MRCPsych CASC exam - a guide for IMGs
- February 11, 2022
In this blog we will explore MRCPsych Clinical Assessment of Skills and Competencies (CASC) including dates, exam locations, fees and eligibility.
In our exploration of CASC, we will take a broad look at the following topics:
- What is the format of the CASC exam?
- How is the CASC marked?
- Am I eligible?
- Assessment Portfolio for Overseas Candidates
- Sponsorship requirements
- How do I apply?
- How much will it cost me?
- Where can I sit the CASC exam?
- How do I prepare for the CASC exam?
- Passed? What next?
For a more general overview of the MRCPsych examinations, click here.
MRCPsych CASC is a practical exam taking the format of an OSCE and tests your clinical skills in a range of competencies.
What is the format of the CASC exam?
The CASC format is like an OSCE (Objective Structured Clinical Examination).
The exam is made up of two circuits of individual stations which will test your clinical skills:
- The morning circuit will have 4 minutes to read the instructions and 7 minutes to complete the task
- The afternoon circuit will have 90 seconds to read the instructions and 7 minutes to complete the task.
The sixteen CASC station exam is made up of:
- five stations focused on History Taking, including risk assessment
- five stations focused on Examination - both physical and mental state, including capacity assessment.
- six stations focused on patient Management
Each circuit follows the topics below:
Circuit 1:
- 6 stations focused on Management
- 1 x station focused on Examination
- 1 x station focused on History Taking
- 4 minutes reading
- 7 minute task
Circuit 2:
- 4 x stations focused on Examination
- 4 x stations focused on History Taking
- 90 seconds reading
- 7 minute task
How is the CASC marked?
You can find details on how the test is marked here. See also marksheets for your information.
The Royal College also suggest taking a look at Passing the MRCPsych - an insider’s guide - a useful guide to help you to get over the first steps.
As ever at IMG Connect we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practice your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining patients with examiners present.
Am I eligible for the CASC exam?
You are eligible to take CASC if you have 24 months post internship experience in Psychiatry, by the time of sitting the CASC.
AND
You have a pass in both Paper A and B
AND
You can demonstrate the following:
AND
- You have sponsorship in place – sponsorship forms must be submitted by an appropriate medical education lead confirming that the eligibility requirements to sit the MRCPsych examinations have been met.
Overseas candidates must show their sponsor evidence of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination.
Assessment Portfolio for Overseas Candidates:
As above, one aspect of eligibility for CASC as to complete an Assessment Portfolio. This must demonstrate achievement of equivalent competencies to those defined in the ARCP documented on the application form, this must include competencies in Psychotherapy AND Child and Adolescent Psychiatry, or Learning Disability have been achieved by the time of applying for the MRCPsych CASC.
In addition, overseas candidates must demonstrate that they undertake the following activities as part of their structured job plans:
- observation in interviewing patients in ward rounds for specified reasons
- observation in interviewing patients in out-patient or community settings or other contexts for specified reasons
- assessment via formal presentation of cases with their medical notes; discuss management of cases with their Clinical or Educational Supervisor
- formal assessment in having achieved competencies in Child and Adolescent Psychiatry or Learning Disability AND Psychotherapy.
Assessments and achievement of competencies should take place in a range of settings and psychiatric specialties with structured, documented feedback on performance having been provided.
Whilst there is not an assessment criteria form available as this is incorporated into the online submission, take a look at the ARCP assessment portfolio form for CT1-3 in the UK, which should help give you a starting point for your own portfolio.
Sponsorship requirements:
International candidates must have a sponsor in place in order to support evidence that their three years of training satisfy Royal College criteria of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination.
Sponsorship is required by all applicants for entry to the CASC examination.
Your sponsor should be an appropriate medical education lead confirming you have met the requirements to sit the MRCPsych examinations.
You will be required to provide the sponsor’s title, full name and email.
