MRCGP & GP Training

Mini-CEX

What is a mini-CEX?

This is a 15-20 minute snapshot of a single doctor/patient interaction in secondary care – i.e. whilst you are in a hospital post. It is designed to assess the clinical skills, attitudes and behaviours essential to providing high quality care. It will only ever be done in hospital posts (in GP posts, you do COTs instead).

Tell me more about the mini-CEX process

You pick a case and ask a trained senior to do a mini-CEX evaluation on you.    You need to do a MINIMUM of 3 per 6 months for each ST1 or ST2 hospital post.  None are required in  ST3 because this year should be GP based (where you will do COTs instead).

The following are categories on the assessment form. This should give you some idea of what sorts of things will be assessed.

  • Pain
  • Airway/Breathing
  • CVS/Circulation
  • Psych/Behaviour
  • Neuro
  • Gastro
  • Other
For more on the process, see the diagram on the right.

The assessor decides what aspect ( or problem) of the clinical encounter (s)he is going to focus on. This might be:

  • History
  • Diagnosis
  • Management
  • Explanation

Tell me about the grading system

The types of things you will be graded on will depend on the focus of the clinical encounter. You may be graded on:

  • History Taking
  • Physical Examination Skills
  • Communication Skills
  • Clinical judgement
  • Professionalism
  • Organisation/Efficiency
  • Overall clinical care
  • Anything else that is especially good will also be noted

For each competency assessed, you’ll be given one of the following grades:

  • Insufficient evidence
  • Below expectations
  • Borderline for completion
  • Meets expectations for completion
  • Above expectation

A mark of “insufficient evidence” is always awarded to those competencies that were not tested on this occaison. However, future cases may need to be selected to help you demonstrate these.

Are non-consultants allowed to assess me?

Yes! The mini-CEX may be observed by

  • Staff grades
  • Experienced specialty registrars or
  • Consultants

In all cases:

  • there must be a different observer on each occasion
  • immediate feedback needs to be provided to the trainee by the observer
  • and that this feedback should form the basis of a mutually agreed action plan
  • The evidence will be rated and recorded in the e-portfolio – encourage your observer to do it there and then (otherwise it will never materialise no matter how well intentioned they are.  Trust us we are talking from experience

Video examples

Got any suggestions or advice?

Got any advice?  Anything we’ve missed?  Then leave a message below.   Got a resource to share: contact [email protected]

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