Guide To MRCGP: Recorded Consultation Assessment (RCA)

The MRCGP (Membership of the Royal College of General Practitioners) is a postgraduate medical qualification that is required to secure Certificate of Completion of Training (CCT) in General Practice. The MRCGP exam consists of three different parts: Workplace-Based Assessments (WPBA), Applied Knowledge Test (AKT) and Recorded Consultation Assessment (RCA). This article will cover the RCA portion of the exam.

What is the RCA? 

The RCA (Recorded Consultation Assessment) was introduced in lieu of the CSA (Clinical Skills Assessment) due to Covid-19. RCA is currently only available at ST3 level. 

The RCA consists of 13 pre-recorded consultations carried out by candidates in their surgeries. Cases must be at the level of complexity of an ST3 trainee. Consultations may be face-to-face; audio or video and candidates must not edit or switch the camera off at any point of the consultation. Patients must be adequately covered during the consultation and no areas of skin that would be covered in a swimsuit should be shown in the RCA. The swimsuit area is: 

• Children up to and under 2 are expected to be covered by a nappy. 

• Over the age of 2, males are expected to have their trunks covered and females are expected to have their trunks and breasts covered. 

• The terms male/female refers to gender identify rather than the sex assigned at birth. 

Consultations must not require interpreters and must be in English with the only exception being to Welsh consultations in Wales. 

FourteenFish is the online resource that GPs often use for appraisals and portfolios. 200 minutes of practice recording will be available on FourteenFish for those eligible to sit the RCA. After applying, 600 minutes will be available. Of those recordings, 13 must be chosen for submission. Once submitted, the recordings will no longer be accessible to candidates and no changes can be made. 

RCA policy dictates that recordings submitted must be uploaded within 26 weeks/182 days of the date of publication of exam results. It is preferable to consultations that have been recorded within 3 months of the exam date. Candidates must ensure that the consultations comply with GDPR with consent evident in the consultation. 
 

Apply for the RCA: 

Applications can be made through the RCGP website. Candidates along with their educational supervisor must confirm the candidate's identity and the validity of the submitted consultations. The 13 consultations must be chosen by the candidate. Consultations used for other assessments must not be included for the RCA as they are evidence for another domain. 
 

Preparing for the RCA:

Like any exam, the RCA can be nerve-wracking for candidates but can be prepared for. Being in General Practice and repeatedly practicing focussed history taking and appropriate investigations and management plans is the best way to prepare. Here is a link where factors resulting in pass or fail of candidates for the CSA exam (now replaced by RCA) can be found. 
 

RCA Marking: 

The grade descriptors range from clear pass, pass, fail and clear fail. Only the first ten minutes will be marked. Each of the candidate’s consultations will be viewed separately by a marker. 

Re-marking consultations is not an option as recordings won’t be available to the RCGP examination department once results are published. 

Here you can find the RCA marking scheme.

GP results: 

It is difficult to set a likely pass rate for cohorts sitting the RCA exam as each cohort differs in nature. The most recent RCA report from May 2021 shows a pass rate of 77.8% of 1283 candidates. 

For MRCGP results, please look at your cohort and their anticipated release as it will be different for each cohort.  

Key Issues in Recording Assessments: 

• Recording failures at the end or during a part of the consultation: examiners can only assess what they see/hear on the submitted consultation and therefore will only be able to assess you on that. No marks will be given to any account given by the candidate during the consultation gap. 

• Consultation was interrupted leading to it being over ten minutes in recording but overall patient interaction is within the ten minute timeframe: the consultation must be continuous with only the first ten minutes of the consultation being assessed. 

• Wi-Fi issues resulting in distorted sound/video: the quality of recording must be at a level that allows the examiner to make an adequate assessment of the candidate. It is the candidate’s responsibility to ensure that it is of appropriate quality. 

References: 

1. Mrcgpexamprep.co.uk. 2021. MRCGP overview | MRCGP AKT Online Practice Exams and Questions. [online] Available at: https://www.mrcgpexamprep.co.uk/mrcgp-overview  [Accessed 23 June 2021]. 

2. 2021. MRCGP Examination Recorded Consultation Assessment Policy. [ebook] RCGP. Available at: https://www.rcgp.org.uk/-/media/Files/GP-training-and-exams/CSA-page/CSA-RCA/MRCGP-examination-RCA-policy-2020.ashx?la=en [Accessed 22 June 2021].

3. 2021. MRCGP Examination Recorded Consultation Assessment Frequently Asked Questions (FAQs). [ebook] RCGP. Available at: https://www.rcgp.org.uk/-/media/Files/GP-training-and-exams/CSA-page/CSA-RCA/FAQs-Recorded-Consultation-Assessment.ashx?la=en  [Accessed 23 June 2021].