry too much about the mark scheme, sometimes leading to confusion when performing. Having a basic idea of the mark breakdown is good, but focusing on a clear, efficient consultation will usually mean all areas are adequately covered.

When do I hear my results?

Your results alongside formative feedback will be available on your e-Portfolio under the RCA section.

How we can help you pass RCA?

Our most popular and comprehensive RCA package is our RCA Gold Pass Package – saving you time, money and planning. All of our RCA resources and material (RCA-145 Online course, 2 Audiobook courses, Case Bank, Data Gathering Flashcards and Medical ‘How to Explain’ Flashcards) are included in this discounted bundle. Access to all material is for 12 months allowing for a complete preparation plan. It covers every aspect of RCA preparation – balancing both scoring high marks and day-to-day consultation needs, in 4 different teaching styles to suit each type of learning. Click here for full details and samples.

Our individual RCA resources including RCA-145 Online CourseRCA Audiobook Courses and RCA digital Flashcards.

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

On a final positive note

Most trainees will get through RCA… you will get through RCA! It will however take a little planning and concerted effort.

If you start early, you’re efficient in your consultations and don’t rely on just one method of preparation, you have every chance of flying through this assessment.

Good luck and contact me for any queries that you may have 🙂

#CanPassWillPass

Dr Aman

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

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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