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How an IMG passed the RCGP Exam on his 5th attempt

RCGP Exam

Picture the weight of disappointment pressing down on your chest like a concrete block, self-doubt whispering in your ear like a relentless critic.

It was a daunting reality for Dr Salman Khattak, whose journey to becoming a fully qualified GP was anything but smooth. However, amidst the challenges and setbacks, Dr Salman emerged triumphant, turning failure into a resounding success.

The Challenges Dr Salman faced

In the face of crushing disappointment, Dr Salman confronted the RCA exam four times, with each failure chipping away at his confidence. It wasn’t a lack of knowledge or practice that hindered him but an absence of belief in himself and his ability to succeed. In this lonely struggle, he questioned his abilities, convinced that the system was rigged against him.

Watch Dr Salman’s full interview

Support System

You lose your self-belief if you don’t have the people there to support you.

Fortunately, Dr Salman could count on his family and his wife for support. They provided the encouragement he needed to keep fighting, their belief in him becoming the fuel that propelled him forward when he was ready to give up.

The Brutal Climb

The journey back to success was marked by stumbles, late-night breakdowns, and moments when doubt resurfaced. Dr Salman realised that he needed to shift his focus from just working harder to working smarter. Embracing patient-centric consultations and empathy as his guiding principles, he transformed his practice into a training ground for personal and professional growth.

Learning and Evolution

Under the watchful eyes of supportive colleagues and within an International Medical Graduates (IMG) group, Dr Salman honed his skills. The diverse approaches of his peers became invaluable lessons, each interaction and observation adding a brushstroke to his evolving portrait as a doctor.

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    Re-sitting RCGP Exam

    Dr Salman fought relentlessly for his fifth attempt. Not passing the final attempt would ruin his dream of becoming an independent GP. Being an IMG, he knew the odds were against him but he had hope. Dr Salman approached the exam with newfound confidence.

    After failing his exam four times, Dr Salman passed RCA with a score of 154, well above the pass mark. The elation was indescribable, a wave of relief washing over years of struggle. He had conquered not just the exam, but his self-doubt. He is currently working as a GP in Manchester.

    Need help to pass SCA Exam?

    Are you struggling with your SCA exam and need help, you may be interested in getting personalised support.

    You can find more information on 1:1 Coaching to see what support we offer to IMGs preparing for the SCA.

    How to Pass SCA Exam with Confidence

    sca exam stress

    Are you feeling stressed about the SCA exam?

    GP Trainees often feel anxious because of fear of the unknown or uncertainty. The SCA exam is daunting but with the correct preparation, you can succeed. In this article, you will learn seven actionable tips to boost your confidence.

    Identify Your Limiting Beliefs

    The first step to overcoming any obstacle is acknowledging its existence. What beliefs are holding you back from excelling in your exam?

    Is it the fear of failure, imposter syndrome, or simply the feeling of being overwhelmed? Write them down and confront each one head-on.

    Reframe Your Mind

    Replace your limiting beliefs with empowering ones. Instead of “I can’t pass this exam,” turn it into “I’m capable of passing my exam with dedication and effort.” Your mind is your most powerful tool. It can work wonders when directed positively.

    Set Clear Goals

    Define specific, measurable, and achievable goals. Break big goals down into smaller manageable goals. Create a roadmap to success. This will not only give you direction but also boost your motivation.

    Join a community

    Preparing for SCA alone is miserable. Reach out to colleagues and mentors for help. Consider joining a study group.

    A common problem is coordinating study sessions due to the level of commitment of other trainees and busy schedules. A group works best when all trainees are planning to sit the SCA exam around the same date.

    Looking for an SCA buddy?

    Connect with like-minded GP trainees by joining our Facebook Support group for free

    Building Confidence

    Spend some time each day visualising yourself excelling in your SCA exam. Picture yourself managing challenging scenarios.

    Work on your communication and consultation skills. Keep track of the progress you make. By showing yourself evidence you are developing your competence, your confidence will catch up.

    Practice Consistently

    Success is not an accident. It’s the result of consistent effort. Schedule time daily for your exam preparation. Practise, revise, and reinforce your knowledge. The more you practise, refine and adjust your consultation the more competent you become. High-performing candidates embed good practices that eventually become second nature.

    Want to pass SCA?

