The Bottom Line
- Build a single consultation skeleton you use for every case.
- The SCA rewards structure: agenda-setting, clinical reasoning, shared plan, safety net.
- Practise the ‘closing script’ until it’s reflexive (most candidates fumble here).
Exam reality (format anchor)
The SCA is 12 simulated consultations, each lasting 12 minutes, delivered remotely. You should train the skill of ‘rapid safe consulting’ — not long-form GP story time.
Stop thinking in ‘cases’ and start thinking in ‘reps’. Your goal is a repeatable consultation engine that survives anxiety and ambiguity. That engine has to do four things quickly: (1) define the problem and agenda, (2) assess risk/red flags, (3) pick the right plan, and (4) communicate it cleanly with safety-netting.
1
Minute 0–1 — Open + agenda (control the room)
One-liner greeting → confirm identity → ‘How can I help today?’ → reflect → *agenda set*: ‘Let’s make sure we cover the main issue and what you’re worried about, then we’ll agree a plan.’
2
Minute 1–5 — Focused data gather (not a checklist)
Symptoms → time course → severity → impact → key differentials → red flags relevant to the presentation. Use ‘one question per differential’ rather than blanket histories.
3
Minute 5–7 — Risk + reasoning (say it out loud, briefly)
Summarise: ‘So this sounds most consistent with X, and I’m reassured by Y. The things I’m checking we’re not missing are A/B/C.’ This earns marks because it demonstrates clinical judgement.
4
Minute 7–10 — Management + shared plan
Offer choices where appropriate, explain benefits/risks, and check understanding. Use a tight structure: self-care → meds → investigations → follow-up. Keep it practical.
5
Minute 10–12 — Safety net + close (where marks live)
Red flags in plain language + what to do + timeframe. Then: ‘What questions do you have?’ + confirm plan + agree review. Close with reassurance that matches the risk level (not generic positivity).
The ‘closing script’ you should memorise
“To recap: we think this is most likely X. Today we’ll do Y. If you develop A/B/C, or if things aren’t improving by [timeframe], please [action]. I’ll arrange follow-up [how/when]. What questions have you got?”
1
2
3
4
5
Practice
Test your knowledge
Apply this concept immediately with a high-yield question block from the iatroX Q-Bank.
SourceRCGP — SCA at a glance (official format)
Open Link SourceHEE — SCA preparation guidance (includes practical timing notes)
Open Link SourceBMJ Careers — SCA overview and candidate considerations
Open Link