Acceptable sponsors are:
- College Tutor
- Training Programme Director
- Educational Supervisor
- Head of School
- Director of Medical Education (or equivalent)
- Head of Department of Psychiatry
- Consultant responsible for employee/trainee appraisal
Once your sponsor has authorised your application, you will receive a confirmation email from the Royal College, and you will be asked to complete your application and proceed to payment.
How do I apply?
To apply you’ll need to complete the Royal College online application form. This form is only available during the published application dates and must be submitted prior to the closing date, if you miss the cut-off, your application will not be considered.
You will need to provide the following:
- Personal details
- Primary Medical Qualifications & Registration
- Training
- Written paper selection
- Sponsor evidence for Assessment Portfolio for Overseas Candidates
How much will it cost me?
At the end of your application you will be directed to an online payment system where you can pay be credit or debit card, so make sure you have your details ready.
Once your application is complete you will receive two confirmation emails, one to confirm receipt of the application and one to confirm the payment has been received.
The fees for MRCPsych CASC for 2023 are as follows:
- PMPT Trainees and Affiliates - £1,054
- Non-PMPT Trainees and Affiliates - £1,171
Where can I sit the CASC exam?
The final diet of the CASC exam which will involve online delivery will be in May 2023. From September 2023, the exam will be back in-person, being delivered in the UK with international test centres to be confirmed from 2024.
Examination dates can be found here and results from the CASC examinations will be released around 1 month later.
How do I prepare for the CASC examination?
With lots of materials online we have discussed with IMGs the best place to start looking for resources and materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. See below:
Syllabus: We always suggest that this is the best place to start – plan your study around the curriculum topics and make a road map to your success in the exams.
Syllabus: summary of areas of core medical knowledge underpinning specialist training in psychiatry
Marking scheme (CASC): A good start with CASC preparation is to get to know how you will be assessed, take a look at the criteria for scoring a pass mark in CASC, as well as the History Marksheet, Management Marksheet and Examination Marksheet.
CASC examination guide: The Royal College have produced a helpful guide for candidates which provides information on stations, role plays and assessment.
CASC preparation videos: Here you will have the opportunity to see CASC stations in action. This will give you a good idea of what to expect and help you prepare.
CASC Blueprint: This helpful summary details stations in some detail and gives a useful overview of the exam format.
The Royal College also suggests taking a look at Passing the MRCPsych - an insider’s guide - a useful guide to help you to get over the first steps.
IMG Psychiatrists MRCPsych CASC Study Course
This is a tailored MRCPscyh CASC course for overseas psychiatrists sitting the CASC exam. This course offers weekly sessions beginning with an overview and in-depth breakdown of the exam and its various domains, including marking and station requirements. This is followed by small group role play sessions to allow IMGs preparing for the exam to practice stations across various scenarios with feedback on each station, delivered by an experienced NHS psychiatrist and specialist psychiatry recruiters. These sessions are completely free to all doctors.
The course is supplemented by additional advice and guidance on MRCPsych as a whole, GMC registration support, as well as guidance and webinars on other topics such as finding work in the NHS, relocation support and specialist registration.
You can access our IMG Psychiatrists CASC Study Course by joining the Facebook group here.
#IMG Tips
- Start your revision early – starting in advance allows you to pace yourself and get ahead of the stresses of last-minute revision and anxiety.
- Find the right materials for you – whether its online courses, books or flashcards, try to figure out what the best materials are to jumpstart your preparation
- Speak to your peers and colleagues – your senior colleagues may have been through this process themselves and may have helpful tips and guidance to share. Or maybe you’ll find a like-minded peer with whom you can be study buddies! Take advantage of those around you to support you on this journey.
- Practise, practise, practise - Our IMGs have shared that it’s crucial that you practice your clinical examinations as often as possible, preferably under the supervision of a senior colleague which will allow you to receive feedback.
- Join the online psychiatry community - for news and updates about all things psychiatry for IMGs, follow IMG Connect on social media and join the conversation.