    Then, you’ll love SCA Blueprint

    Join over 800+ subscribers and receive SCA mini-course

      Stay Optimistic

      Being optimistic is important, particularly when things don’t go to plan. Setbacks are a natural part of any journey. Use them as opportunities to learn and grow stronger.

      With the right mindset and preparation, you’ll not only conquer your exam but also become the GP you aspire to be.

      How Dr Yoginee passed SCA exam?

      Dr Yoginee was consumed by self-doubts and fears. Check out how she conquered her fears and passed SCA on her first attempt.

      Dr Yoginee’s Case-study

      Lessons from an IMG who Cracked the SCA Exam

      sca exam

      Meet Dr Srujan, an International Medical Graduate (IMG) who had no choice but to pass the SCA exam so he could CCT in February.

      Watch Dr Srujan’s Case-study​ to learn about his unique preparation and the proven strategies he used to pass the SCA in his first attempt.

      Challenges with the SCA exam

      Dr Srujan faced several challenges on his journey. He was skeptical of his ability to pass the new exam. He didn’t know how to prepare and what to expect. ​

      Being an IMG, Srujan found it particularly difficult to consult without appearing formulaic. This was noticeable when it came to exploring ICE and psychosocial elements. Many GP trainees tend to ask questions out of context under pressure.

      The usual suspects are:

      Who is at home?

      Do you smoke?

      From setback to comeback

      Unfortunately, Dr Srujan also faced health issues during his preparation and had to take a break. It wasn’t easy but with the right support and guidance. After this setback, Dr Srujan made a comeback. He was fortunate to have an amazing study group and a supportive network.

      During the exam, Dr Srujan encountered IT glitches due to a poor connection. Four stations were affected. He was allowed to have three re-runs. He kept his calm and persevered.

      Proven strategy

      Dr Srujan had to first unlearn the old practices before he could learn new ones. For instance, exploring psychosocial elements in context. He applied proven strategies and worked smart. Dr Srujan focused on his areas of weakness mapped on the twelve clinical experience groups.

      He used Consultation Blueprint to organise his preparation and developed a consultation framework that fits his style. After a couple of months, he could see significant changes in his consultation.

      Cracking SCA Exam

      Dr Srujan passed the first SCA sitting in November. The transformation of this IMG despite the personal challenges he faced is truly inspiring.

      Are you preparing for the SCA and looking for a breakthrough? Our intensive 1 to 1 coaching might be the solution for you. Join over 200 trainees who sought help to achieve their goals.

      Applications for 1 to 1 coaching are considered on an individual basis.

      Book your Free 15min call

      SCA Exam: 5 Tips To Consult in 12 Minutes

      SCA exam

      Are you struggling to finish your consult in 12 minutes?

      GP trainees commonly find themselves short of time in SCA Exam.

      This is particularly more of an issue with high-challenge cases or those involving medical complexity. In this article, you will learn five tips to compress your consultation.

      Learn to prime a case

      Priming a case before the start of the consultation is vital. Use the three minutes reading time to plan and prepare your consultation. Use the information provided and anticipate the consultation. Write down key questions you shouldn’t miss to make a safe assessment. Consider relevant differential diagnosis and management plans.

      Dissect your consultation

      To effectively manage time, one needs to first identify the reasons for poor use of time. One of the best tools to dissect your consult is to record and analyse the causes of a consultation going over 12 minutes. The usual suspects are lack of structure, not being willing to commit to a diagnosis or excessive use of summary.

      Don’t dwell on data gathering

      Many GP trainees dwell in data gathering beyond 7-8 minutes due to a fear of missing important information. As a result, they don’t leave sufficient time to tackle clinical management. Trainees may have to rush and don’t discuss treatment plans, arrange follow-up or provide safety netting advice.

      Structure your consultation

      Without a structure, you might jump back and forth from clinical management to data gathering. Structuring your history-taking may save you time. Consider revisiting consultation models and use a crib sheet to organise your thoughts and plan before initiating the consultation. I go into more detail about the various consultation models in this post.

      How to consult well using consultation model

      Use a timer

      Keep track of time during your consultation. Get yourself a timer and keep track of the length of time you spend in data gathering. Aim to progress the consultation and transition to clinical management at minute 6.

      Want to Consult in 12 Minutes?

