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
An excellent job opportunity for an experienced Consultant Adult Inpatient Psychiatrist to join a private healthcare organisation near to Birmingham. This role is based within a well-established inpatient setting, offering a great chance to advance your medical career and earn a higher salary compared to the NHS. This job provides CESR Portfolio Pathway support, welcoming international applications from IMGs.
Working in Private Healthcare
This private organisation is recognized for its commitment to delivering exceptional mental health services. They are known for its multidisciplinary approach, working collaboratively to provide holistic, patient-centric care. Specializing in general adult psychiatry, they focus on promoting recovery and improving the quality of life for its patients. The team is dedicated to ongoing innovation and quality improvement, ensuring that the highest standards of care are consistently met. This job offers a unique opportunity to be part of a dynamic team that values professional development and excellence in clinical practice.
The Psychiatry Department & Team
The Psychiatry Department has a 10-bedded ward for psychiartric intensive care unit for females of working age, and another 9-bedded ward for acute service which provides treatment for females of working age. The department is comprised of a multidisciplinary team dedicated to providing comprehensive inpatient care for adults with severe mental health conditions. The team includes consultants, junior doctors, psychologists, nurses, and allied health professionals, all working together to deliver evidence-based treatments. The department is committed to fostering a supportive and collaborative environment, where every team member plays a vital role in patient care.
The approach emphasizes continuous improvement and innovation, with regular team meetings and clinical governance sessions to ensure the highest quality of care.
Continued Professional Development:
This job offers further training & accreditation within general adult psychiatry, including CESR Portfolio Pathway Support, access to specialty training, and the opportunity to develop sub-specialist interests. They support its medical staff in pursuing their professional goals, providing access to a wide range of CPD opportunities, including in-house training programs and supervision. This commitment to professional development ensures that consultants are well-equipped to advance in their careers while delivering the highest standard of care to their patients.
Location
This private healthcare organisation is located in the midlands not fare from Birmingham. The area boasts a low cost of living, making it an attractive option for those relocating. It is a safe and family-friendly area with excellent schools, a rich cultural scene, and plenty of recreational activities. The region is known for its natural beauty, with easy access to national parks and outdoor pursuits. Additionally, it has excellent transport links, making it easy to connect with other parts of the UK.
Am I eligible for this role?
UK based candidates:
- Experience in General Adult Psychiatry
- CCT (Preferred)
- Section 12
- AC Status (Preferred)
EEA candidates:
- Experience in General Adult Psychiatry
- European Specialist Qualification
Non-EEA candidates:
- MRCPsych
- Experience in General Adult Psychiatry
An excellent NHS job opportunity for an experienced psychiatrist to join this NHS Trust as a Specialist Doctor working in a community psychiatry setting in the UK. This NHS job offers CESR Portfolio Pathway support and international applications from IMGs are welcome.
The NHS Trust
The NHS Foundation Trust is a renowned provider of integrated healthcare services, covering a broad spectrum of care. The Trust is committed to delivering high-quality, compassionate care and has received accolades for its innovative approaches and excellent clinical outcomes. As part of the NHS, the Trust ensures comprehensive mental health services, physical health care, and specialist services to the community. Their robust partnership with local authorities and healthcare providers enhances their service delivery, making it an exceptional place for medical professionals to grow and make a significant impact.
The Department & Team
The Child & Adolescent Mental Health Services (CAMHS) team is a forward-thinking, dynamic department. The team provides community-based services to young people up to 18 years old. The department includes a mix of professionals, such as a substantive consultant, trainees, non-medical prescribers, and a well-resourced multidisciplinary team (MDT). The service boasts various specialized programs like the Mental Health in Schools teams, CAMHS Psychiatry Liaison, and Enhanced Support services. Pebble Lodge, the CAMHS inpatient unit, holds an outstanding rating from the Care Quality Commission, reflecting the high standards of care provided.
Continued Professional Development
This NHS job offers further training & accreditation within Child & Adolescent Psychiatry, including CESR Portfolio Pathway Support, access to specialty training, and the opportunity to develop sub-specialist interests. The NHS Foundation Trust supports continuous professional development with structured training programs, opportunities for research, and participation in innovative projects, ensuring doctors can advance their careers and contribute to service development.