I've passed, what’s next?
Once you’ve passed MRCPsych CASC, you’ve completed the Royal College of Psychiatrists examination suite. Great stuff, this is a massive achievement! Armed with this and your English language test, you are ready to apply for full GMC registration with license to practice.
You may want to start looking for NHS jobs and with the click of a button, you can receive them directly to your inbox. To receive jobs postings which you can tailor to your desired grade, specialty and sub-specialism, sign up here.
As ever at IMG Connect, we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practise your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining children with examiners present.
Getting started
If you have any questions about any element of CASC, the Royal College exams as a whole or any other queries related to the processes involved in IMGs coming to the UK to work in the NHS, please get in touch and one of our psychiatry specialists will be more than happy to assist you.
For access to a community of like-minded MRCPsych aspirants and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
Relevant Jobs
Consultant Psychiatrist – Child and Adolescent Mental Health Service (CAMHS)
South Wales
A dynamic and transformational CAMHS service in South Wales is seeking a Consultant Psychiatrist with a strong interest in child and adolescent mental health. The successful candidate will join a well-established multidisciplinary team delivering specialist care across the region, contributing to service development and clinical leadership within a collaborative and forward-thinking environment. Doctors with MRCPsych, CESR interest, or a European Specialist qualification are encouraged to apply.
This is a fantastic opportunity to work within a progressive mental health service with access to regional tier 4 services and a population of approximately 380,000. The post supports the organisation’s strategic vision to integrate CAMHS more closely into community settings while developing clinical pathways in areas including eating disorders, complex care, youth justice, and neurodevelopmental disorders.
We welcome applications for full-time, part-time, or flexible working arrangements and will support CESR (Certificate of Eligibility for Specialist Registration) development on an individual basis.
JOB REQUIREMENTS AND DETAILS
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Salary: £109,725 – £145,478 dependent on Consultant experience.
-
Full GMC registration with a licence to practise is essential.
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Eligibility for inclusion on the GMC Specialist Register or within six months of CCT.
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Section 12 approval (or eligibility within 6–12 months).
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Experience delivering psychiatric care in CAMHS or related services is required.
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A collaborative, developmental, and family-focused approach, with excellent communication and leadership skills, is highly valued.
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Opportunities for career development through CPD, peer supervision, quality improvement, and service leadership.
CORE DUTIES OF THIS ROLE
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Provide consultant-level psychiatric care to children and adolescents as part of a multidisciplinary CAMHS team.
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Lead clinical care planning, review, and treatment delivery in partnership with colleagues across mental health, health, education, and social care.
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Work closely with specialist regional services including adolescent inpatient units, eating disorder outreach services, and forensic CAMHS consultation teams.
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Participate in the CAMHS consultant on-call rota (with prospective cover).
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Contribute to service improvement, pathway development, and integrated working in line with strategic planning goals.
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Provide supervision and clinical leadership to junior medical staff and allied professionals.
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Participate in annual appraisal, job planning, and revalidation, with access to local peer groups and CPD.
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Uphold principles of clinical governance, information governance, and risk management across the CAMHS Directorate.
LIFE IN SOUTH WALES
South Wales offers a rare combination of coastal beauty, green open spaces, and urban convenience. With beautiful landscapes, affordable living, and excellent local amenities, it is an ideal location for professionals and families alike. The region is well-connected by public transport and road networks and offers easy access to nearby cities and airports.
Healthcare professionals in the area benefit from a supportive and inclusive working environment and access to a wide network of services across health, education, and social care.
If you are passionate about delivering outstanding CAMHS care and want to help shape future services in a supportive, innovative setting, we welcome your application. Please note that we may close this post early if sufficient applications are received.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect, you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
-
CV preparation with a bespoke session with one of our specialists.
-
Application support with expert knowledge of NHS specialisms & recruitment practice.
-
At least two video interview preparation sessions.
-
Contract and offer negotiations for salary, relocation packages, tenure, and more.
