The MRCGP: Simulated Consultation Assessment (SCA) is a challenging exam known to cause anxiety among trainees. This guide will give you 10 actionable tips to help you build confidence and pass SCA.
1. Develop a growth mindset
Your mindset plays a key role in your success. While the SCA is undoubtedly a high-pressure assessment, embracing a growth mindset can turn this challenge into an opportunity for learning.
- Tip: Believe in your ability to improve. Every time you practise and reflect, you refine your skills and build confidence.
- Why It Matters: Candidates who struggle with nerves often underperform—not due to lack of knowledge but because of self-doubt. Cultivating a “can-do” attitude will prepare you for any scenario.
2. Understand the format and marking
Knowing what to expect reduces uncertainty and allows you to focus on what matters. The SCA includes:
- 12 consultations: 9 video and 3 telephone.
- Domains assessed:
- Relating to Others (36 marks)
- Data Gathering and Diagnosis (36 marks)
- Clinical Management (54 marks)
Key Facts:
- There is no physical examination component.
- The pass mark is typically in the range of 75–77 marks but every mark matters. Some candidates have missed passing by just half a mark.
- Poor performance in one domain can be offset by strong performance in others.
Tip: Familiarise yourself with the marking criteria and use it to assess your practice consultations.
3. Prepare early
It is recommended that you plan your preparation at the beginning of ST3. Aim to sit the exam when you are at your peak to increase your chance of passing the SCA. Avoid rushing to sit the exam before you are ready. Most trainees will need three months of preparation. Give yourself ample time to embed consultation skills so that they are internalised and become automatic for the exam.
4. Start a study group
Starting a study group can be helpful to prepare for the SCA. It allows you to practice your consultation and communication skills. A study group works well with three people in it: one to be the doctor, one to be the simulated patient, and one to observe, keep track of time, and provide feedback.
The role of the observer is far from passive. Embrace being an observer, put yourself in the shoes of an examiner and analyse the doctor’s performance. It can be insightful to develop your own consultations.
It is useful to form a study group with trainees who are planning to take the SCA in the same sitting as you. This ensures everyone in the group works together to pass. As the exam date approaches, you can decide to increase the intensity and frequency of the study sessions. It is important to practice with colleagues from various backgrounds so you can gain new perspectives and insights.
5. Seek constructive feedback
Constructive feedback is a gift to the trainee who wants to excel. Without feedback, it’s difficult to identify your blind spots and shortcomings. Use the Consultation Observation Tool (COT) and audio-COT to record challenging consultations. Watch or listen to your recorded consultations and pick up on the patient’s verbal and non-verbal cues. Evaluate the performance as if you were observing a colleague and reflect on what you might do differently. Share your recorded consultations with your trainer regularly and seek constructive feedback. Have an honest discussion with your trainer about any areas of weakness that you need to work on.
6. Manage your time effectively
Many trainees struggle to finish their consultations in 12 minutes. If a trainee regularly needs 18 minutes per case in surgery, the latter is likely to struggle with the SCA. Identify the reasons for poor use of time. It could be due to a lack of structure, not being willing to commit to a diagnosis or excessive use of summary.
There is a tendency among trainees to dwell on data gathering past 7-8 minutes due to a fear of missing important information. As a result, trainees don’t have enough time to tackle clinical management. Trainees may have to rush and can’t properly discuss treatment plans, arrange follow-up or provide safety netting advice. Consider challenging yourself to consult in 10 minutes to speed up your pace.
Priming a case prior to the start of the consultation is vital. Use the golden three minutes to prepare how you are going to approach the station. Write down key questions you shouldn’t miss to make a safe assessment.
7. Readdress idea, concern and expectation (ICE)
A common pitfall is not returning to the ICE gathered in the first half of the consultation. It is not good practice to explore ICE and then not address it. In general practice, we don’t merely treat diseases. Patients have worries and an agenda. We ought to consider the psychology of our patients. It’s crucial to address the patient’s ICE. You ought to integrate ICE into the discussion when explaining your working diagnosis and formulating a shared treatment plan. Readdressing the patient’s ICE will allow you to take a patient-centered approach.
Preparing for the MRCGP SCA is daunting for many IMGs but with the right preparation, success is within reach.
We understand the anxiety you may have while preparing for your exam. If you want to pass SCA and CCT with confidence, get the Blueprint that Dr Vijay used for free.
8. Verbalise your thoughts
You might receive glowing reviews from your patients but for examiners, actions speak louder than words. They don’t know what you’re thinking or whether you’re competent and safe for independent practice unless you demonstrate it during the consultation.
Examiners can only assess what they observe. If a behavior or clinical reasoning isn’t explicitly shown, it can’t be marked.
For instance, if you suspect a patient has a migraine but fail to verbalise your thought process, the examiner can’t assume you’re managing the correct condition. To succeed, you need to verbalise your thoughts.
9. Be genuinely empathetic
It is common for trainees to say, “I’m sorry to hear that”, just for the sake of appearing empathetic then jump to a completely different topic. Trainees often use stock phrases in an attempt to show empathy. By doing so, they come across as formulaic.
Empathy is showing you understand and can feel the pain of another person. How you say something is as important as the words. You have to genuinely empathise. A useful technique to demonstrate empathy is giving a receipt.
For example, a patient might say, “I’m having an awful headache.” The doctor replies, “I hear you. This headache sounds painful.”
10. Learn to manage medical complexity
Expect cases with the complexity and uncertainty you face in real-life practice. To prepare, observe how your trainer navigates challenging consultations—experienced GPs often use time as a tool to manage uncertainty effectively.
Take a proactive approach by identifying areas in the SCA Blueprint where you feel less confident or have limited experience. For instance, cases involving genetic diseases, ethical dilemmas, learning disability or breaking bad news. Collaborate with your receptionist to schedule patients with these types of scenarios, giving you valuable exposure and practice.
The SCA is challenging, but if you plan and put in the necessary work to embed good consultation practice, you can pass this exam with confidence. I hope you find the 10 tips helpful in your preparation.
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 GP and GPSTs, join our Facebook Support Group
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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.