Location
The area is a vibrant coastal town known for its stunning beaches, beautiful parks, and a variety of cultural and recreational activities. The area offers a high quality of life with excellent schools, safe neighborhoods, and affordable living costs. With easy access to natural areas of beauty and efficient transport connections to major cities, it is an ideal location for international doctors and their families seeking a balanced lifestyle in the UK.
??????Am I eligible for this role?
UK based candidates:
- Experience in Child & Adolescent Psychistry
EEA candidates:
- Experience in Child & Adolescent Psychistry
- European Specialist Qualification
Non-EEA candidates:
- MRCPsych
- Experience in Child & Adolescent Psychistry
An excellent NHS job opportunity for an experienced Consultant Psychiatrist to join this NHS Trust in the West of England as a Consultant working in an established acute psychiatric ward in the UK. This NHS job offers CESR Portfolio Pathway support and international applications from IMGs are welcome.
The NHS Trust
This NHS Trust provides Community Health, Mental Health, Social Care, and specialist Learning Disability services. Formed from the merger of two previous trusts, it has been operational since October 1, 2019, and received a ‘Good’ rating from the CQC in 2022. This role offers a unique opportunity to be part of a forward-thinking team dedicated to enhancing patient outcomes.
The General Adult Psychiatry Department & Team
The General Adult Psychiatry department includes acute wards, a PICU, a low-secure unit, and a Hospital-Based Place of Safety. The Consultant Psychiatrist will lead a multidisciplinary team, including a Specialty Doctor, Foundation Doctor, Core Trainee, and nursing staff. Responsibilities include direct patient care, consultation, and supervision of junior doctors, ensuring comprehensive management plans for inpatient treatment and community reintegration. The department is recognized for its high standards, receiving accolades and accreditations from the Royal College of Psychiatrists and the Healthcare Commission.
Continued Professional Development
This NHS job offers further training & accreditation within General Adult Psychiatry, including CESR Portfolio Pathway Support, access to specialty training, and the opportunity to develop sub-specialist interest. Opportunities for teaching, research, clinical governance, and quality improvement projects are integral to the role. The Trust supports continuous professional development with dedicated training for educational and clinical supervision, participation in job planning reviews, and providing resources like a full-time medical secretary, dedicated office space, and modern IT facilities.
Location
This region in the West of England offers an excellent quality of life for international doctors and their families. The cost of living is relatively affordable, and the area boasts a variety of good schools, making it an ideal location for families. The region is rich in history and culture, with numerous attractions, including historic landmarks, museums, and festivals. It is surrounded by beautiful natural areas, perfect for outdoor activities. With excellent transport links, including proximity to major motorways and direct train lines to major cities, this region is well-connected, offering the best of both urban and rural living in the UK.
Am I eligible for this role?
UK based candidates:
- CCT or Specialist Registration (preferred)
- Experience in General Adult Inpatient Psychiatry
- S12
- AC (preferred)
EEA candidates:
- Experience in General Adult Inpatient Psychiatry
- European Specialist Qualification
Non-EEA candidates:
- MRCPsych (preferred)
- Specialist/Consultant Experience in General Adult Inpatient Psychiatry
We are looking to recruit a Consultant Psychiatrist to a Crisis & Assessment Team role in the Channel Islands, a UK territory sitting off the coast of France and just a 1 hour flight from London. This job presents a great opportunity to advance your medical career in the UK.
The health service, separate from the NHS, is an integrated, taxation-funded system, free at the point of delivery, managed by the Health and Community Services Department on the island. Key benefits of working there are higher salaries than the NHS, lower taxes and sunnier weather.
Consultant Pay range - £110,257 to £164,372
Single rate of tax - 20%.
The Department & Team
The Crisis and Assessment Team (CAT) serves as the primary gateway to adult and older people\'s mental health services, conducting assessments in the community and emergency settings, alongside medical reviews. They collaborate closely with law enforcement, responding to Adult Protection Notices and coordinating mental health law assessments. This role within the CAT focuses on streamlining referrals, providing short-term crisis interventions, and ensuring individuals receive appropriate ongoing care. You\'ll engage with both working-age adults and older adults, with responsibilities extending to police referrals and mental health law assessments during standard working hours, with on-call commitments.
