1. Aneesha

2. How Do You Feel Now?

3. Ideas o Something you have got to do o No way of getting out of it o How soon to do it- should you put it off or do it early o Would be better to revise in group o Going to take a lot of preparation o Fit it in with everything else I need to do

4. Common Concerns mentioned by GPSTs I‘m really scared I don’t want to travel to London How will I pay for it ? How will I pay for the re-sit? I’ll never be prepared for it/good enough How do I book it? Where do I start revising Do I need to go on more courses? Have I given myself enough time to revise?

5. Expectations Should reflect a typical surgery session in general practice.

6. Reality It is a pain going to London It is expensive It is scary BUT They are not trying to trick you Everybody is very pleasant and they try to put you at ease. Get into the swing of it really quickly

7. Aim of CSA “Test a doctors ability to gather information and apply learned understanding of disease processes and person-centred care appropriately in standardised context, make evidence-based decisions, and communicate effectively with patients and colleagues.”

8. Curriculum domains Problem-solving skills Person-centred care Clinical practical skills Primary care management Comprehensive approach Attitudinal aspects

10. Booking it RCGP website MRCGP heading and click on csa, then click on the apply for CSA,this will give you the dates for when the exam is, 3x a year November, February and May This year costs £1525, have to pay in 1 instalment Website can be slow dates first open

11. Where Purpose built building in Euston 30 Euston Square, London NW1 https://maps.google.co.uk/maps?hl=en&q=30+euston +square&ie=UTF-8 https://maps.google.co.uk/maps?hl=en&q=30+euston +square&ie=UTF-8 Euston Mainline and Euston Square tube station 5 mins on foot away. Don’t go by car – no parking! Arrive by 9:00 or 12:15 for am and pm sittings Usually leave around 1pm and 5pm respectively

12. Structure Arrive, sign in, show your ID ( passport or photo driving licence) and hand in your mobile Put in a room with everyone else- given a brief Once everyone arrives taken to your floor Put your things in your locker including doctors bag and go to your room with plastic wallet Remain in same room for whole exam unless home visit or telephone consult

13. Structure On desk will be an iPAD with all the cases for that session as well as peak flow chart, prescriptions, med 3s, tuning fork and tongue depressors. Examination couch as well Buzzer rings to mark start and end of consultation 2 minutes between each case Break of 10-15 minutes after 7 cases, water coffee and tea. With all other candidates and cannot speak about exam At the end they will knock on your door and leave Could well include home visits and children simulators over 11

14. Thing you must bring BNF Stethoscope Ophthalmoscope Auroscope Thermometer Patella hammer Tape measure Peak flow meter and disposable mouthpieces (N.B. These must be EU standard)

15. Marking schedule 13 cases Marked on the 3 domains of data gathering, clinical management and interpersonal skills. Each domain has an equal numerical score Marked as clear pass ( 3), pass ( 2), fail (1) and clear fail (0) Total 9 for each case- 117 overall Examiner also marks whole case as pass, fail or borderline For borderline cases score is added and averaged Based on this they will integrate the scores and produce the pass mark – around 72 +/-2

16. How did it feel? Worst bit was the waiting No surprises Nothing came up which you wouldn’t expect in a normal surgery in fact probably a lot more straight forward i.e patient only had 1 problem Be yourself Don’t panic even if you muck up a case If you don’t know something admit this to a patient Don’t waste time writing prescriptions/ sick notes

17. On reflection What went well Get a revision group together- minimum 3 Have a consultation plan Videoing Practising cases with your trainer Courses: Pennine CSA course, RCGP, HDR mock CSA Cases- look at topic domains and write your own Suitable accommodation (including Euston building itself) 0% interest credit card

18. Reflection cont What went less well Books cases fairly complicated and not all have marking schemes Make sure you don’t all have the same ones!! Make sure you are consulting at 10 minutes What I would change Attend a mock CSA; invaluable experience Discuss difficult everyday cases with colleagues Don’t talk about it once you are out

20. Final word..... Do what you would normally do in a surgery Don’t try to second-guess the case.. Remember you’re the patient’s advocate!