Once you have accepted your new role, you’ll be supported by one of our dedicated relocation executives, who will guide you through the process, including:
-
Document gathering and checking.
-
COS and Visa Application support, if applicable.
-
Support sourcing short- and long-term accommodation.
-
Travel arrangements and family support for finding schools and other aspects of pastoral care.
Consultant Psychiatrist – Acute Inpatient Service
South of England | Close to London
- Salary: £109,725 – £145,478 dependent on Consultant experience.
- Recruitment premia £15,000 over 3 years *subject to policy requirements
- Relocation allowance: up to £8000 *subject to policy requirements
An inclusive and progressive NHS mental health trust in the South of England is seeking a Consultant Psychiatrist with a strong interest in acute inpatient care. The successful candidate will join a compassionate and collaborative multidisciplinary team, providing high-quality psychiatric care to adults and clinical leadership across inpatient services. Doctors with MRCPsych, CESR interest, or a European Specialist qualification are encouraged to apply.
This is a fantastic opportunity to join a leading NHS Foundation Trust known for integrated working, a strong culture of kindness and respect, and its commitment to clinical excellence and innovation.
Applications are welcome for full-time, part-time, or flexible working patterns. CESR (Certificate of Eligibility for Specialist Registration) support is available and tailored to individual needs.
JOB REQUIREMENTS AND DETAILS
-
Full GMC registration with a licence to practise is essential.
-
Eligibility for inclusion on the GMC Specialist Register or within six months of CCT.
-
Section 12 approval (or eligibility within 6–12 months).
-
Clinical experience in managing acute adult mental illness in inpatient settings is required.
-
Strong teamworking, communication, and leadership skills are essential.
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Ongoing opportunities for professional development through training, leadership pathways, teaching, and academic engagement.
CORE DUTIES OF THIS ROLE
-
Provide Consultant-level psychiatric care to adult inpatients, in line with the Trust’s Acute Operational Policy.
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Deliver clinical leadership and active involvement in quality improvement initiatives.
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Work collaboratively with multidisciplinary teams and contribute to a recovery-focused, trauma-informed approach to care.
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Coordinate with specialist and community teams to ensure effective patient transitions and continuity of care.
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Supervise and support junior doctors, specialty trainees, and students.
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Participate in Consultant on-call rota (details available on request).
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Engage in audit, teaching, research, and service development activities.
LIFE IN THE SOUTH OF ENGLAND
Located in the South of England, this opportunity offers the perfect balance of professional fulfilment and quality of life. The area combines vibrant urban centres, picturesque countryside, and excellent transport links — with London just 30 minutes away by train, and both Heathrow and Gatwick airports nearby for easy international travel.
This region is known for its historic market towns, outstanding schools, and a wide range of cultural and recreational activities. Whether you\'re relocating alone or with family, it offers something for everyone — from city convenience to coastal calm.
The Trust is committed to inclusivity, wellbeing, and the development of its workforce, offering access to flexible working and a wide range of staff benefits.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect, you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
-
CV preparation with a bespoke session with one of our specialists.
-
Application support with expert knowledge of NHS specialisms & recruitment practice.
-
At least two video interview preparation sessions.
-
Contract and offer negotiations for salary, relocation packages, tenure, and more.
Once you have accepted your new role, you’ll be supported by one of our dedicated relocation executives, who will guide you through the process, including:
-
Document gathering and checking.
-
COS and Visa Application support, if applicable.
-
Support sourcing short- and long-term accommodation.
-
Travel arrangements and family support for finding schools and other aspects of pastoral care.
Consultant Psychiatrist (General Adult Psychiatry) – Republic of Ireland
Location: Republic of Ireland - South
Salary: €222,215 to €266,925 per annum
Organisation: Health Service Executive (HSE), Ireland
Specialism: General Adult Psychiatry
Job Type: Inpatient and Community Services
A trust in the South of the Republic of Ireland is seeking a Consultant Psychiatrist with expertise in General Adult Psychiatry to lead a multidisciplinary team delivering both inpatient and community mental health services. The psychiatry department consists of a diverse and well-established team, including Consultant Psychiatrists, Nurse Team Leads, Community Mental Health Nurses, Occupational Therapists, Psychologists, Support Workers, and other allied health professionals.