Continued Professional Development
Professional development is integral to their ethos, offering CESR Portfolio Pathway support, access to specialty training, and opportunities for sub-specialist development. They prioritize ongoing learning through conferences, local CME events, and a generous study leave allowance.
Life in the area
Living in this location offers significant financial benefits. The flat income tax rate of 20% is notably advantageous compared to the UK, and a generous public sector pension scheme is provided, not constrained by UK lifetime or annual contribution limits. The consultant contract closely mirrors the UK model but offers higher incremental levels starting at £110,257 and with a top basic salary of £164,372.
Am I eligible for this role?
UK based candidates:
- Experience in General Adult Psychiatry
- Specialist Registration or locum consultant experience
EEA candidates:
- Experience in General Adult Psychiatry
- European Specialist Qualification
Non-EEA candidates:
- MRCPsych
- Experience in General Adult Psychiatry
We are looking to recruit a Consultant Psychiatrist to an Old Age role in the Channel Islands, a UK territory sitting off the coast of France and just a 1 hour flight from London. This job presents a great opportunity to advance your medical career in the UK.
The health service, separate from the NHS, is an integrated, taxation-funded system, free at the point of delivery, managed by the Health and Community Services Department on the island. Key benefits of working there are higher salaries than the NHS, lower taxes and sunnier weather.
Consultant Pay range - £110,257 to £164,372
Single rate of tax - 20%.
What is the health & community service like?
Working in this location is professionally rewarding, offering high-quality, patient-centered care. Clinicians lead in developing and managing services, supported by strong links with UK specialists. With a generous study leave budget, doctors are encouraged to pursue further education. Exciting developments include a new general hospital and a new mental health inpatient unit. The service fosters strong relationships between mental health, primary, and secondary care, promoting joint learning and teaching in a modern education center.
What is the department & team like?
The inpatient services are currently undergoing extensive refurbishment, including two wards for older adults. One ward offers 14 assessment beds for individuals over 65 experiencing functional mental health issues, with some flexibility for those under 65. The other ward provides 10 assessment beds for patients with dementia. Following the refurbishment, the latter ward will feature 8 acute assessment beds and 8 transitional/step-down beds for those with dementia or enduring mental health problems who cannot be supported in local nursing or residential homes.
The Older Adults Community Mental Health Team (OACMHT) manages a caseload of about 300 patients, including new referrals triaged by the Crisis and Assessment team, providing both short-term treatment and long-term care coordination. The role involves providing medical support to the OACMHT alongside two other consultants and a staff grade doctor.
The post holder will join an established team, comprising 2 WTE older adult consultants, 1.0 WTE Associate Specialist (Memory Assessment Service), 2.0 WTE staff grades (inpatient and community), and 1.0 WTE F1 doctor (inpatients and community). Dedicated administrative support includes a 0.5 WTE medical secretary and ward and team secretarial support.
Continued Professional Development
This position offers further training and accreditation within psychiatry, including CESR Portfolio Pathway support, access to specialty training, and the opportunity to develop sub-specialist interests. The post holder will have ample opportunities to develop knowledge, skills, and experience through attendance at relevant courses, conferences, and locally organized CME events. The organization supports Continuing Medical Education with time and financial support, offering study leave of 30 days in 3 years and an annual study leave allowance. Regular case discussions, teaching sessions, and MDT supervision ensure ongoing professional development, meeting the Royal College of Psychiatrists\' CPD requirements.
Living in the Area
Living in this location offers significant financial benefits. The flat income tax rate of 20% is notably advantageous compared to the UK, and a generous public sector pension scheme is provided, not constrained by UK lifetime or annual contribution limits. The consultant contract closely mirrors the UK model but offers higher incremental levels starting at £110,257 and with a top basic salary of £164,372.
Am I eligible for this role?Am I eligible for this role?
UK based candidates:
- Experience in Old Age Psychiatry
- Specialist Registration or locum Consultant Experience
- Experience in Old Age Psychiatry
- European Specialist Qualification
- MRCPsych
- Consultant experience in Old Age Psychiatry