MRCPsych CASC exam - a guide for IMGs
- April 06, 2023
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 outstanding opportunity for a psychiatrist to join Forensic Psychiatry Department as Specialty Doctor that has received outstanding ratings from the CQC on three occasions. You will offer psychiatric input and conduct assessments, both psychiatric and physical, for patients on two wards. One ward is a self-contained low secure rehabilitation unit situated away from the main hospital premises, while the other is a medium secure rehabilitation ward. This role offers exposure to a broad spectrum of clinical presentations, including personality, affective, anxiety, psychotic, neurodevelopmental, and substance-related disorders. Moreover, it provides a platform for developing knowledge and understanding of forensic mental health sections. This position also offers CESR support for those seeking progression within the UK NHS Jobs system.
This is a great opportunity for overseas Specialty Doctors who want to establish themselves in the NHS, and grow their career. The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.
What is the NHS Trust like?
The Mental Health NHS Trust is a leading provider of mental health service serving a population of 1.2 million. With five main inpatient sites and 25 community locations, they offer comprehensive support for both mental and physical health needs, catering to young people and adults alike. From managing phobias and anxiety to addressing conditions like bipolar disorder and schizophrenia, their services are diverse and inclusive. They integrate community health services with mental health care, enabling simultaneous treatment of conditions such as diabetes and mental health issues, promoting holistic patient care.
Forensic Psychiatry Team & Department
The Forensic Service enjoys a stellar reputation, earning an \'Outstanding\' rating from the Care Quality Commission. The Forensic Service delivers care in low and medium secure environments, featuring specialized facilities such as the National Stalking Clinic and the Fixated Threat Assessment Centre (FTAC). These services focus on evaluating and managing risks for prominent individuals.
The inpatient service consists of one acute assessment and treatment medium secure male 4 4 ward, four treatment and intervention medium secure male wards, one female medium secure ward, one medium secure and one low secure male learning disability ward, one low secure male FICU ward and 4 low secure male wards. There are currently 25 Consultant Forensic Psychiatrists in post, working with 5 senior psychiatric trainees who rotate with posts at other forensic psychiatric services in the region. There are 5 junior psychiatric trainees, coming from the UCH training schemes. The service currently employs 10 specialty doctors, working in the prisons and in the rehabilitation parts of the service.
Life in the area
The area offers a blend of urban and suburban living, providing both rural escapes and city conveniences. Residents can explore scenic parks or enjoy activities at different parks. The area boasts a range of quality schools and easy access to universities like Middlesex University. Transport links are excellent, with frequent trains to central London and nearby cities, as well as efficient connections to major airports. Housing options vary from historic cottages to modern apartments, catering to diverse preferences and lifestyles.
Career Development and Opportunities Available
With an extremely active education/teaching programme supported by the consultant team, there is opportunity to work towards and complete CESR, RCPsych exams, get involved in active research and many aspects of CPD.
Participation in research and educational activities will be encouraged.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Forensic Psychiatry (Desirable)
Non-EEA Candidates:
- MRCPsych
- Experience of working in Forensic Psychiatry (Desirable)
UK based applicants
- Experience of working in Forensic Psychiatry (Desirable)
An excellent opportunity for an experienced Consultant Old Age Psychiatrist to join an established NHS community clinic in London. The post if suitable for overseas psychiatrists, including candidates who are pursuing CESR. Specialists in Psychiatry, holding a specialist certification would be suitable for this post, based on experience entering at either Specialty Doctor or Consultant grade.
WHAT IS THE DEPARTMENT & TEAM LIKE?
The post offered is that of Specialist Psychiatrist in Older Adult Psychiatry, working in both the community mental health team and the memory clinic. In addition to this post, three additional CMHTs make up the older adult community service for the borough. The personnel of the CMHT include: medical staff, Community Psychiatric Nurses, Occupational Therapist, and Psychiatric Social Workers. There is a Psychological Therapy Department which provides therapy for older adults and which works across CMHTs in the Borough as does the Occupational Therapy Service.
The post holder will have responsibility for the diagnostic assessment and treatment of older adult psychiatric patients from the designated catchment area referred to and accepted by the service. Outpatient clinics and domiciliary visits in the community will constitute the majority of the direct clinical care provided by the post holder.
WHAT IS LIFE LIKE IN NORTH LONDON FOR PSYCHIATRISTS?
This great world city is far more than just the capital of the United Kingdom of Great Britain and Northern Ireland. London is bustling, vibrant, multicultural and cosmopolitan. London is both old and new, a place where traditional pubs rub shoulders with the newest cocktail bars. Its most ancient castle is right next door to its newest skyscrapers. London\'s energy, as 8.6 million people go about their everyday lives, is tangible in every journey on the Underground, every stroll through a market and every walk along the banks of the River Thames. From the royal parks to the theatre stage, London really does have it all.
