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MRCGP SCA Format: 12 Consultations and Marking Domains

Specialty Exam Guides Family Medicine

MRCGP SCA Format: 12 Consultations and Marking Domains

UK MRCGP SCA format explained: 12 consultations, station timing, video and telephone cases, and how the marking domains shape your overall score.

  • Oral board prep
  • MRCGP SCA
  • Family Medicine
  • Exam format

The MRCGP SCA format is straightforward on paper: 12 simulated consultations, each with 3 minutes' reading time and 12 minutes with a role player. What catches candidates out is that the mark is not about passing a target number of stations. You are judged across three marking domains in every case, and Clinical management and medical complexity carries extra weight in the overall scoring.

Why the format matters

RCGP has kept the structure and format of the SCA unchanged through the August 2025 curriculum update. It also states that there is no preferred consultation model or script. So your aim is not to sound polished or theatrical. Your aim is to look like a safe, adaptable GP under time pressure.

The passing standard is the newly qualified GP who is fit to consult without supervision in UK general practice. Cases are drawn from a blueprinted bank and delivered in a standardised way through trained role players, so examiners are listening for repeatable behaviours: selective data gathering, safe management, and person-centred communication. That is the lens to use when you practise.

MRCGP SCA format on the day

The exam consists of 12 consultations. Most are with simulated patients, but the case may also involve a carer, parent, or another health or social care worker. Some stations are video, some are telephone, and physical examination is not assessed in the SCA itself.

In the current examination day guide, the session runs as two blocks of six stations with a 10-minute break in the middle. Each station is 15 minutes long in total: 3 minutes to read the brief, then 12 minutes to consult. The published guide also shows scheduled AM and PM session windows, and notes that some circuits may include a rest station of standard length.

Use the 3-minute reading time to decide four things quickly:

  • What is the task here: diagnose, explain, negotiate, refer, or safety-net?
  • What would make this unsafe if I miss it?
  • What endpoint must I reach by minute 12?
  • What might matter to this person apart from the diagnosis?

That keeps you anchored to the mark scheme instead of to a memorised opener.

What can appear in the 12 consultations

The brief does not always tell you the true purpose of the consultation. Some stems are obvious; others are deliberately less signposted. RCGP says each exam day differs, the 12 cases cannot be predicted in advance, and cases are drawn from a bank of hundreds mapped to the curriculum.

The blueprint is broad. Across the whole exam, cases are spread across clinical experience groups such as children and young people, sexual and reproductive health, long-term conditions, older adults, mental health, urgent care, health disadvantage and vulnerability, ethnicity and culture, new undifferentiated presentations, prescribing, investigation and results, and professional conversations or dilemmas. Prepare for range, not for a guessed case list.

How the MRCGP SCA marking domains work

Each case is marked in three domains: Data gathering and diagnosis (DG&D), Clinical management and medical complexity (CM&C), and Relating to others (RTO). For each domain, the examiner awards Clear Pass, Pass, Fail or Clear Fail. A different examiner marks each case after the exam, so your overall result is built from 12 separate examiner judgements rather than one person's impression.

Just as important, there is no rule that you must pass a certain number of stations. RCGP states that candidates are judged across the whole assessment, with case pass marks derived by borderline regression rather than a fixed station mark. So do not think in terms of needing 8 out of 12. Think in terms of producing safe domain-level performance all day.

Data gathering and diagnosis

At passing level, examiners want targeted information gathering, red-flag awareness, and a structured approach to a differential or working diagnosis, especially when the presentation is vague or complex. They do not want a full review-of-systems recital. In a 67-year-old with chest pain, for example, selective questions about timing, character, associated symptoms, risk, and immediate instability score better than an exhaustive but unfocused history.

Clinical management and medical complexity

This domain asks whether your plan is safe, prioritised, guideline-aware, feasible in UK general practice, and sensible for the short and long term. It includes prescribing, referral, follow-up, continuity, uncertainty, prevention, multimorbidity and safeguarding. RCGP also weights this domain compared with the other two, and its toolkit highlights poor or outdated management as a common reason for weak performance.

Relating to others

This is not a bonus communication mark added at the end. Examiners are looking for person-centred communication, ethical awareness, adaptation to communication barriers, and a shared understanding with the patient. The feedback guide specifically warns against formulaic consulting, stock phrases, poor cue-picking, and failing to explore agenda, beliefs or preferences.

A good station usually feels clinically ordinary. You identify the problem safely, say what you think is going on, offer a workable plan, and bring the patient with you.

A simple structure that fits the mark scheme

RCGP's consultation toolkit describes the 12-minute consultation as starting with data gathering and making a diagnosis, then moving into clinical management and medical complexity, with relating to others running throughout. That is a useful mental map because it matches the mark scheme without forcing you into a script.

A practical station structure looks like this:

  • Reading time: identify task, risk, likely agenda, and likely endpoint.
  • Opening minute: establish why the patient is here and whether there is any immediate safety issue.
  • Middle phase: ask targeted questions that narrow the problem and show diagnostic reasoning.
  • Final third: explain your working diagnosis, give a safe plan, arrange follow-up, and safety-net clearly.
  • Throughout: listen for cues, respond naturally, and check the patient's understanding.

Use that framework lightly. RCGP explicitly says there is no preferred consultation model, so if the patient is distressed, angry, confused, or high risk, adapt early rather than waiting to get through your checklist.

Common mistakes

  • Taking too long over data gathering, then rushing management, explanation and follow-up at the end.
  • Giving a vague or outdated management plan, especially around referral or prescribing.
  • Sounding scripted: repeated empathy phrases, missed cues, weak active listening.
  • Trying to pass by station-counting instead of producing steady domain performance across the whole exam.
  • Treating every case as a video station. Telephone consultations need clearer signposting, sharper summaries, and more explicit checking of understanding.
  • Spending precious time describing a full physical examination routine. Physical examination is assessed in WPBA rather than the SCA.

Practice workflow

Use official resources first: the RCGP consultation toolkit, feedback statements, webinars for ST2 and ST3 candidates, and the examination day guide. RCGP's webinar page advises attending at least three months before you plan to sit. Then build your own mock SCA or mock viva-style rehearsal around the three domains, not around memorised phrases.

A simple rehearsal loop works well:

  • Run two or three timed mocks a week.
  • Score each mock separately for DG&D, CM&C and RTO.
  • Debrief with three questions: Did I make sense clinically? Was my plan safe and current? Did the patient feel understood?
  • Rotate blueprint groups over a month so you keep breadth.
  • Re-run one weak consultation within 48 hours, after feedback.

If one domain keeps dragging you down, isolate it. A warm but vague candidate needs referral, prescribing and follow-up drills. A knowledgeable candidate who runs out of time needs selective-history practice. Diagnose the consultation problem properly, then train the right fix.

Summary

  • The current MRCGP SCA format is 12 consultations, each with 3 minutes' reading time and 12 minutes to consult; stations may be video or telephone, and physical examination is not assessed in the SCA.
  • Cases are blueprinted and unpredictable, so broad preparation beats trying to guess the case mix.
  • Every case is marked in DG&D, CM&C and RTO, with CM&C weighted in the overall scoring.
  • You do not need to pass a fixed number of stations; whole-exam performance matters.
  • The best mock viva practice mirrors the domains, uses real timing, and ends with a focused debrief.

References

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