What is SPEX SCA

SPEX SCA (Simulated Consultation Assessment) provides structured support to develop consultation skills, including a video presentation and a personalised tutorial with a SPEX educator as part of the programme, with additional support available where further input would be beneficial.

SPEX SCA Session 1: SPEX Start – Foundations for Excellent Consulting

This pre‑recorded video presentation introduces the SPEX programme, outlines key consultation theory, and provides practical guidance to help GPRs consult more effectively. It also introduces self‑assessment tools and supports the development of a personalised learning plan to improve consultation skills.

GPRs will also be provided with a link to access up‑to‑date information on the SCA via the RCGP website, along with our SPEX resource outlining the ‘Big Four’ key areas for passing the SCA.

Each GPR will be allocated a SPEX educator for their SPEX SCA tutorial, which includes detailed analysis of recorded consultations and tailored feedback to support exam preparation.

SPEX SCA Tutorial

This session is an individualised tutorial with the GPR, their Educational Supervisor and a specially trained SPEX educator.

Prior to the tutorial, the SPEX educator will review three recorded consultations and provide targeted feedback to support development of consultation skills in preparation for the SCA.

Following the tutorial, GPRs are encouraged to continue recording consultations and to work on their development with their Educational Supervisor.

What is SPEX SCA 1 to 1

SPEX SCA 1 to 1 is a personalised meeting with a member of the SPEX team, available to GPRs who are approaching their 4th and 5th attempt at the SCA.

This session aims to provide tailored support by exploring each doctor’s individual learning needs, previous SCA attempts, and any challenges they may have faced. These sessions focus on developing personalised approaches to consultation technique and exam strategy.

Advice is often drawn from doctors who have successfully passed after multiple attempts, highlighting approaches that have proved effective.

Video Recording Information

Recorded Consultation Analysis

SCA Hints and Tips

SCA at a glance

  • An assessment of twelve simulated consultations, each lasting twelve minutes (audio and video cases)
  • Conducted remotely in a GP surgery (usually your own)
  • Sat during ST3
  • Cases reflect real‑life general practice based on real patient consultations
  • No change to RCGP curriculum
  • Physical examinations are not assessed

Preparation

  • Read the most up‑to‑date information on the RCGP website carefully
  • Use RCGP SCA resources, including the consultation toolkit, videos and webinars
  • Use the Consultation Overview and RAG rating within the toolkit to analyse consultations
  • Ensure you cover all curriculum areas and address any knowledge gaps
  • Consider the capabilities required for a safe GP consultation
  • Practise using a timer and develop awareness of consultation timing
  • Prepare your environment in advance:
    • test equipment and set‑up
    • familiarise yourself with the exam platform
    • use a “do not disturb” approach to avoid interruptions
  • Consider using aide memoires (e.g. Consultation Overview) to support consultation structure

Consultation skills and approach

  • “Consult like a GP” rather than a hospital doctor
  • Listen actively and respond to the patient’s answers
  • Ensure consultations feel like a natural conversation rather than a checklist
  • Establish ICE (ideas, concerns, expectations) and psychosocial context, ensuring these are reflected in the management plan
  • Make a working diagnosis and develop a clear shared management plan
  • Verbalise your thinking and involve the patient in decision making
  • Practise explanations of common conditions so they are clear and concise
  • Use appropriate safety netting and ensure clear follow‑up arrangements
  • Remember: you are only marked on what you say and demonstrate — verbalise key steps

Using practice and feedback effectively

  • Keep consulting, recording and reviewing consultations regularly
  • Use recorded consultations to reflect on your performance and identify patterns
  • Focus on improving one or two areas at a time
  • Seek regular feedback through:
    • Educational Supervisor sessions
    • Joint surgeries
    • Tutorials
  • Use SPEX tutorials and feedback to guide further development

Exam approach

  • Each case is marked across three domains:
    • data gathering & diagnosis
    • clinical management & medical complexity
    • relating to others
  • Across the 12 cases, the clinical management and medical complexity domain is weighted more heavily
  • Manage time effectively to ensure that all three domains are addressed within each consultation
  • Aim to complete data gathering within the first half of the consultation (by 6 minutes)
  • Focus on applying knowledge effectively within the consultation, ensuring you balance appropriate clinical decision‑making and recommendations with a patient‑centred approach.

Learning with others

  • Establish a regular revision/practice routine
  • Practise with peers (in person or virtually)
  • Use structured practice (e.g. doctor/patient/examiner roles)
  • Rotate roles to gain different perspectives
  • Share cases and discuss different approaches
  • Teaching and explaining consultations helps reinforce learning
  • Create and discuss clinical scenarios to support learning

SPEX SCA Key resources

Resources to support your SCA preparation: