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MRCPsych CASC exam - a useful guide for IMGs

• April 08, 2020

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 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 test?
• 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 CASC exam? 

The Clinical Assessment of Skills and Competencies (CASC) tests your skills in a range of clinical situations.

The CASC format is like an OSCE (Objective Structured Clinical Examination).

The CASC 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. 

• History Marksheet 
• Management Marksheet 
• Examination Marksheet 

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:

• be observed interviewing patients in ward rounds for specified reasons 
• be observed interviewing patients in out-patient or community settings or other contexts for specified reasons 
• be assessed via formal presentation of cases with their medical notes; discuss management of cases with their Clinical or Educational Supervisor
• be assessed formally 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. 

See below table of MRCPsych fees for 2020

Where can I sit the CASC test? 

You can currently sit the CASC test in both the UK and two overseas venues, Hong Kong and Singapore. 

2020 MRCPsych CASC Exam dates have been released, these are: 

2020 fees have been released – the MRCPsych (CASC) costs £1,093 in the UK and £1,491 in Hong Kong and Singapore. 

To ensure you get a space on the exam, you have to apply online during the application window. Applications submitted after the closing date will be rejected. The application windows for London are below: 

Results from the CASC examinations will be released on the following date: 

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 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 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.

Passed? What next? 

First of all, congratulations! After you have passed all parts of MRCPsych you can apply for a full registration with a license to practice. Once the GMC have approved your application, you can work as a doctor in the UK. 

To help you find a job in the NHS simply follow these easy steps:

• • Register with IMG Connect
• • Fill in the 'Personal details' section.
• • Arrange a chat with your dedicated IMG Consultant 
• • Sign up to receive 'job alerts’ 
• • Search our live Psychiatry jobs

Searching for psychiatry jobs in the NHS could not be easier

If you want to find out more about the many different psychaitry roles available within the NHS - it only takes a minute to register with IMG Connect and receive expert advice and representation. We have helped many overseas psychiatrists secure consultant, specialty doctor, registrar, clinical fellow and staff grade NHS jobs, whilst offering expert guidance to many more IMGs on NHS doctor pay, MRCPsych exams and English language testing. We’d be happy to help you!