Hello! If you are considering applying for GP training then this blog is for you! For our ultimate and most comprehensive All-in-One MSRA Gold Pass Package for GP Entry, click here. To watch back our last MSRA ‘2 week check webinar’ from August 2021 click here: https://youtu.be/5dDjJBpFsGc. To join our National GP Training Support group for daily GP Entry …
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!
To register for our next Free RCA Booster webinar on 7th December 2021, click here.
To watch back our latest RCA Booster webinar from 8th September 2021 click here.
What is covered in this blog:
– What is the RCA?
– How do I take it?
– RCGP RCA Dates
– Which cases should I submit for RCA?
– Gaining Consent for RCA
– How is the RCA marked?
– When do I get results?
– How we can help you pass
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 2022 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.
Upcoming RCA Dates
September 2021 RCA
Apply: 17th-31st August 2021
Submissions by: 30th September 2021
Results: 28th October 2021
November 2021 RCA
Apply: 12th-25th October 2021
Submissions by: 22nd November 2021
Results: 16th December 2021
January 2022 RCA
Apply: 14th December 2021-5th January 2022
Submissions by: 24th January 2022
Results: 24th February 2022
March 2022 RCA
Apply: 25th January-8th February 2022
Submissions by: 21st March 2022
Results: 28th April 2022
April 2022 RCA
Apply: 11th-28th March 2022
Submissions by: 21st April 2022
Results: 9th June 2022
Which cases should I submit?
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.
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?
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 flagship 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?
1) 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-90 Online course, 2 Audiobook courses, Case Bank, Clinical Flash cards, Medical ‘How to Explain’ Flash cards and RCA/CSA Poster) are included in this mega discounted bundle. Designed to use over a 3-12 month preparation plan, it covers every aspect of RCA preparation – balancing both scoring high marks and day-to-day consultation needs, in as many as 5 different teaching styles to suit each type of learning. Click here for full details and samples.
2) Our RCA-90 Online Course. 90 RCA-type consultations broken down in an intense 6+ hour online training course. I break down the most common presentations, situations and scenarios in terms of data gathering, interpersonal and management. Includes key red flags, up-to-date guidelines, relevant psychosocial links as well as options for shared management. Watch-back, pause and rewind as many times as you like throughout a 1, 3, 6 or 12 month subscription option. Full details of coverage here.
3) Our RCA On-the-Go Audiobook Course. 5 hours of pure audio teaching, breaking down 100 core scenarios, focusing on all 3 key elements – data gathering, interpersonal and clinical management – including all key red flags and guidelines. Designed to download to your phone or tablet, to listen to online or offline, with no expiry. Increase your efficiency whilst listening and preparing whilst commuting or out and about. All future updated versions come free. Listen to a free sample here.
4) Our Medical ‘How to Explain’ Audiobook Course. 220+ medical conditions, diagnoses, tests and treatments explained in there most simple terms, ideal to use in your RCA consults. Improve the quality of your cases by breaking down your explanations into patient-friendly language. Also designed to download to your phone or tablet, to listen to online or offline, with no expiry. Increase your efficiency whilst listening and preparing whilst commuting or out and about. All future updated versions come free. Listen to a free sample here.
5) Our Clinical Guideline Flash Cards. 150 simple, beautifully crafted quick reference cards containing core clinical information useful for use during clinics. Core guidelines, investigations and approach to management, ideal to help maximise your management plans. Click here for samples.
6) Our Medical Explanation Flash Cards. 150 simple, beautifully crafted quick reference cards containing simple explanations of conditions for use during clinics. Increase the efficiency of your RCA consultations by going straight to the point in your explanations, in a patient-friendly manner. Click here for samples.
7) #aroraDaily emails – our free daily evening revision emails including a quick clinical scenario and a short video teaching tutorial – designed to make preparation more efficient and ticking over everyday: http://eepurl.com/duAwXr
8) Free teaching on Social Media. We have 400+ RCA-type teaching videos on our YouTube channel, carry out lots of teaching via our main GP Training Facebook Support group and also teach daily through image on Instagram (@dr_aman_arora) and on Twitter (@aman999arora).
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 🙂
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 *
Dr Aman’s free revision video direct to your inbox every evening!
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