MRCGP & GP Training

The MRCGP Training Map

When should I do what?

Trainees are often puzzled as to when to do some of the things like AKT and CSA, amongst other things.  It’s understandable because there are so many elements and deadlines to GP training in the UK.   So, this page is an attempt to demystify some of that and help you make some decisions for yourself.    Many trainees are of the mindset of wanting to get things “out of the way”.   This is dangerous territory – some of the things (like the exams) are at quite a financial cost.    Wouldn’t you prefer to take it just the once and pass?   And for the exams, for instance, you need some good experience in Generap Practice in order to pass them.     The advice offered on these pages is simply that – advice. 

When should I do the exams then?

At the very minimum, you should not attempt the AKT until you are in your first post of ST3 in General Practice.   Why?   Because you can read all you want, but some of the questions will be around specific GP stuff that you might not find in the more academic books.   

In terms of CSA, its best to take this in the 2nd 6m of your ST3.  The CSA requires a lot of practise as well as knowledge.  You need to practise your consultation, clinical and organisational skills in the first 6m of ST3 and then hopefully, you should be good by the 2nd 6 months.  

Some educators believe that you should take both AKT and CSA towards the beginning of your 2nd post in ST3.  Why?  Because they say that the CSA is not just about communication skills.  It has a heavy emphasis on clinical knowledge too!   So why not do both near together.  In that way, the knowledge you will have gained from preparing for the AKT will be “fresh” for the CSA too.

I’ll let you decide which you think would be best for you.   

What about the different elements of WPBA like COTs and CBDs etc - what do I do and when?


  • Mini-CEXs are done in hospital posts and not in GP posts.   In GP posts, you do COTs instead.
  • CEPS – try and get many of these done during your hospital post.
  • PSQs will only be assessed in the primary care setting.
  • MSF will involve clinical raters only when in secondary care BUT both clinical and non-clinical raters (e.g. admin team) when in primary care.

First of all, here are some soft rules to remember that relate to WPBA like the COTs, CBDs, MSFs, PSQs and so on.   Click the button on the left to go to the graphical page which summarises which assessments to do when and how many.  

  • You are responsible for knowing and organising which assessments need to be completed in each post and organise them.
  • You decide when these assessments take place.
  • Pace yourself; your trainer or hospital consultant won’t be happy if you try and squeeze all the assessments into the last few weeks of your post.
  • Give your trainer/hospital consultant adequate notice (“Can we do a CBD next week?”).
  • Complete the minimum number of assessments before at least 1 month BEFORE the end of your post.  They need to all in place before your Educational Supervision meeting.  Otherwise, the Educational Supervisor will not sign you off.
  • Remember, the minimum number of assessments IS THE MINIMUM NUMBER.  You should be aiming to do lots more.


Preparation is necessary.  Case selection is very important: different cases will allow demonstration of different competences, and you need to cover all of them to complete GP training.

  • KEY POINT ONE: responsibility
    • Just to make sure you are clear: it is the responsiblity of the trainee to ensure that they complete the appropriate assessments and build up a record of their training and evidence of competence AT THE APPROPRIATE TIMES through the ePortfolio.   Therefore, you (the trainee) need to tell your trainer or hospital consultant when you are ready to do a specific type of assessment (not the other way around).
  • KEY POINT TWO: ‘needs further development’
    • Please do not see ‘needs further development’ as a failure. We expect you to have quite a few ‘needs further development’ especially if you are in ST1 or ST2. If you had all “competent” or “excellent” grades in ST1 or ST2, we’d be worried – how can you have no learning needs at such an early stage in your training.
  • KEY POINT THREE: Hospital Consultants
    • Some of your hospital colleagues may not be that familiar with what they are doing in the GP assessments. They are hospital specialists in their particular field, and it is understandable that they would be confused or not so clear about some of the things we require from a GP point of view.   So, please help them by
          • firstly, attaining a  good understanding of how the assessments work and what each domain or competency means so that 
          • you are empowered to help guide your consultant if they are struggling or confused with something.  
    • In this way, we are sure that your hospital consultants will get the hang of our GP training things in no time and in return it will really help you to get the best out of them. So, please help them.

Got any suggestions or advice?

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

Make GP Training Better Together’

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