This role offers an excellent opportunity to work across varied settings, contributing to high-quality care for adults with complex mental health needs. Applicants with European Specialist qualifications or UK CCT are strongly encouraged to apply, and both internationally based and Ireland-based doctors are welcome.
Job Requirements and Details
- Consultant-level experience in General Adult Psychiatry.
- Eligible for Medical Council of Ireland (MCI) registration with an equivalent European or UK specialist certification.
- Prior experience in adult mental health services is essential.
- Salary ranges from €222,215 to €266,925, depending on experience and qualifications.
Core Duties of the Role
- Provide clinical leadership in General Adult Psychiatry across both inpatient and community settings.
- Supervise and support the development of junior doctors and multidisciplinary colleagues.
- Deliver patient-centred care in collaboration with a skilled multidisciplinary team.
- Contribute to ongoing service development and quality improvement within the department.
Life in the Republic of Ireland – South Region
The South of Ireland is known for its high quality of life, combining vibrant urban life with the tranquillity of coastal and rural living. The region offers beautiful landscapes, excellent schools, rich cultural traditions, and a welcoming community. Well-connected transport links and a variety of recreational and family-oriented opportunities make it a fantastic place to live and work.
How IMG Connect Will Support You
By applying through IMG Connect, you will benefit from dedicated support throughout your relocation and recruitment journey, including:
- CV and application preparation tailored to Irish medical systems.
- Interview preparation, including two in-depth coaching sessions.
- Contract and salary negotiations to ensure you receive the best relocation package.
Once placed, our relocation team will assist with:
- Document collection and verification
- Visa and work permit guidance
- Short- and long-term accommodation solutions
- Travel planning and pastoral support for you and your family, including school search and local integration
This is an exciting opportunity to join a progressive and supportive mental health service, delivering high-impact care in General Adult Psychiatry within one of Ireland’s most scenic and vibrant regions.
Consultant Psychiatrist (Old Age Psychiatry) – Republic of Ireland
Location: Republic of Ireland - South
Salary: €222,215 to €266,925 per annum
Organisation: Health Service Executive (HSE), Ireland
Specialism: Old Age Psychiatry
Job Type: Inpatient and Community Services
A trust in the South of the Republic of Ireland is seeking a Consultant Psychiatrist with expertise in Old Age Psychiatry to lead a multidisciplinary team providing both inpatient and community services. The psychiatry department consists of a diverse team of professionals including Consultant Psychiatrists, Nurse Team Leads, Community Mental Health Nurses, Healthcare Support Workers, Care Home Liaison Nurses, Young Onset Dementia Nurses, Occupational Therapists, Psychologists, Dementia Post-Diagnostic Support, Care Managers, and other support staff.
This role offers a unique opportunity to work across both inpatient and community services, allowing for a broad and varied clinical experience in the field of old age mental health care. The position is open to both international applicants and those already based in Ireland, and those with equivalent qualifications such as a European Specialist qualification or CCT in the UK are strongly encouraged to apply.
Job Requirements and Details
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Consultant level experience in psychiatry.
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Eligible for Medical Council of Ireland (MCI) registration with equivalent European certification.
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Prior experience in Old Age Mental Health is essential.
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Salary will range from €222,215 to €266,925 depending on experience and qualifications.
Core Duties of the Role
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Provide clinical leadership in Old Age Psychiatry services across both inpatient and community settings.
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Supervise and support the training and professional development of junior doctors.
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Work collaboratively with the multidisciplinary team to provide high-quality care to patients.
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Participate in the development and improvement of services within the department.
