Dr Mahibur Rahman
After each MRCGP CSA examination, the examiners release a report highlighting key information from the last exam. This includes pass marks and rates for the sitting, along with the number of candidates sitting the exam. Since the February 2012 exam they also started releasing a feedback report highlighting key areas that candidates found challenging.
These topics are likely to continue to feature in future CSA sittings, as there is a common case bank, so it is worth ensuring that you have a good understanding of how to tackle them.
If you are thinking of sitting the MRCGP CSA in November 2012 or January / February 2013, then you have probably started preparing. As the January / February sitting is the most popular each year, we thought it would be helpful to look at the feedback and challenging areas from this sitting in 2012. The sumary report for the May 2012 CSA exam is not yet available.
Key facts from the February 2012 MRCGP CSA exam:
Number of candidates: 2074
Proportion sitting the CSA for the first time: 92.5%
Overall pass rate: 71.8% (1490 candidates passed, 584 candidates failed)
The top score was 111 out of 117
The mean score was 81 out of 117
The lowest score was 37 out of 117
97 candidates (4.7%) scored 100 or more out of 117
67 candidates (3.2%) scored 20 or more marks below the pass mark.
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The examiners’ report from the February 2012 diet of the MRCGP CSA exam was released in April, and highlighted the following areas that caused candidates difficulty:
Genetics in primary care
Cases involving genetics regularly cause CSA candidates problems in the exam. Examples of cases you should be prepared to handle include:
Prenatal counselling for risk of single gene disorders – e.g. sickle cell disease, Huntington’s, neurofibromatosis, cystic fibrosis etc.
An asymptomatic patient requesting a colonoscopy with a family history of colon cancer.
While you do not need to have an in depth knowledge of specific genetic disorders, you should be able to take a good history and draw a family tree. You should also be able to explain the difference in risk for autosomal dominant and autosomal recessive disorders, and know when it is appropriate to refer to a genetics counselling service.
In some cases in the CSA you will actually perform a physical examination. In some cases, candidates lost marks for being unable to be focused in their choice of examination, or not being able to perform the examination proficiently. Examples of a lack of focus would include requesting a full physical examination in someone with hearing loss – it would be more appropriate to examine the ears, and to perform a Rinne and Weber test. Examples of an inadequate examination highlighted by the examiners included listening to a patient’s chest with through their shirt! Most examinations in the CSA are fairly straightforward – you should try to practice all the common examinations with a study group until you are fluent. Ask your trainer to observe you and to provide feedback.
The MRCGP CSA is a challenging, comprehensive examination, so it is important that you start preparing for it early. Try to get as many observed consultations as possible with your trainer, and form a study group early on.
Complete February 2012 CSA Summary report
The Emedica MRCGP CSA Course includes teaching on the new CSA mark scheme including the new 2012 CSA feedback statements. Each course only takes 6 GP registrars, with a strong emphasis on practice with individual feedback. Practice sessions are donw in groups of 3, allowing each candidate to have 4 mock CSA practice cases. There is detailed, constructive 1 to 1 feedback after each case using the new marking criteria. Our mock CSA cases are done in a realistic setting with professional simulated patients and timed in the same way as the real exam.