Skip to main content

Surviving (and hopefully passing) CSA

Dr Ravi Parekh
ST3 GP trainee & ACF

Throughout my years in GP VTS training the three letters C, S and A have been hanging over my head like a grey cloud. There seemed to be an incredible hype and fear surrounding the exam with rumours flying around, to the extent that I was surprised on the day to see that the examiners were actually real human beings and not monsters!
I thought it might be useful to share some of my experiences in preparing for the exam, and the actual day itself for those who will be sitting the exam in the future. As medics, we are all very familiar with exams and I am sure each candidate understands which revision technique works well for them– so I must emphasise this is my experience and by no means the “right” or “best” way to approach CSA.

The most important thing that helped me in preparing for the CSA was practise, practise and more practise. Amongst the ST3s in our VTS we formed a revision group,   initially gathering once a week (after VTS teaching seemed to work well) for one or two hours going through cases. We increased this to twice weekly about a month prior to the exam.  The cases are readily available in resources which you can buy or rent. I found the CSA Case Workbook Mock Exam by Ellen Welch very useful with cases which appropriately reflect the level required. The cases available on the Bradford VTS website were expertly written and very realistic to cases that were seen in the exam. The CSA practise cards from the RCGP were also very useful at making me think how I would explain basic concepts. Many practises may have these available to use or borrow which can save you money.
We tried to ensure a minimum of three people so we had a patient, doctor and observer/examiner. Looking back, I think it was important to ensure that we were all comfortable with everyone being open in their feedback whether that was positive or negative. There is a real pressure to always be nice and not hurt your friends’ feelings; however I feel being open and constructive was the best way to get the most out of these sessions.
 In terms of courses, there is a handful to choose from all costing around £300 - £400. I attended the London MRCGP course in Lambeth. Personally I found it to be an excellent confidence builder and a chance to get an idea of the standard expected, which perhaps is more difficult without a course. However, these courses are not cheap and may not be suitable for everyone. It might be useful to consider if you are the type of learner / personality type that would benefit from these intensive courses, and whether you would want to spend this extra money.
I did find it difficult to know the level of theoretical knowledge that would be expected for the exam and therefore how to split my revision between practical revision and bookwork. I found the majority of the knowledge expected in the exam, I was already using on a day to day basis in my GP surgery. Remember this is a clinical exam and majority of the marks are around how you take a history, examine, explain and negotiate with the patient rather than how well you have memorised a NICE guideline.

The day itself…
As with most clinical exams, I find the nerves and apprehension is the worst part. On the day the college do very well to try and keep you at ease and as relaxed as possible. You will be given a morning or afternoon session with specific detailed instructions of timings and equipment to bring. There are also videos on the RCGP website which are useful to give you a “walk through” the exam centre.
After arriving and registering, candidates are lead to an exam briefing to give you an overview of the day and answer any questions people may have. Refreshments are provided throughout the day. You are allocated your own individual clinic room with a locker inside, which will be your home for the whole of the exam. This is a nice contrast from medical school OSCE days, running around from room to room and forgetting your stethoscope along the way! It also allows you to get comfortable in your room and helps settle the nerves. The actors and examiners then rotate around the rooms.
The patient details and relevant information are located on your own personal i-Pad which allows you to scroll through all the cases from the beginning. In addition you also have a white board and marker to make notes. There is a large digital timer directly in front of you to let you know how many minutes you have left in each consultation. In total there are thirteen cases and you will have a break after seven cases.
Overall, remember that the pass rates for the exam are usually between 80-90% and the exam is there to test you on what you will be doing daily in your GP surgery. Try to ignore much of the anxiety around the exam, practise your consultation skills and focus on what went well in each station. 

I hope this is of some use and good luck!


Popular posts from this blog

Introducing the WATCCH Project - Widening Access to Careers in Community Healthcare

The Undergraduate Primary Care Education team in the Department of Primary Care and Public Health at Imperial College London has kicked off an exciting new work experience programme called WATCCH – Widening Access to Careers in Community Healthcare.
There is a shortage of work experience in the health sector for pupils, particularly for those who have no connection to healthcare professionals. WATCCH aims to open up work experience opportunities in the healthcare sector by offering placements for sixth form pupils from disadvantaged backgrounds to shadow various allied healthcare professionals in general practices. These 16/17 year olds have completed their GCSEs with good grades, do not have placements elsewhere, and are the first in their family applying to university. 
Pupils will attend a pre-placement induction at Imperial College's Charing Cross Hospital Campus, and will then have a 3-day work experience session at a general practice where they will observe a variety of allie…

Say hello, wave goodbye...

Our GP Derm and Paeds Course Lead Dr Emma Metters sadly left us this month to take a new post at St George's. She reflects on her time at Imperial below:
My time as GP Derm and Paeds Course Lead has come to an end but the good news is the wonderful Senita Mountjoy is returning from her maternity leave to take up the post again.  She brings so much energy and enthusiasm for the courses that she was instrumental in the design of initial delivery of.  I am sure she has many ideas of where she wants to take them so watch this space for new and exciting teaching developments on the horizon.
This is not really goodbye as I will be continuing my involvement in Imperial in various ways so may well cross paths with some of you again.  I have really enjoyed my time at Imperial, in several different roles, and have gained a wealth of experience which I will be taking with me to my new role as Clinical Lecturer in Primary Care at St George’s University. 
I hope many of you continue your invo…

Year 3 MICA (Medicine in the Community Apprenticeship) course update

The year 3 Medicine in the Community Apprenticeship pilot year is drawing to a close and the new cohort of 150 students have been selected and are ready and poised to start phase 2 in September 2017!
Our wonderful tutors have done an excellent job hosting students for 10 weeks at their surgeries. We have really seen our students thrive during this attachment. We have realised the value in giving the students true authentic roles where they begin seeing their own patients in clinic by week 3 and follow up their own patient case loads throughout. The student feedback has been overwhelmingly positive and they have really enjoyed feeling like integral members of the team.
Not only have we had involvement from excellent GP tutors, we have also had many specialists and other GPs hosting our students for their experience and clinical skills sessions. We are excited to be using more hospital sites and GP services to help us next term.
We would like to thank all the faculty involved in developing…