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:

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 

  1. Start your revision early – starting in advance allows you to pace yourself and get ahead of the stresses of last-minute revision and anxiety. 
  2. 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 
  3. 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. 
  4. 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. 
  5. 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

105,504 - 139,882

A leading NHS mental health hospital in the East of England is looking for a Consultant Psychiatrist in Old Age Psychiatry with a focus on functional illness within inpatient care. The service sits within a well-integrated healthcare system combining mental and physical health services. The post is based on a 22-bed ward, supported by a multidisciplinary team including psychologists, occupational therapists, physiotherapists, and speech and language therapists. This Old Age Psychiatry job is open to both international and UK-based doctors, with MRCPsych or EEA specialist certification most encouraged to apply.

Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.

JOB REQUIREMENTS AND DETAILS
  • Consultant level experience in old age psychiatry

  • Be eligible for GMC registration, either with MRCPsych (Full), or EEA specialist certification

  • Consultants with an interest and prior experience in old age psychiatry and inpatient functional illness should apply

  • The salary will be between £105,504 to £139,882 dependent on experience or grade

CORE DUTIES OF THIS ROLE
  • Provide medical oversight and psychiatric input for 22 beds (14 for functional illness, 8 for organic illness) on an inpatient ward

  • Conduct psychiatric assessments, care planning, and contribute to regular MDT reviews

  • Supervise junior doctors and support their training and development

  • Collaborate with community teams including the Crisis Resolution and Home Treatment Team for Older People (CRHTT-OP)

  • Liaise with other services such as social care, physical health teams, and voluntary sector partners to ensure coordinated care

  • Engage in clinical documentation, audits, research, and educational activities

LIFE IN THE REGION

This region offers a balance of vibrant urban living and tranquil countryside settings. From lively city centres with extensive amenities to quiet villages rich in charm, there’s something for everyone. The area benefits from excellent rail and road connections (50 minutes to London) high-performing schools, and a diverse mix of leisure and cultural attractions.

Steeped in history, the region is known for its architectural heritage and community spirit, making it a highly desirable location for professionals and families alike.

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 calling interview preparation sessions

  • Contract and offer negotiations for salary, relocation packages, tenure, and more

Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you all the way to starting your new post, including:

  • Document gathering and checking

  • COS and Visa Application support if applicable

  • Support sourcing short- and long-term accommodation

  • Travel arrangements

  • Family support for finding schools and any other aspects of pastoral care

107,144 - 142,369

An NHS Board in Eastern Scotland is looking for a Consultant Psychiatrist with experience in Old Age Psychiatry to lead an outpatient community team.. The Psychiatry department comprises a team of psychiatrists and multidisciplinary professionals including Nurse Team Lead, Community Mental Health Nurses, Community Mental Health Nurses, Healthcare Support Workers, Care Home Liaison Nurses, Young Onset Dementia Nurse, Occupational Therapists, Psychologist, Dementia Post Diagnostic Support, Care managers, DPDS Link Worker, Alzheimer Scotland Link Worker.

This Psychiatry job is open to both international applications and UK-based doctors, though those with European Specialist or MRCPsych or equivalent are most encouraged to apply.

Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.

JOB REQUIREMENTS AND DETAILS

  • Consultant level experience in psychiatry

  • Be eligible for GMC registration, either with MRCPsych (Full), or EEA specialist certification

  • Prior experience in Old Age mental health care.

Anyone with consultant experience in old  age psychiatry should apply. The salary will be between £107,144 - £142,369 per annum, dependent on experience or grade.

CORE DUTIES OF THIS ROLE

  • Provide clinical leadership and management in Old Age Psychiatry services.

  • Supervise junior doctors and contribute to their training and professional development.

  • Work closely with multidisciplinary teams to deliver high-quality patient care.

  • Participate in service development and improvement initiatives within the department.

LIFE IN SCOTLAND

This location offers a blend of urban convenience and rural tranquillity, with easy access to major cities such as Edinburgh, Dundee, and Glasgow. Whether you prefer city living with vibrant culture and nightlife or coastal and countryside retreats with stunning landscapes, there are plenty of options.
The region has excellent transport links, making commuting easy, and offers high-quality schools and a wealth of recreational activities, including outdoor pursuits, cultural festivals, and family-friendly attractions.
Scotland is steeped in history, known for its ancient castles, famous universities, and contributions to global innovation. The country provides a unique cultural experience, rich in traditions and scenic beauty.

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 calling interview preparation sessions

  • Contract and offer negotiations for salary, relocation packages, tenure and more

Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting your new role including:

  • Document gathering and checking

  • COS and Visa Application support if applicable

  • Support sourcing short- and long-term accommodation

  • Travel arrangements

  • Family support for finding schools and any other aspects of pastoral care

107,144 - 142,369
An NHS Board in Eastern Scotland is looking for a Consultant Psychiatrist with an interest in General Adult Psychiatry. The Psychiatry department comprises a team of consultants and multidisciplinary professionals and is supported by a large team of middle-grade doctors. This Psychiatry job is open to both international applications and UK-based doctors, though those with European Specialist or MRCPsych or equivalent are most encouraged to apply.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.

