Sat my CSA exam last weekend. Thought I'd share my experience. I will not comment on the exact content of the exam as that would be breaking the rules.

The above picture would be more apt for the AKT exam but hey, Slumdog won the oscar..so why not?

The centre is pretty easy to find. Step out of East Croydon train station, look left and you cannot miss the "50 pence coin shape" building to the left. The exam is held on the top floors ( 18th - 20th ). Smart decor inside. A short induction with tea/coffee and then to the exam. As is well known, each candidate is given a room. I took my equipment in a transparent bag after leaving other belongings in a locker. Unfortunately, the college has decided that we can not take timers / clocks with us anymore. I had been practising with a timer and it was a shame I could not take it to the room. Why? Do not ask me..it did not even make a sound. There is a large clock on the consulting table, well out of the field of vision. I could not look at that clock even in one consultation and was able to finish only 5 out of 13 consultations in time. I felt it was unfair. It is meant to be a real life consultation scenario. How does a timer clock interfere with our assessment? Did not finishing in time affect my results? - read more to find out.

Before the exam, I wasn't very sure as to what to wear. I hate wearing ties and feel as if someone is suffocating me. I wore a full sleeve shirt, khaki trousers and a jacket. Most of the guys were dressed to impress and looked smart in their suits. Two or three were tie-less. The girls almost all wore a smart suit with a few exceptions. Overall, no fixed dressing etiquette.

Once the exam started, time flew. 7 cases finished in a blink of an eye. A ten minute break that I used to go to the loo, have a glass of water and just walk about. The helpers were very friendly and easily approachable. It was good to be able to chat to others to realise that nobody was finishing the cases in 10 minutes. We were not allowed to talk about the cases and frankly speaking, I did not feel like talking about the cases. The next 6 cases also passed pretty quickly and the next thing I know, I had done the CSA. Phew! What a relief is an understatement. The cases were varied and almost all of my cases were typically representative of UK general practice. I am 6 months into my primary care experience and I doubt if I would have been able to successfully take the exam any sooner. 6-9 months into general practice placement is a good time to take it. In the end, it seemed like a fairer exam than the AKT.

Found out yesterday that I passed both my AKT and CSA. Passed 11/12 stations and the one I failed was a clear fail .
So, despite not finishing the majority of the stations in the exam, it is possible to pass it. Once you pass it, It feels like a big burden is off the shoulders. Am I a better GP after passing it? I am not sure.

My tips for passing the CSA would be ( in order of decreasing importance) :

1. See as many patients as you can - all cases were real life cases. One particular difficult case in my exam was similar to one I had seen in surgery and discussed with my trainer a month ago.
2. Video your consultations at least once a week and see them with your trainer. My trainer gave me some fantastic tips. My data gathering was all over the place to start with and my explanations sounded garbled. I would forget to share management options. Repeated comments from my trainer made me tweak these things and I found this very helpful in my exam. He would use a marking sheet that looked at all 3 domains tested in CSA.
3.Practice cases with a friend / spouse. Fortunately my wife is a GP and took the first CSA in October 2007. It was helpful to practice 10 minute CSA mode consultations with her acting as a patient. Thank you, Navita
4. Go on a CSA preparatory course - One might think after paying almost an arm and a leg in exam fee, there is no scope for a preparatory course. Problem is, the CSA is a new exam and many trainers have only had one or two trainees who have taken it in the past. Their experience in advising about CSA might be limited and this is where a good, inexpensive course is handy.
5. Sit for the AKT and CSA together- yes, it is do-able. I did it and felt that the preparation for the AKT helped me with the data gathering and clinical management domains. