The CSA

For the most part being a GP trainee is absolutely fantastic and I cannot imagine doing any other career in medicine. However, for a long time during our training there was one thing that loomed rather ominously ahead of us. The Clinical Skills Assessment (or CSA) is the big final exam that we all have to get through before we qualify and is based around a simulated surgery with actors who play patients with frequently very tricky problems.

As we were heading towards the mid-way point of our final year as GP trainees we were beginning to get the CSA fear. For months it seemed to be the only thing we could think about. We lived and breathed consultation structures, difficult situations, safety-netting, follow-up and that dreaded ten minute time limit.

The good news was that a lot of people seemed to be aware of how anxious we were becoming. Our trainers and the advisors in Aberdeen had seen all of this before and they had tried and tested methods on hand to help us through.

Our revision kicked off with a fantastic CSA revision course which was heavily promoted by our deanery, and for good reason. The course is an annual two day revision course held in the beautiful town of Nairn on the Moray coast. It is run by the North Faculty of the RCGP which means that many GPs who are CSA examiners were there to provide constructive input into our consultation styles. The year we went we even received additional funding to go along!

We were divided into small groups and took it in turns to have consultations with actors while being observed by an examiner and your peers. The actors were fantastic (i.e. very good at playing 'difficult' patients) and the feedback and insider tips we received were incredibly useful. The course really spurred us on to form our own CSA study groups based on this format. It was actually pretty fun!

Of course the most instrumental person in developing my consultation skills for the CSA was my trainer. Work on this had been a subtle and gradual process over the course of both ST1 and ST3. Initially we watched my video consultations and I received encouragement along with advice about little improvements I could make. Next we arranged for my trainer to sit in on my consultations on a regular basis. This was extremely useful as it meant I could start to get a feel of what it was like to have someone observing in exactly the same way as the real exam.

The cumulative effect of these things helped my consultation skills enormously. It also equipped me with the skills to critique my own consultations as well as those of my peers in our CSA study group.

Although the thought of the impending exam was terrifying, there was a real sense of community among the trainees in Aberdeen. We all knew when we were each planning on sitting the CSA and were able to support each other through the stresses and strains we were all under.

On the whole the support I received in the build up to the exam was phenomenal. And the best part was I passed!

Dr. David Lovell
GP Speciality Registrar