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      🤔 Up for a Challenge

      Consult in 10 minutes as an experiment. By applying a constraint, you will have to increase your pace and be more selective with your questions and progress your consultation.

      How This IMG Conquered The MRCGP Exam

      Meet Dr. Fungai, an IMG who worked hard to achieve CCT. She spent many hours studying for the clinical component of the MRCGP exam. Being an educational scholar, she felt she would sail through her exam.

      However, when she learned the results, her world came crumbling down. Her confidence was shattered after she failed the exam. Her desire to be self-sufficient and reunite with her sister was jeopardised.

      In the wake of this crushing blow, Dr Fungai had to be honest with herself. Initially, she may have been overconfident. She was unaware of her blindspots. Dr Fungai came to the painful realisation that her preparation was flawed.

      Seeking support

      She had to approach her exam differently to get the desired results. Dr Fungai sought expert guidance and support. Although she received support from her deanery, she decided to seek more guidance and support. She got in touch with us and we agreed to work together. We strategised and worked on her mindset, consultation skills and aptitude so she could consult better despite the stress and pressure.

      A major issue in her consultation was poor time management. Her consults overran beyond the 12-minute end point. She needed to unlearn old habits before she could embed sound consultation practice. After receiving personalised guidance and constructive feedback, she underwent an incredible transformation. Dr Fungai increased her pace and streamlined her history-taking. She successfully compressed her consult within 12 minutes.

      Passing the MRCGP Exam

      I passed!!! Thank you so much for your support. All the best in your career supporting trainees pass and inspiration qualified GPs especially in the first few years post CCT. I can definitely say the investment was worth it.

      Dr Fungai Mashingaidze GPST3
      MRCGP

      The change in approach paid off. She eventually passed her exam with a score of 152 and is due to CCT this December. The story of Dr Fungai serves as a beacon of hope and determination for those facing uncertainty and self-doubt. Her journey reminds us that failure is not a dead end but a stepping stone on the path to greatness.

      Ready to get help?

      The intensive 1 to 1 coaching is ideal if you need support to pass your final MRCGP exam.

      Applications for 1 to 1 coaching are considered on an individual basis.

      Book your Free 15min call

      With humility, perseverance, and a commitment to learning from one’s mistakes, one can overcome adversity and achieve their dreams.

      If you found this article educational, you will likely find our range of Resources useful. Start applying proven strategies to get ahead in your MRCGP SCA revision.

      Choosing the Best SCA Course

      sca course

      Are you a GP trainee preparing for the MRCGP SCA exam? Choosing a preparatory course that fits your needs is crucial. With a wide range of courses with differing price points, making an informed decision may not be easy. In this article, we’ll explore the key factors to consider when choosing an SCA (Simulated Consultation Assessment) course for MRCGP preparation.

      Cost-Effective

      It’s essential not to confuse the costs of a course with the value. Cost is what you pay and value is what you receive. A course may initially appear expensive but provides outstanding value with expert guidance and a proven methodology with high pass rates. A budget-friendly course might seem tempting to save on cost. However, if the course turns out to be insufficient to address your learning needs, it might not be a cost-effective decision.

      A good course provides value that exceeds its cost. Investing in cost-effective preparation course can ultimately save you from exam resits fee, which can be more expensive in the long run.

      Learning Methods

      Every trainee has unique learning preferences and styles. When choosing a course for SCA preparation, it’s vital to consider the teaching methods in use. Common methods include traditional didactic teaching, online courses, hybrid models and one-day courses. Here’s a brief overview of each:

      1. Didactic Teaching:

      Pros: Expert guidance and structured learning

      Cons: Limited personal interaction, one-size fit all approach and passive

      2. Online Courses:

      Pros: Study at your own pace, access to a wide range of resources, and often lower costs Cons: Limited personal interaction and potential distractions

      3. Hybrid Courses:

      Pros: Combines the best of both worlds, offering structure and flexibility

      Cons: May be more expensive than purely didactic teaching

      4. One-Day Courses:

      Pros: Intensive and focused for quick revision or addressing specific weaknesses

      Cons: May not suffice as a stand-alone preparation method

      Select a learning method that aligns with your style and preferences. Many SCA courses now offer blended options to cater to diverse audiences, striking a balance between structure and flexibility.

