In your final week, stop expanding your notes. Use this MRCPsych CASC exam week checklist instead: run timed stations every day, rehearse the first 30 seconds and last 20 seconds of common tasks, and remove every avoidable logistics error. At this stage, reliability beats range.
Why the last week matters
The current CASC is a 16-station, same-day exam with two circuits. In current College guidance, one circuit has six management stations, one examination station and one history station with four minutes of reading time before each seven-minute task; the other has four examination and four history stations with 90 seconds of reading time before each seven-minute task, and the College notes that the order of the circuits may change. Linked stations are no longer used, and communication is assessed in every station.
The syllabus and blueprint in use are mapped to the 2022 Core Psychiatry Curriculum. They place explicit emphasis on personalisation and respect, and on the interaction between mental and physical health; every running order also includes at least one risk or safety-planning focus, one cognitive or capacity focus, and one physical-health history or examination focus.
The pass standard is double: you must meet the overall pass mark and pass at least 12 stations. So your aim in exam week is not a few heroic stations. It is a safe, consistent performance across the whole day.
MRCPsych CASC exam week checklist
7 to 5 days out
Use the blueprint to choose stations, not your mood. Before the week ends, make sure you have practised risk or safety planning, cognition or capacity, and physical health, because those themes are built into every running order.
- Do one timed practice block each day: ideally 4 to 6 stations, not endless passive reading.
- Split revision by task type: history, examination or mental state, and management or explanation.
- Keep one one-page prompt sheet for each station type. If your notes are longer than that now, they are probably too long for exam week.
- Rehearse your opening lines out loud. The first 20 seconds should sound calm, respectful, and purposeful.
- Revisit your weakest station type first, not last.
A good final-week rule is this: every station you practise must end with a summary and a clear next step. If you keep running out of time, the problem is usually structure, not knowledge.
4 to 2 days out
Now narrow further.
- Replace broad reading with short, repeated drills.
- Practise reading-time decisions: identify the task, pick three priorities, choose a closing sentence.
- Run at least one mock with someone who interrupts you, becomes tearful, gets angry, or answers vaguely. That is closer to the real exam than a cooperative study partner.
- Do one management-heavy session and one history or examination-heavy session.
- Write out, then speak aloud, your structure for: suicide risk, capacity, explaining a diagnosis, antipsychotic side effects, confidentiality, and involving family or carers.
Do not spend these days trying to memorise niche facts. Examiners are much more reassured by a candidate who sounds safe, organised, and clear than by one who throws in isolated details without a plan.
24 hours before
At the time of writing, College guidance says the UK CASC takes place in Sheffield. Current RCPsych FAQs also state that you need valid photo ID, the dress code is smart casual, a blank notepad and pen are provided, and clinical equipment such as a stethoscope is provided for you. If you want to bring a comfort aid, seek approval in advance from the Exams Team. Check your admissions document carefully because venue and operational details can change.
Pack and prepare:
- photo ID
- admissions document and travel details
- comfortable professional clothes
- water, snacks, and any usual medication
- a simple lunch that will not make you sleepy
- a backup travel plan if trains or parking go wrong
Then stop. A short, calm review of your frameworks is enough.
Morning of the exam
Your only job is to look settled and usable.
- Do not start the day with a new topic.
- Warm up your voice with two or three station openings out loud.
- Remind yourself that seven minutes is enough for a focused task, not a full clerking.
- In reading time, identify the verb first: assess, explain, manage, discuss, take a history, examine.
- Decide early what you must leave out.
If panic rises, simplify the station. Open well, find the core problem, assess immediate safety, and close with a plan.
What to rehearse, not reread
Because this exam still spans history, examination, and management stations across a broad psychiatric blueprint, final-week revision works best when you drill reusable structures rather than chase more content.
Keep five short frameworks on one sheet:
- History station: opening, presenting problem, key symptoms, risk, function, relevant background, summary.
- Mental state or examination station: explain what you are doing, focus on the task, describe findings clearly, say what they mean.