Working as a psychiatrist in London brings a range of exciting prospects. You will have the opportunity to work in some of the best mental health trusts in the UK, who will offer you the opportunity to constantly grow your medical and scientific knowledge and skills. In London you will have the opportunity to work in a wide range of settings, and as you progress through your career, you will have more opportunity to shape the way you work; you can develop research, work part time or full time and can combine your career with a wide range of other interests.
WHAT OPPORTUNITIES ARE AVAILABLE TO YOU AT THE TRUST?
With an extremely active education/teaching programme supported by the consultant team, there is opportunity to work towards and complete CESR, RCPsych exams, get involved in active research and many aspects of CPD.
Participation in research and educational activities will be encouraged.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
-
6 years experience of working in Older Adult Psychiatry
-
Board Certified Specialist in Psychiatry (desirable)
Non-EEA Candidates:
-
MRCPsych (desirable)
-
6 years experience of working in Older Adult Psychiatry
UK based applicants
-
6 years experience of working in Older Adult Psychiatry
-
S12 (desirable)
An NHS job opportunity is available for an ambitious and passionate General Adult Psychiatrist to join a trust rated \"Outstanding overall\" CQC. This position presents an ideal prospect for psychiatrists from overseas who aspire to establish themselves within the UK\'s NHS system and progress toward a consultant-level career. It is well-suited for candidates seeking support to achieve Certificate of Eligibility for Specialist Registration (CESR). Doctors must have 6 years work experience after finishing core psychiatry training or equivalent international qualification to be considered for this opportunity.
What is the department & team like?
The department boasts a comprehensive General Adult Psychiatry department, equipped to deliver exemplary mental health care. Staffing includes a proficient team of consultants and dedicated junior doctors committed to providing superior patient care and support. The department\'s activity is marked by a wide spectrum of cases, ranging from common mental health disorders to more complex presentations. Patients receive tailored treatment plans incorporating evidence-based therapies, medication management, and holistic approaches to ensure comprehensive care.
Facilities within the department are modern and conducive to patient well-being, fostering an environment conducive to recovery and healing. Patients benefit from comfortable inpatient units, outpatient clinics, therapy rooms, and recreational spaces. On average, the department manages a significant caseload of general adult psychiatry cases annually, indicative of its pivotal role in addressing mental health needs within the community. The team\'s dedication to excellence and patient-centered care underscores the department\'s status as a leading provider of psychiatric services in the region.
What is the area like?
Location in a beautiful part of the south of England with easy links to London and Cambridge. Housing options range from historic cottages in quaint villages to modern developments, catering to diverse lifestyles. The location truly provides a balanced living experience, combining natural beauty, cultural richness, and modern comforts.
ELIGIBILITY FOR THE ROLE:
Non-EEA:
- MRCPsych (Desirable)
- 6 years specialist experience in General Adult Psychiatry
- Specialist certification in psychiatry (desirable)
- 6 years specialist experience in General Adult Psychiatry
- 6 years Specialty Doctor experience in General Adult Psychiatry
Join an Older Adult Community Mental Health team led by experienced consultants and supported by a dynamic team of Specialty Doctors. This NHS Trust, rated \"Good\" overall by the CQC, prioritizes staff support and offers a flexible training program for career advancement and work-life balance. Ideal for overseas Consultants and specialists seeking to establish themselves in the NHS and also Junior Doctors or Specialty Doctors already in the UK. MRCPsych is essential for mosts doctors trained outside of Europe. European doctors would need specialisation in psychiatry with ideally expertise in old age.
The post holder is expected to provide direct psychiatric services through the comprehensive evaluation, diagnosis, treatment planning, and treatment of patients assigned to him/her. The post holder is expected to be involved in discussions about assessments, treatment and risk management of patients in accordance with medical standards. The final decision rests with the consultant.
Life in the West Midlands
The West Midlands offers a blend of rural charm and urban amenities, catering to diverse preferences of residents. Its picturesque countryside provides opportunities for outdoor activities such as hiking, cycling, and exploring historic landmarks like Worcester Cathedral. The area boasts reputable schools and universities, ensuring quality education for families. Transportation links are convenient, with access to major cities like Birmingham and Bristol, as well as airports for domestic and international travel. Housing options range from quaint cottages in rural villages to modern developments in bustling towns, accommodating various lifestyles and preferences.
Career Development & Opportunities Available
The NHS Trust provides an environment that actively supports career development and offers various opportunities for professional growth. Staff members have access to ongoing training and development programs to enhance their skills and stay abreast of the latest advancements in healthcare. The Trust encourages and facilitates career progression, with opportunities for staff to take on additional responsibilities and roles within their specialties. Continuous professional development is promoted, ensuring that individuals can advance their careers and contribute effectively to patient care.