      Group Vs 1:1 Coaching

      Personalised coaching is a game-changer in MRCGP preparation. One-to-one coaching can offer tailored guidance, addressing your specific strengths and weaknesses. Here’s what you need to know:

      1. Small Group Coaching:

      Pros: Collaborative learning, shared experiences, and collective problem-solving

      Cons: May not cater to individual learning needs as effectively as one-on-one coaching

      2. One-to-one Coaching:

      Pros: Highly personalised, tailored to your specific needs, and focused on your weak areas

      Cons: Higher cost than group coaching

      Choose between small group and one-on-one coaching based on your learning style and needs. Collaborative learners might benefit from small group coaching, while those needing a personalised approach may opt for one-on-one coaching.

      Level of Support

      Ensuring ongoing support and guidance in your SCA preparation is vital. Seek programmes that provide post-course support, access to resources, and additional learning opportunities even after course completion. Continuity helps consolidate knowledge and address lingering questions or challenges.

      Look for courses offering post-course follow-up sessions, mentorship, or discussion forums to connect with instructors and fellow trainees. This support system can be invaluable in the weeks leading up to the exam, keeping you on track and confidently tackling any remaining uncertainties.

      Conclusion

      Selecting the right SCA course for MRCGP exam preparation is a crucial decision in your path to becoming a successful General Practitioner. Consider cost-effectiveness, learning style, learning needs, and the availability of follow-up and continuity in the course. Don’t hesitate to reach out to current or former trainees for recommendations and reviews. Investing in a high-quality course will increase your chances of MRCGP exam success and prepare you well for your future as a GP. Best of luck with your MRCGP journey!

      How Dr Lawrence passed SCA?

      After a failed SCA attempt with a score of 69, Dr Lawrence’s confidence was crushed. Check out how Dr Lawrence conquered SCA after this major setback.

      Dr Lawrence’s Case-study

      SCA Exam Prep: 9 Tips For a Clear Pass

      SCA exam prep

      Are you looking for actionable tips to prep for the MRCGP SCA (Simulated Consultation Assessment)?

      Sitting this exam can be daunting, especially if it’s your first attempt or if you’re feeling anxious and uncertain. In this article, we’ll break down nine practical tips to help you kickstart your preparation and increase your chances of success.

      Plan and Prepare Early

      Successful GP trainees start with meticulous planning. Consider the time you need to prepare based on your exam date. Allocate at least three months of solid preparation. Adequate preparation is the foundation of your success.

      Embed Sound Consultation Practice

      Early exposure to consultations and gaining experience is vital. By learning and practicing consultation skills, you can embed good practice and make them second nature. The goal is to develop an instinct you can rely when facing challenges during the exam.

      Structure Your Consultation

      Structure is key to organise your consultation. Familiarise yourself with various consultation models like Calgary-Cambridge, Neighbour and Berne’s model. Test them and develop your framework by borrowing elements that suit your style. A structured approach ensures a systematic and efficient consultation process.

      Minimise Overthinking

      During the early stages of learning, overthinking can hinder your progress. When you learnt to drive I bet you it felt overwhelming in the begining – excessive internal conversations can distract you. Focus on reducing internal noise to direct your attention effectively.

      Ask Great Questions

      Effective questioning is fundamental. It’s vital to balance open, closed, and facilitative questions. Open questions are great for initial part of data gathering, while closed questions are more suitable for specific enquiries. Facilitative questions encourage detailed responses without leading the patient.

      Practise Active Listening

      Active listening is a crucial skill. It’s vital to give patients your full, undivided attention. Quiet your mind and stay focused on what the patient is saying, not on your internal thoughts or distractions.

      Learn to Prioritise

      Prioritising is essential for complex consultations. I suggest you prioritise early in the consultation, based on urgency and importance. This ensures that you and your patient address the most critical issues first. Additionally, when safety netting, be specific and realistic about what to expect and when to seek medical advice.

      Talk through a Smile

      Smiling while you talk conveys enthusiasm and friendliness through your voice. This approach helps build rapport, gain patient trust and create a positive energy.

      I hope these actionable tips optimise your consultation skills, and increase your confidence in tackling this critical exam. Remember, success in the SCA requires dedication, structured learning, and effective communication skills. Need help with your exam prep? You might like to check our free SCA Resources

      Bonus Tip

      Seek support from colleagues who have passed or are also sitting the SCA. Talking with other colleagues who have faced similar challenges can be incredibly helpful. If you would like support from a community of GPs and GPSTs, join our Facebook Support Group

      How Dr Lawrence passed SCA?

