MRCGP Simulated Consultation Assessment
SCA marking scheme explained
The SCA is twelve simulated consultations of twelve minutes each. Every case is marked in the same three domains, and each examiner marks just one case throughout the exam, which keeps the marking consistent. Below is how the grading works, followed by a sample of SCA Prep’s AI marking on a full consultation.
The three marking domains
Data gathering and diagnosis
Gathering targeted information safely, including red flags, existing notes and the patient’s psychological and social context, then reasoning towards a sensible working diagnosis, even when the problem is undifferentiated.
Clinical management and medical complexity
A safe, guideline-based plan that fits the patient: prioritising by risk, managing several problems and uncertainty, prescribing safely, referring when needed and arranging follow-up. This domain carries extra weight in the overall mark.
Relating to others
Person-centred, ethical communication: exploring the patient’s agenda and beliefs, responding to cues, explaining in language they understand and agreeing a plan together.
The four grades
In each case, each domain gets one of four grades. The standard is that of a newly qualified, independent GP.
- Clear pass
- Above the standard
- Pass
- Meets the standard
- Fail
- Not enough shown to meet the standard
- Clear fail
- Clearly below the standard
The RCGP’s descriptors guide examiners’ judgements. They aren’t a tick-box list, and not every point applies to every case.
How the pass mark works
- Your result is your total across all 12 cases, reported as a mark out of 126. You don’t need to pass a set number of cases, so falling short in one case doesn’t mean you’ve failed the exam.
- There’s no fixed pass mark for each case. Examiners also give every consultation an overall judgement (pass, bare pass, bare fail or fail), and the RCGP uses these to set each case’s pass mark, a method called borderline regression.
Source: RCGP, Marking and results for the SCA (amended June 2025).
Sample marked consultation
This is a representative example of the feedback shown after an AI roleplay consultation. It uses static sample data and does not generate, save, or charge for AI marking.
Pass
Based on examiner expectations, this consultation would likely pass with an overall score of 68/100. The candidate met the expected standard, showing good competence in clinical management. Continued practice will help consolidate skills across all domains.
Good clinical instincts. Let's polish the edges.
Domain Scores
RCGP Examiner Feedback
- DG2Existing information about the case was insufficiently utilised
What You Did Well
- ●You opened with a broad invitation and allowed the patient to describe the problem in their own words before moving into focused questions.
- ●You characterised the key symptoms clearly, including onset, duration, severity, triggers, associated symptoms, and the impact on day-to-day functioning.
- ●You actively screened for important red flags and explained why you were asking, which made the safety assessment feel purposeful rather than formulaic.
- ●You explored the patient's main concern and picked up that they were worried about something serious, which helped you frame the rest of the consultation.
What Was Missing
- ●Existing information was not used as fully as it could have been. The referral note and recent observations should have been explicitly checked and incorporated into your reasoning.
- ●The social context was touched on but not developed. A little more about work, home support, and practical barriers would have helped you tailor the plan.
- ●Your differential diagnosis was sensible, but you did not verbalise it clearly enough for the examiner to see how you were prioritising risk.
How to Improve
- ●Use a quick signposting phrase before focused data gathering: "I am going to ask a few questions to check for anything serious, then we can talk through what this is most likely to be."
- ●When records are available, make them visible in the consultation: "I can see from the discharge letter that your observations were stable, but I want to check how things have changed since then."
- ●State your working diagnosis and alternatives briefly: "The most likely explanation is X, but I also want to rule out Y because of the symptoms you described."
Get this feedback on your own consultations.
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