For those seeking further qualifications or specialization, the Trust may provide support for relevant educational pursuits, contributing to the professional development of its staff. CESR is a key feature of this role, with a current cohort of candidates working through CESR you will benefit from excellent support.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Specialist Qualification in Old Age Psychiatry
Non-EEA Candidates:
-
MRCPsych (Desirable)
-
Experience of working in Old Age Psychiatry (essential)
UK based applicants
- Experience of working in Old Age Psychiatry (essential)
- MRCPsych (desirable)
- Section 12 (desirable)
An exciting opportunity for an experienced Consultant in Child & Adolescent Psychiatry to join an award winning CAMHS inpatient unit. The team supports each other in balancing high quality patient care while you are pursuing your own special interests. The team is part of an NHS Foundation Trust that is a leading Trust in mental health research. The Trust was rated as \"good\" overall by the CQC in 2019. The post if suitable for overseas consultants, including candidates who are pursuing CESR. Specialists in Child & Adolescent Psychiatry holding a specialist certification would be suitable for this post, based on experience entering at either Specialty Doctor or Consultant grade.
Overseas applications from experienced Specialty Doctors and Consultants are welcomed.
WHAT IS THE NHS FOUNDATION TRUST LIKE?
The NHS Foundation Trust is the leading trust in mental health research. They provide excellent opportunities for professional development. The NHS Foundation Trust provides a broad range of community and inpatient mental health services, community services (including therapies), learning disability services, healthy lifestyle support and addictions services to a population of 765,000 people of all ages who live within areas of more than 4,700 square kilometres.
The Trust employs approximately 2,800 staff across more than 79 sites at locations throughout 4 towns. Their budgeted income for 2022/2023 is £186m. The NHS Foundation Trust works closely with major academic partners which ensures the nurturing of workforce of tomorrow\'s doctors, nurses and other health professionals. They aim to be a leading provider of integrated health services, recognised for the care compassion and commitment of their staff and known as a great employer and a valued partner.
The way they deliver their services has a direct bearing on their patients and carers’ experience of the Trust and, most importantly of all, their health. The Humber Teaching NHS Foundation Trust aim to provide the best services they can and constantly look at how they can improve them aspiring to excellence and be the best that they can be. They offer a wide range of benefits to help support a healthy work-life balance and support their employees\' overall health & wellbeing.
WHAT IS THE DEPARTMENT & TEAM LIKE?
The service is a team of excellent and forward thinking doctors consisting of: psychiatrists, psychologists, nurses, creative therapists and family therapists. There is currently funding for 4.8 WTE Community Consultant Child & Adolescent Psychiatrists. The service aims to keep children and adolescents at home with increased support if possible. The Trust provides a comprehensive Specialist Child & Adolescent Mental Health Service for young people that are 19 years and under.
The department has a Crisis Team that operates 24 hours a day, 7 days a week. While the Home Treatment (Intensive Intervention Team) aims to work from 8AM to 6PM, 7 days a week. The services is provided at various locations across the town in order to be able to offer families an accessible and convenient service within a less stigmatising and less threatening environment. There is also a team that works with people aged between 14 and 65, who are experiencing their first episode of psychosis or might be at risk of developing psychosis.
The post holder expected to make assessment of referrals/admissions. The post holder will liaise and collaboratively work with other services/agencies. The successful candidate is expected to have a care plan and treatment formulation, guidance on evidence-based treatment and effectiveness.
WHAT IS LIFE LIKE IN THE AREA?
Blessed with rural beauty, bustling towns and a dramatic coastline, the town makes a wonderful place to call home. Affordable property prices make living here even more appealing, with luxurious city-centre apartments, quiet suburban new builds and charming country cottages to choose from. Some of the UK’s finest beaches are located right here. Affordable property prices make living here even more appealing, with luxurious city-centre apartments, quiet suburban new builds and charming country cottages to choose from.
The town is known for its quirky narrow streets and bustling harbour overlooked by the striking Gothic ruins. It is a fascinating town, unlike any other. You will enjoy the quirky fishing villages, the unspoilt sandy beaches, the staggering views from the clifftops, and the popular seaside resorts. You will enjoy the 800km of bridleways that weave through the peaceful and colourful countryside of the North York Moors National Park.
WHAT OPPORTUNITIES ARE AVAILABLE TO YOU AT THE NHS FOUNDATION TRUST?
With an extremely active education/teaching programme supported by the consultant team, there is opportunity to work towards and complete CESR, exams, get involved in active research and many aspects of CPD.
Participation in research and educational activities will be encouraged.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Child & Adolescent Psychiatry
- Board Certified Specialist in Child & Adolescent Psychiatry
Non-EEA Candidates:
- Experience of working in Child & Adolescent Psychiatry
UK based applicants
- Experience of working in Child & Adolescent Psychiatry
- Within 6 - 12 months of completing CCT