- Capacity station: the decision in question, understand, retain, use or weigh, communicate, then the clinical implications.
- Management station: summary, immediate safety, main treatment options, collaboration, follow-up and contingency.
- Explanation station: what you think is happening, what matters most right now, what you recommend next, and how you will check understanding.
Try these as final-week drills:
- A 67-year-old with new persecutory beliefs and recent falls. Do not stay in pure psychiatry mode; ask yourself about cognition, delirium, medication effects, and immediate physical-health risk.
- A 24-year-old after an overdose who says, I am fine now. Practise a risk station that covers intent, ongoing thoughts, impulsivity, substance use, protective factors, access to means, and a clear safety plan.
- A mother asking whether her 15-year-old needs admission. Practise a management answer that is calm, specific, and honest about thresholds, alternatives, and contingency plans.
- An autistic adult who is overwhelmed by noise and eye contact. Practise adapting your style, checking preferences, and showing personalisation rather than pushing through a standard script.
What examiners are listening for
College guidance emphasises professional behaviour, a systematic consultation, sensible prioritisation, response to verbal and non-verbal cues, jargon-free explanations, effective risk assessment, and a coherent management plan that is safe and in line with current UK best practice. The guidance also warns against sounding rude, dismissive, or dependent on stock phrases.
In practice, that means your answer should sound like this:
- I want to understand what has changed and whether there is any immediate risk today.
- Before I suggest options, can I check what your main worry is?
- From what you have told me, my immediate priorities are safety, symptom control, and support at home.
- I am not certain yet that this is a primary psychotic illness, and I would want to clarify the physical-health picture before I commit to that.
These phrases work because they show structure, listening, and judgement. They are not scripts to recite. If the role player gives you a cue, use it.
Common mistakes
- treating every station like a full clerking rather than the task in front of you
- spending reading time absorbing the stem instead of choosing priorities
- leaving risk, capacity, or safeguarding until the final seconds
- giving long lectures before checking what the patient or relative already understands
- sounding polished but generic, with empathy lines that do not match what was actually said
- ignoring physical health, medication adverse effects, or collateral context
- ending without a summary, shared plan, or safety net
- changing your entire technique the day before the exam
A simple practice workflow for the last few days
Keep the workflow boring and repeatable.
- Warm-up, 10 minutes: say two openings, one risk close, and one management summary out loud.
- Mock viva, 45 to 60 minutes: run 4 to 6 timed stations.
- Debrief, 15 minutes: identify one thing to keep and one thing to change.
- Repair loop, 15 minutes: immediately repeat your worst station.
- Short review, 20 minutes: revise only the topics that exposed a real weakness.
If you use AI practice, use it for timing, role-play variation, and debrief prompts. Do not let it train you into stiff, over-produced wording.
The day before the exam, do one light session only. You want to arrive mentally sharp, not drained.
Summary
- In exam week, practise stations, not chapters.
- Protect your weakest station type first.
- Rehearse risk, capacity, and physical-health themes before anything niche.
- Make every answer sound safe, structured, empathic, and clear.
- Lock down logistics early so you can spend the final 24 hours staying calm.
References
- https://www.rcpsych.ac.uk/training/exams/preparing-for-exams/preparing-for-the-casc
- https://www.rcpsych.ac.uk/training/exams/faqs-about-preparing-for-exams
- https://www.rcpsych.ac.uk/docs/default-source/training/examinations/casc-syllabus-march-2023.pdf
- https://www.rcpsych.ac.uk/training/exams/applying-for-your-exam/apply-to-take-casc
- https://www.rcpsych.ac.uk/training/exams/exams-news-and-updates
- https://www.rcpsych.ac.uk/docs/default-source/training/examinations/exams-eligibility-criteria-and-regulations---may-2025.pdf
- https://www.rcpsych.ac.uk/docs/default-source/training/examinations/casc-syllabus-march-2023.pdf?sfvrsn=1fe04f2b_4