      After a failed SCA attempt with a score of 69, Dr Lawrence’s confidence was crushed. Check out how Dr Lawrence conquered SCA after this major setback.

      Dr Lawrence’s Case-study

      How to Consult in 12 Minutes for the SCA Exam

      Are you preparing for SCA Exam? Consulting within 12 minutes is challenging for many GP trainees. Recently, I spoke with a GP registrar whose SCA preparation has hit a brick wall. He struggled to drive his consultation forward, often getting flustered and running out of time. After an in-depth analysis, we identified a major weakness in his consultations – a lack of structure.

      sca exam

      The Importance of Structure

      Without a structured approach, consultations can easily spiral out of control. So, how can you consult more effectively for SCA exam? This article explores three valuable consultation models that can transform your consultation skills.

      Consultation Models

      1. Pendleton’s Model

      The Pendleton Model, one of the pioneering patient-centered models, emphasises involving the patient in the management plan. It outlines seven crucial tasks within a consultation:

      1. Define the reason for the patient’s attendance: Understanding why the patient is seeking help is essential.

      2. Consider other problems: Patients often have multiple issues, so screen for additional concerns.

      3. Choose an appropriate action for each problem: Prioritise which problems to address during the consultation.

      4. Achieve a shared understanding: Understand the patient’s perspective to make informed decisions together.

      5. Involve the patient in the management: Encourage patient involvement and shared responsibility for their care.

      6. Use time and resources appropriately: Distinguish between patient needs and wants to optimize resource utilization.

      7. Establish or maintain a relationship: Building rapport is essential for positive outcomes.

      2. Neighbour’s Model

      In the Inner consultation, Neighbour proposed a five-stage framework that aligns with the natural flow of a consultation:

      1. Connecting: Establish rapport and a connection with the patient.

      2. Summarising: Summarise the patient’s concerns to ensure clarity and alignment.

      3. Handing over: Transition smoothly to the next phase of the consultation.

      4. Safety netting: Provide guidance on when and how the patient should seek medical attention.

      5. Housekeeping: Manage your emotions and prepare for the next consultation.

      3. Calgary-Cambridge Guide

      The Calgary-Cambridge Model is another patient-centered approach, organised into five stages:

      1. Initiating the session: Start the consultation effectively, setting the stage for collaboration.

      2. Gathering information: Collect relevant data and listen actively to the patient’s narrative.

      3. Physical examination: If necessary, conduct a physical examination.

      4. Explanation and planning: Discuss findings and create a shared plan with the patient.

      5. Closing the session: Conclude the consultation while ensuring the patient’s questions and concerns are addressed.

      Building Relationships and Providing Structure

      In addition to the stages, both the Neighbour and Calgary-Cambridge models emphasize building a strong doctor-patient relationship and maintaining structure throughout the consultation. They incorporate the psychosocial aspects of a patient’s life, ensuring a holistic approach to care.

      Creating Your Consultation Style

      Each consultation model has its merits, and none is perfect. Consider experimenting with different models and adapting components that work best for you. I suggest you develop your unique consultation style that combines the strengths of these models while aligning with your personality and patient needs.

      Conclusion

      Mastering consultation models is a vital step toward success in the MRCGP SCA exam. These frameworks provide structure, enhance patient-centered care, and improve your overall consultation skills. As you progress in your medical career, you’ll find that these models empower you to navigate challenging consultations with confidence.

      Need help with the SCA?

      You might like to check our free SCA Resources

      SCA Exam GP Tips from Neighbour

      mrcgp sca

      The MRCGP SCA exam (Simulated Clinical Assessment) has evolved to meet the new needs of general practice. In this interview, Dr Roger Neighbour, renowned teacher on the skills of communication with a deep understanding of GP consultation, provides his insights into the Simulated Consultation Assessment.

      We cover the changing landscape of consultation skills, common pitfalls in listening, and the importance of mastering your craft for success in the MRCGP SCA.

      If you like to discover valuable insights to help you excel in your MRCGP SCA preparation, you are in for a treat.

