MRCGP

The Membership of the Royal College of General Practitioners (MRCGP) exam is a key assessment for doctors aiming to pursue a career in general practice in the United Kingdom. It is divided into three parts: the Applied Knowledge Test (AKT), the Clinical Skills Assessment (CSA), and the Work-based Assessment (WPBA). Let's break down each part in detail:

Applied Knowledge Test (AKT)

The Applied Knowledge Test (AKT) is a computer-based exam that evaluates candidates’ knowledge and understanding in general practice. The AKT is designed to assess clinical medicine, evidence-based practice, administrative topics, and health informatics within primary care settings. The exam reflects the Royal College of General Practitioners (RCGP) curriculum, covering areas such as diagnosis, investigation, management, and holistic patient care.

Currently AKT Exam consists of 200 multiple-choice questions, with duration of 3 hours and 10 minutes, but from October 2025, there will be following changes.

Key Changes from October 2025:

• The number of questions has been reduced from 200 to 160.
• The exam duration has been shortened from 190 minutes to 160 minutes.
• Despite these changes, the core curriculum coverage remains unchanged:
• • Clinical Knowledge: 80%
  • Evidence-Based Practice: 10%
  • Primary Care Organisation and Management: 10%

The Simulated Consultation Assessment (SCA)

It is crucial component of the MRCGP (Membership of the Royal College of General Practitioners) examination. It evaluates a candidate's ability to integrate clinical knowledge, communication skills and professionalism in the context of patient consultations which are fundamental aspects of general practice. Let's explore the SCA in detail.

Purpose

The SCA aims to assess a candidate's competence in conducting effective patient consultations in a simulated primary care environment. It evaluates the candidate's clinical reasoning, history-taking skills, physical examination abilities, diagnosis formulation, treatment planning and patient management.Communication skills, empathy, rapport-building, shared decision-making and cultural sensitivity are also assessed. The assessment reflects the core competencies and values required for safe, patient-centered, and evidence-based practice in general practice.

• To provide a standardised examination which didn't require trainees to collect cases from within your surgeries
• To reduce the time taken in preparing for your examinations
• To have cases which reflected the prevalence of conditions seen in the UK
• To have cases which reflected the type of work done in UK general practice
• To champion accessibility, convenience, time saving, cost saving and sustainability
• To have more opportunities to sit within the year

Format

During the Simulated Consultation Assessment (SCA), candidates will engage in twelve consultations with professional role-players, each lasting twelve minutes. These cases are meticulously crafted to mirror real-life scenarios encountered in general practice settings. Our role-players are extensively trained, calibrated and standardized to ensure consistency and authenticity across all interactions. While the case material remains consistent for all candidates, it dynamically responds to each individual's approach, simulating the variability seen in actual patient encounters. Additionally, the cases have undergone rigorous review by linguists and experts in equality, diversity and inclusion (EDI) to eliminate potential biases, particularly for candidates whose first language may not be English.

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The cases may involve patients, their caregivers, parents, or other healthcare and social care professionals. While most consultations will involve face-to-face interaction, some may be conducted via audio only. There will be a brief three-minute interval between each case to allow for reflection and preparation.

It's important to note that GP consultations in the UK are diverse and multifaceted, lacking a singular model or script to follow. The SCA acknowledges this complexity and aims to assess candidates' transferable capabilities from their workplace consultations in a simulated environment. Transparency is maintained through clearly defined assessment criteria, marking domains, and feedback statements provided in the marking and results section.
Please be aware that physical examinations will not be assessed during the SCA; these skills will be evaluated separately within the Work-based Assessment (WPBA).
rainees will undertake the Simulated Consultation Assessment (SCA) in a local GP surgery using an online IT platform. In many instances, this will be conducted at their own accredited training practice. We are collaborating with deaneries and practices to ensure that sufficient IT infrastructure is in place to meet the examination's requirements.
The entire examination process will be remotely recorded and later reviewed and evaluated by examiners. Each of the twelve cases will be independently assessed by a different examiner. This ensures a fair and impartial evaluation of each candidate's performance.

Assessment Criteria

The candidate's performance in each consultation is assessed based on predefined criteria aligned with the RCGP (Royal College of General Practitioners) competency framework.
Criteria may include history-taking skills, clinical examination techniques, diagnostic reasoning, management planning, communication effectiveness, empathy, professionalism and patient safety.
Assessors use rating scales or checklists to score the candidate's performance, considering both clinical and non-clinical aspects of the consultation.
Feedback is provided to candidates after each consultation, highlighting strengths and areas for improvement.

Scoring and Feedback

• Scores from multiple consultations are aggregated to provide an overall assessment of the candidate's consultation skills
• Performance is typically benchmarked against established standards or compared to the performance of other candidates
• Feedback sessions allow candidates to reflect on their performance, receive constructive criticism, and identify areas for further development
• Feedback is an essential part of the learning process, helping candidates enhance their clinical and communication skills and prepare for independent practice as general practitioners

Work-based Assessment (WPBA)

The WPBA is an ongoing assessment conducted throughout the general practice training program to evaluate the candidate's progress and competence in various clinical and non-clinical domains.
It includes several components:

Clinical Supervision: Regular meetings with a designated clinical supervisor to review cases, discuss learning objectives, and receive feedback.
Case-Based Discussion (CBD): Structured discussions with the clinical supervisor about specific cases encountered in practice, focusing on clinical decision-making, management plans, and reflection.
Clinical Examination and Procedural Skills (CEPS): Direct observation and assessment of the candidate's clinical skills during patient encounters, including physical examinations, procedures (e.g., suturing, joint injections), and clinical reasoning.
Patient Satisfaction Questionnaires: Feedback from patients regarding their experience of care provided by the candidate.
Multi-Source Feedback (MSF): Feedback from colleagues, peers, and other healthcare professionals on the candidate's clinical and professional performance.

The WPBA aims to ensure that candidates develop the necessary competencies and meet the standards required for independent practice as a general practitioner.
Overall, the MRCGP exam assesses the knowledge, skills, and attributes required for safe, effective, and compassionate general practice, reflecting the core values and principles of primary care in the UK.

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