As a GP trainee gearing up for the Simulated Consultation Assessment (SCA) exam, understanding how you will be marked is crucial to your preparation. Whilst I don’t have the exact mark scheme the examiners use; the Royal College of General Practitioners (RCGP) has provided clear domains and criteria that will be used to evaluate your performance. These are:
- Data Gathering & Diagnosis (DG&D)
- Clinical Management & Medical Complexity (CM&C)
- Relating to Others (RTO)
Marking Criteria
Each domain is marked on a scale of Clear Pass (CP), Pass (P), Fail (F), and Clear Fail (CF). The RCGP has also outlined standard descriptors for each domain, which you should meet as and when relevant to the case to achieve a grade of P or CP. Let’s break these down:
Data Gathering & Diagnosis (DG&D)
- Systematically gathers and organizes relevant and targeted information to address the needs of the patient and their problem(s).
- Adopts a structured and informed approach to problem-solving, generating an appropriate differential diagnosis or relying on first principles where the presentation is undifferentiated, uncertain, or complex.
Clinical Management & Medical Complexity (CM&C)
- Demonstrates the ability to formulate safe and appropriate management options which include effective prioritization, continuity, and time and self-management.
- Shows commitment to providing optimum care in the short and long-term, while acknowledging the challenges.
Relating to Others (RTO)
- Demonstrates ethical awareness.
- Communicates in a person-centred way.
- Exhibits initiative and flexibility in using various consultation approaches to overcome communication barriers and reach a shared understanding with the patient.
Capabilities
Each domain has associated capabilities that are too numerous to list here. I strongly advise you to familiarize yourself with these capabilities on the RCGP website. Remember, you do not need to demonstrate each capability for every domain. Instead, engage with them to the extent they are relevant to the cases presented.
Overall Performance and Borderline Regression
Your performance is assessed across all 12 cases in the exam. You do not need to pass a specific number of stations to pass the overall exam. In addition to marking individual domains, examiners will judge your general performance in each case. This judgment will help determine the pass mark through a standard-setting process called Borderline Regression.
Borderline Regression Explained
Borderline Regression is an established method used in medical OSCE-type examinations. It ensures that there is no fixed pass mark for each case. Instead, it adjusts based on the overall performance of all candidates, providing a fair and consistent standard.
Final Thoughts
It’s important to remember that failing to meet the pass mark in one case doesn’t mean you’ve failed the entire exam. Your overall mark is based on your cumulative performance across all 12 cases. Stay focused, be systematic in your approach, and communicate clearly and ethically. By understanding the marking criteria and preparing accordingly, you can approach the SCA exam with confidence. Good luck!
Reference: https://www.rcgp.org.uk/mrcgp-exams/simulated-consultation-assessment/Marking-and-results
Dr Sakaria Farah
PassCME SCA Tutor
