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
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS
A CCT in Child and Adolescent Psychiatry or General Adult Psychiatry, or being within six months of obtaining one, is preferred for this role. Section 12 approval under the Mental Health Act is essential. Candidates with an interest in adolescent mental health care are encouraged to apply. The salary will be between £105,504 and £139,882, dependent on experience or grade.
CORE DUTIES OF THIS ROLE
- Provide clinical leadership for a general adolescent inpatient unit focusing on acute mental health needs and short-term treatment pathways.
- Lead multidisciplinary assessments, treatment planning, and case management for adolescents with complex mental health disorders.
- Supervise junior medical staff and contribute to training programs within the service.
- Participate in clinical governance activities, including audits and service development initiatives.
Located in the vibrant North West region of England, this role offers a blend of urban and rural living opportunities. With excellent transport links to major cities and nearby countryside, the area provides a variety of housing, leisure activities, and cultural experiences. Families will benefit from outstanding schools and ample recreational opportunities. The region also boasts a rich industrial and cultural history that shapes its unique character.
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
- 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
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS
Full GMC registration, doctors with CCT or close to completing CESR, and those with AC and/or S12 are encourage to apply for this role. Anyone with an interest in community-based multidisciplinary services and patient-focused care should apply. The salary will be competitive and dependent on experience or grade.
CORE DUTIES OF THIS ROLE
- Lead and support the community mental health team in implementing transformation programs.
- Collaborate with primary care, voluntary sectors, and local providers to create integrated care systems.
- Provide patient care directly in the community while supervising and guiding the team on care pathways.
- Foster team development through training and shared clinical responsibilities.
This role is based in the West Midlands, a region known for its vibrant cities and scenic countryside. Popular areas include urban centers like Birmingham and quieter towns offering family-friendly environments. The region features excellent schools, diverse leisure activities, and strong transport links, including rail and international air connections.
Historically, this area has been central to Britain’s industrial and cultural growth, offering a rich heritage and modern lifestyle opportunities.
A hospital in the South West of England is looking for a Specialty Doctor in Psychiatry with an interest in community-based acute mental health care. The psychiatry department is well-supported by a comprehensive Home Treatment Team (HTT) and a wider multidisciplinary network. This role is open to both international and UK-based doctors, particularly those with Section 12 Mental Health Act approval or equivalent qualifications from recognized psychiatric bodies.
Candidates requiring support for CESR portfolios will be considered on an individual basis.
JOB REQUIREMENTS AND DETAILS
- Candidates must hold GMC registration and have a minimum of 3 years of psychiatric training or equivalent experience.
- The post is suited to doctors with an interest in mental health crisis care and alternatives to inpatient admission.
- The salary will range between £52,530 and £82,400, depending on experience and grade.
- Conduct psychiatric assessments, including acting as a doctor in Mental Health Act evaluations.
- Work collaboratively with the Home Treatment Team to deliver high-quality, urgent care and reduce hospital admissions.
- Participate in weekly case and risk review meetings within a multidisciplinary setting.
- Engage in clinical governance activities, including audits and quality improvement initiatives.
The South West is renowned for its picturesque coastline, rolling countryside, and vibrant communities. Options for living range from coastal towns with bustling activities to serene rural villages.
The region boasts strong transport links, including rail connections to major cities and convenient access to motorways. Families will find a variety of schooling options, and the area offers numerous leisure activities, from outdoor pursuits to cultural events.
The South West has a rich history, with links to notable figures and contributions to tourism, literature, and maritime heritage in the UK.
A mental health provider in London seeks a Consultant Psychiatrist in Older Adult Psychiatry, with an interest in ECT and dementia care. The position is based on a 14-bedded ward within a newly established mental health campus, supported by a skilled multidisciplinary team. Applications from both international and UK-based doctors are welcome, with preference given to those with MRCPsych or equivalent qualifications.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS:
- GMC registration, Section 12 approval, and Approved Clinician status (or eligibility) are required.
- Relevant experience in older adult psychiatry is essential.
- The salary will be competitive, dependent on experience or grade.
- Lead a multidisciplinary team to provide high-quality care for older adults with psychiatric conditions.
- Manage and supervise the delivery of ECT services, ensuring compliance with clinical standards.
- Mentor and support trainee doctors in a teaching-focused environment.
- Contribute to service improvement initiatives through quality audits and projects.
This lively part of London combines the charm of urban living with access to serene suburbs and green spaces. Residents benefit from excellent schools, diverse cultural attractions, and efficient public transport connecting them to central London. The area’s rich history and modern amenities make it a popular location for professionals and families alike.
Here’s the anonymized version of the job advert:
A UK-based mental health provider is seeking a Senior Specialist in Psychiatry with an interest in memory assessment services for older people. The psychiatry department includes a skilled team of consultants and clinical nurse specialists, offering a supportive environment for career growth. This opportunity is open to both international applications and UK-based doctors, with preference for those holding European Specialist training or MRCPsych qualifications.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS
- MRCPsych or equivalent qualification is required, along with a minimum of six years in relevant psychiatry roles.
- An interest in dementia and memory-related care is essential.
- The salary will be competitive, dependent on experience or grade.
CORE DUTIES OF THIS ROLE
- Provide senior medical leadership within the Memory Assessment Service (MAS), overseeing complex cases.
- Collaborate with a multidisciplinary team to assess, diagnose, and treat dementia and related memory disorders.
- Supervise and mentor clinical staff and contribute to their professional development.
- Participate in service improvement and innovation initiatives.
LIFE IN THE REGION
The region offers a mix of urban living in vibrant towns and peaceful countryside settings, providing options to suit a range of lifestyles. It is well-connected by major transport links and boasts excellent schools, recreational opportunities, and cultural attractions for individuals and families. The area also has a rich history and cultural significance, adding to its charm as a great place to live and work.