      Embracing the Shift to SCA Exam

      The RCGP exam has undergone a transformation, moving from traditional face-to-face consultations to online video and telephone consults, primarily conducted in candidates’ own or nearby surgeries. This change eliminates the need for costly travel and makes the process more convenient for GP trainees.

      Evolution of Consultation Skills

      Before the pandemic, most GP consultations were face-to-face. However, the shift towards remote consultations brought about significant changes in the consultation landscape. Now, a significant number of consultations are conducted remotely, primarily over telephone. This shift necessitates that trainees adapt to new models and skill sets.

      The Art of Effective Listening

      Effective listening is a vital skill for GP trainees, especially during consultations. Common pitfalls include being too caught up in internal dialogue and overthinking. As trainees progress, they ought to learn reducing internal noise and direct their attention outward, fostering better patient interactions.

      The Importance of Timing and Preparation

      Trainees often feel pressured to take exams prematurely due to the intense pressure in ST3 year. However, it is crucial to invest time and effort in learning and practicing consultation skills to the point where they become second nature. This approach allows candidates to perform confidently during the SCA.

      How is your preparation going?

      In preparing for the MRCGP SCA, trainees need to adapt to the changing landscape of modern general practice. By embracing the transformation, focusing on effective listening, and mastering their craft through practice, candidates can navigate the SCA successfully, even in familiar surroundings. Preparing for the SCA is not just about controlling every word but allowing your skills to shine naturally when it matters most.

      How Dr Yoginee passed SCA?

      Dr Yoginee was consumed by self-doubts and fears. Check out how she conquered her fears and passed SCA on her first attempt.

      Dr Yoginee’s Case-study

      How to pass SCA?

      SCA preparation

      Preparing for the MRCGP Simulated Consultation Assessment can be challenging for a lot of GP trainees. Finding the time to revise, staying motivated and practicing for SCA can feel overwhelming.

      If you haven’t been taught the essentials of remote consulting, it can be dauting to navigate phone or video consultations. Every GPST needs to develop their consulting skill in managing challenging and complex cases to succeed their final MRCGP exam.

      Roger Neighbour’s Top Tips

      Roger Neighbour introduced groundbreaking concepts including safety netting and housekeeping in The Inner Consultation. This book has transformed the way we approach patient care. Safety netting is crucial to manage the degree of uncertainty in general practice.

      Effective communication is vitally important in General Practice. It’s the lifeblood that keeps everything running smoothly. It can be difficult to build rapport remotely but it doesn’t stop a clinician from providing compassionate care without seeing a patient. Neighbour believes in treating patients as whole individuals, focusing not just on their medical needs but also on their emotional well-being.

      There is a risk GP trainees can be overtaught in the early stage of learning consultation models. When someone first learns to drive a car, it can be overwhelming to think of all the tasks involved. However with exposure, some tasks can be internalised and become second nature. It is vital that GPSTs practice and refine consultation skills early so they can embed good practice for your exam.

      In 1969 Matthew Broadwell, introduced 4 stages of learning to acquire a skill. This model applies to consultation skill.

      1. Unconscious Incompetence: At the beginning of any learning journey, we may not even realise what we don’t know. It’s the stage of blissful ignorance, where skills and knowledge gaps exist but are not recognised. Acknowledging this phase is the first step towards growth.
      2. Conscious Incompetence: As we delve deeper into our profession, we start to recognise our limitations and the areas where we need improvement. This can be a humbling experience but is crucial for growth. It’s where we consciously acknowledge what we don’t know and become motivated to learn.
      3. Conscious Competence: With dedicated effort, learning, practice and refinement, we begin to master the skills and knowledge. However, this competence requires conscious focus and effort. You’ve likely experienced this phase when certain tasks that once seemed daunting become second nature through practice and repetition.
      4. Unconscious Competence: Finally, we reach the stage where our skills and knowledge have become so ingrained that they flow naturally without conscious effort. Imagine the difference between driving a manual and an automaic car. It’s the stage of mastery, where you perform tasks effortlessly and instinctively.

      If you are developing your communication and consultation skill for SCA, it is helpful to ask yourself what stage are you currently at. Found this article hepful, you might want to check MRCGP SCA resources we have for you.

      How Dr Lawrence passed SCA?

      After a failed SCA attempt with a score of 69, Dr Lawrence’s confidence was crushed. Check out how Dr Lawrence conquered SCA after this major setback.

      Dr Lawrence’s Case-study