The universal GP Training website for everyone, not just Bradford.   Created in 2002 by Dr Ramesh Mehay

The CSA with Confidence



An introduction to the CSA

CSA Frameworks

CSA Practise Tools

Top Tips



Scripts & Phrases for the Consultation

These scripts and phrases may help you with your communication skills.  Generally , I don’t recommend memorising scripts and phrases because a conversation between two people should flow naturally – in other words, a conversation where each person responds to what each other has just said – and most of the time you cannot second guess what the other person will say.  So – beware of scripts and phrases – they can make the consultation look artificial or contrived and the CSA examiners are very good at picking up things that sound artificial.   For example, don’t explore Ideas, Concerns and Expectations (ICE) just because others have told you it is a good thing to do in everyone.  Do it because you are genuinely interested and because you think it will be helpful.  The same goes for the psycho-social-occupational (PSO) exploration of the impact of an illness. 

On the other hand, scripts and phrases can provide you with a starting point by giving you some idea of what to say.    They sound better if you can modify them so that they fit with your personality and style.   


Examiners’ Feedback Statements

There’s a lot you can learn from Examiners’ feedback statements on previous exams.  They highlight common difficulties and failures – which you can learn from!






An intro to the CSA

First of all, if you don’t properly understand how the CSA works or what it is testing, then it is unlikely you will succeed.    Think about it for a moment – if you truly understand the marking schedule, then actually you have the ‘answer’ sheet which should guide you how to pass.    So step one to passing is going back to basics and truly understanding what the CSA is about and what it is testing. 

These are the 3 areas you will be tested on:

  1. In Data Gathering, they are testing communication skills AS WELL AS clinical skills like clinical examination; around 3 stations will involve clinical examination.
  2. Clinical management includes synthesis, diagnosis, appreciation of co-morbidity, flexibility and sharing management options with the patient.
  3. Interpersonal skills include, communication, respect for others, professionalism and other behavioural indicators.

And finally, always safety net (ask your trainer if you don’t know what this means).

More information is available on the RCGP CSA pages.

Develop your own framework (i.e. structure)

Reading a consultation book or two will definately help you get some of the cores communication skills to consult effectively with patients.   Although some people are naturally good at patient-centred consultting and others less so, the good news is that these skills can be learnt.   Yes!  Even if you are not good at consulting in a person-centred way, with practise you can learn to be as good as those who are naturally good.   Of course, the key word here is practise!

Some good consultation books are…

  1. The Inner Consultation by Roger Neighbour (a great starter esp for ST1s).
  2. Skills for Communicating with Patients by Silverman et al (one of the best foundation books around – a definite worthwhile read).  
  3. The Doctor’s Communication Handbook by Peter Tate (another foundation book).
  4. The Naked Consultation by Liz Moulton (covers a variety of tricky scenarios – another definite worthwhile read).
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Bradford VTS was created by Dr. Ramesh Mehay, a Programme Director for Bradford GP Training Scheme back in 2001. Over the years, it has seen many permutations.  At the time, there were very few resources for GP trainees and their trainers so Bradford decided to create one FOR EVERYONE. 

So, we see Bradford VTS as  the INDEPENDENT vocational training scheme website providing a wealth of free medical resources for GP trainees, their trainers and TPDs everywhere and anywhere.  We also welcome other health professionals – as we know the site is used by both those qualified and in training – such as Associate Physicians, ANPs, Medical & Nursing Students. 

Our fundamental belief is to openly and freely share knowledge to help learn and develop with each other.  Feel free to use the information – as long as it is not for a commercial purpose.   

We have a wealth of downloadable resources and we also welcome copyright-free educational material from all our users to help build our rich resource (send to bradfordvts@gmail.com).

Our sections on (medical) COMMUNICATION SKILLS and (medical) TEACHING & LEARNING are perhaps the best and most comprehensive on the world wide web (see white-on-black menu header section on the homepage).