Book Review - MRCGP Practice Cases: Clinical Skills Assessment

This book provides a wealth of practical information for candidates taking the CSA, says Dr Suchita Shah.

'Revision: reading the notes for the first time the morning before the examination.' This insightful comment on the realities of many students' examination preparation, made by an eminent professor of anatomy who taught my undergraduate year, still rings true today.

However, only the foolhardy would tackle the MRCGP clinical skills assessment (CSA) with such an approach. The second edition of this book, by Dr Raj Thakkar with input from newly qualified GPs, is certainly not one to be read the night before the examination.

Examination structure
With 39 practice CSA cases, divided into three examination 'circuits', the book mirrors the actual examination structure and lends itself to small group work over a period of time.

The first few chapters of the book provide practical information about the history and format of the examination. It is useful to understand the context of the CSA, particularly in light of recent questions about its applicability to a broader, multicultural patient demographic.

Practice cases are divided into instructions for the candidate, instructions for the role player and notes based on the CSA marking schedule. Choosing cases is always difficult, but this book provides a good mix, reflecting real general practice, with demonstrable coverage of the RCGP curriculum.

The content is appropriately challenging, including some ethical dilemmas, and suitably holistic. The overall aim of each case is stated clearly in the notes section, which is helpful, although I think some ad libbing on the part of the patient role player would not go amiss.

Evidence-based
I did feel that the depth of evidence-based guidance was occasionally inconsistent between cases. For example, the notes on hypertension were detailed and comprehensive, whereas those on medical certification were notably sparse and did not discuss the new 'fit note'.

A better balance between learning tools and facts would have made this a more comprehensive text, reflecting the reality of many candidates' needs when revising for this examination.

Useful tips
The writing style is informal and punctuated clearly with 'useful tips'. The structure and layout of the text could have been made more appealing to the reader's eye, but the black and white format is helpful when highlighting and annotating.

The inclusion of access to online film clips showing CSA scenarios allows this book to compete with the established texts on the market. Ultimately, which of these you choose will depend on personal preference, but this book is worth a look before you decide.

  • Dr Shah is a GP tutor in Oxford

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