Life in the Republic of Ireland - South Region
The South of Ireland offers a wonderful blend of vibrant urban areas and peaceful rural settings. With stunning coastlines, charming villages, and bustling cities, it’s an ideal location for both professional and personal life. Major cities offer excellent cultural, recreational, and family-oriented opportunities.
Transport links are efficient, and the region is home to highly regarded schools, a wealth of outdoor activities, and a rich cultural scene. Ireland\'s unique history and traditions provide a welcoming and enriching experience.
How IMG Connect Will Support You
When applying through IMG Connect, you’ll receive the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We will support you with:
-
CV preparation with a bespoke session with one of our specialists.
-
Application support with expert knowledge of Irish medical specialties and recruitment processes.
-
Interview preparation including at least two video calling interview sessions.
-
Contract and salary negotiations for the best possible relocation package, including accommodation and other benefits.
Once you have accepted your new role, IMG Connect’s relocation team will guide you through the entire transition, including:
-
Document gathering and verification.
-
Visa and work permit assistance if required.
-
Accommodation support for both short- and long-term housing.
-
Travel and relocation assistance, including support for your family in finding local schools or any other necessary pastoral care.
This is an exciting opportunity to join a dynamic team and contribute to the ongoing development of services in the field of Old Age Psychiatry in the Republic of Ireland\'s South Region.
A Health Board on the South Wales coast is seeking a Consultant Psychiatrist to join a central clinic as part of an evolving mental health service committed to delivering a 24-hour single point of admission, supported by two treatment wards and five dynamic community mental health teams.
This is a fantastic opportunity to lead clinical change within a supportive and multidisciplinary environment, where collaboration with management and clinical colleagues is highly valued.
This opportunity is open to both UK-based and international doctors, with CESR portfolio support available to help progress toward specialist registration.
Job Requirements and Details
Qualifications: Full GMC registration with a licence to practise, MRCPsych preferred, CCT or equivalent specialist qualification and training in Psychiatry.
Experience: Applicants must have significant experience in general adult psychiatry.
Desirable: Previous leadership roles, community mental health experience, and involvement in service development or clinical governance.
Salary: £106,000 to £154,760 per annum, dependent on experience and length of service.
Core Duties of This Role
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Take overall clinical responsibility for outpatient care, including the development and oversight of Care and Treatment Plans.
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Provide leadership and supervision to the multidisciplinary team, with clear delegation of responsibilities.
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Contribute to service planning in line with the strategic direction of the Health Board.
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Provide educational supervision to junior medical staff, supporting training and development in line with Royal College guidelines.
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Actively participate in quality assurance, clinical governance, risk management, and clinical audit processes.
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Fulfil on-call commitments on a 1:14 rota, with prospective cover across the SBUHB area.
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Engage in continuous professional development, including annual job plan review and maintenance of Royal College CPD requirements.
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Opportunities for involvement in research and innovation are encouraged and supported.
Living and Working on the South Wales Coast
The South Wales coast offers a unique blend of coastal beauty and urban convenience. With stunning beaches, nearby national parks, and a thriving cultural scene, the region provides a high quality of life for professionals and families.
The area is well connected, with excellent schools, vibrant communities, and strong transport links to Cardiff, Bristol, and London. Whether you\'re seeking outdoor adventure or a peaceful place to call home, the South Wales coast offers an ideal setting for both work and leisure.
How Will IMG Connect Support You?
When applying with IMG Connect, you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We will assist you with:
-
CV preparation with a bespoke session from one of our NHS recruitment specialists.
-
Application support tailored to psychiatric roles and NHS expectations.
-
Two comprehensive video interviews to prepare for your NHS panel.
-
Contract negotiation including salary, relocation, and service expectations.
Post-offer, your IMG Connect relocation executive will guide you through:
-
Visa sponsorship (including COS and application support).
-
Accommodation search assistance.
-
Family relocation support (schools, childcare, etc.).
-
Local area orientation and integration advice.