JOB REQUIREMENTS AND DETAILS
  • Consultant level experience in psychiatry
  • Be eligible for GMC registration, either with MRCPsych (Full), or EEA specialist certification
  • Prior experience in adult community mental health care is desirable.

Anyone with an interest in community or inpatient psychiatry should apply. The salary will be between £107,144 - £142,369 per annum, dependent on experience or grade.

CORE DUTIES OF THIS ROLE

  • Provide clinical leadership and management in General Adult Psychiatry services.
  • Supervise junior doctors and contribute to their training and professional development.
  • Work closely with multidisciplinary teams to deliver high-quality patient care.
  • Participate in service development and improvement initiatives within the department.

LIFE IN SCOTLAND

This location offers a blend of urban convenience and rural tranquillity, with easy access to major cities such as Edinburgh, Dundee, and Glasgow. Whether you prefer city living with vibrant culture and nightlife or coastal and countryside retreats with stunning landscapes, there are plenty of options.
The region has excellent transport links, making commuting easy, and offers high-quality schools and a wealth of recreational activities, including outdoor pursuits, cultural festivals, and family-friendly attractions.
Scotland is steeped in history, known for its ancient castles, famous universities, and contributions to global innovation. The country provides a unique cultural experience, rich in traditions and scenic beauty.

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 calling interview preparation sessions
  • Contract and offer negotiations for salary, relocation packages, tenure and more

Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting your new role including:

  • Document gathering and checking
  • COS and Visa Application support if applicable
  • Support sourcing short- and long-term accommodation
  • Travel arrangements
  • Family support for finding schools and any other aspects of pastoral care
105,504 - 139,882

An NHS mental health hospital in the North West of England is looking for a Consultant in Old Age Psychiatry, with an interest in both functional and organic disorders. The Mental Health department is part of a well-established multidisciplinary team, working alongside Consultants, Specialty Doctors, and various healthcare professionals. This psychiatry job is open to both international applicants and UK-based doctors, though those with MRCPsych (Full) or an EEA equivalent qualification are most encouraged to apply.

Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.

JOB REQUIREMENTS AND DETAILS

  • Minimum of two years\' experience in old age psychiatry.
  • UK applicants with CTT and S12 and AC status preferred 
  • Be eligible for GMC registration, either with MRCPsych (Full) or an EEA qualification.
  • Prior experience in old age inpatient mental health care is desirable.
  • The salary will be between £105,504 - £139,882 per annum, dependent on experience or grade.

CORE DUTIES OF THIS ROLE

  • Provide psychiatric care and assessments for adult and older adult patients with both functional and organic mental health conditions.
  • Work closely with other Consultants, specialty doctors and the multi-disciplinary team to support care planning and patient management.
  • Run inpatient services and contribute to continuity of care between community and inpatient settings.

LIFE IN THIS UK REGION

This region offers a mix of urban and rural living, with bustling towns and peaceful countryside options for residents. The area boasts excellent transport links, making it easily accessible from major UK cities. There are highly rated schools, a variety of leisure facilities, and plenty of green spaces, making it a great location for professionals and families alike. Historically, the region has played a key role in British heritage, with significant contributions to industry, culture, and transportation.

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 calling interview preparation sessions.
  • Contract and offer negotiations for salary, relocation packages, tenure, and more.

Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting your new role, 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 any other aspects of pastoral care.
105,504 - 139,882
A mental health service in the UK is looking for a Consultant in General Adult Psychiatry with an interest in crisis intervention and intensive home treatment. The psychiatry team consists of consultants and a multi-disciplinary support staff, working with a caseload of 15–20 patients. Applications are open to both UK and international doctors, with MRCPsych or CESR eligibility being particularly desirable.

Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.

JOB REQUIREMENTS AND DETAILS
  • Candidates must hold MRCPsych (or equivalent) and be eligible for GMC registration with Specialist Registration in General Adult Psychiatry or within six months of gaining CCT.
  • Prior experience in community or inpatient psychiatry is required.
  • The salary will be between £105,504 - £139,882 per annum, dependent on experience.
CORE DUTIES OF THIS ROLE
  • Provide clinical leadership for the Intensive Service team, ensuring high-quality home-based crisis care.
  • Assess and treat patients referred to the Intensive Team, contributing to care planning and management discussions.
  • Collaborate with inpatient services, community teams, and crisis services to support effective patient care.
  • Participate in the teaching and development of junior doctors and multidisciplinary colleagues.
LIFE IN THE REGION

This region offers a balance of rural and urban living, with access to beautiful countryside, historic landmarks, and well-connected towns. Professionals moving to the area benefit from excellent schools, transport links, and a range of cultural and outdoor activities.

The region has a rich historical significance, featuring historic towns, world-renowned heritage sites, and a vibrant local community. It is a desirable location for families and professionals looking for a high quality of life.

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 calling interview preparation sessions.
  • Contract and offer negotiations for salary, relocation packages, tenure, and more.
Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you all the way to starting your new role, including:
  • Document gathering and checking.
  • COS and Visa Application support if applicable.
  • Support sourcing short- and long-term accommodation.
  • Travel arrangements.
  • Family support for finding schools and any other aspects of pastoral care.

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