This complete MRCGP SCA exam guide is designed for GP trainees preparing for the Simulated Consultation Assessment. It explains the SCA exam format, marking domains, common case types, revision strategy, mock practice, and what to do if you have failed the SCA exam.
The MRCGP SCA, or Simulated Consultation Assessment, is the consultation skills exam used as part of the Membership of the Royal College of General Practitioners. It assesses whether GP trainees can apply clinical knowledge, communicate effectively, gather focused information, manage risk, and agree safe, patient-centred plans within realistic GP consultations..
The MRCGP SCA consists of 12 simulated consultations. Each consultation lasts 12 minutes, with 3 minutes of reading time before each case. The cases are performed by trained role players and may involve patients, carers, parents, or other health and social care professionals. Most cases are video consultations, but some may be audio only. Physical examination is not assessed in the SCA and is assessed separately through WPBA.
The SCA assesses whether you can manage realistic GP consultations safely and effectively. You are marked on how well you gather relevant information, make appropriate clinical decisions, manage complexity, communicate with the patient, respond to cues, explain risk, safety-net, and agree a shared management plan.
The SCA is marked across three domains: Data Gathering and Diagnosis, Clinical Management and Medical Complexity, and Relating to Others. To score well, candidates need to show safe clinical reasoning, focused information gathering, patient-centred communication, appropriate management, and clear safety-netting.
MRCGP SCA cases can involve a wide range of realistic GP consultations. These may include new symptoms, long-term condition reviews, medication requests, abnormal results, safeguarding concerns, mental health presentations, children’s health, women’s health, urgent problems, professional conversations, and patients who are worried, frustrated, confused, or reluctant to follow advice.
To prepare effectively, GP trainees should practise cases across different clinical experience groups and focus on how they consult, not just what diagnosis they reach. Strong SCA performance usually depends on focused data gathering, safe clinical reasoning, clear explanations, shared decision-making, appropriate safety-netting, and responding to the patient’s ideas, concerns and expectations.
Common reasons candidates struggle include unfocused questioning, weak structure, missing cues, poor time management, vague management plans, limited safety-netting, and not addressing the patient’s main concern. Regular mock consultation practice with feedback can help trainees identify these patterns early and improve before the exam.
PassCME supports GP trainees preparing for the MRCGP SCA through SCA teaching, case practice, mini mocks, feedback and exam-focused consultation skills training.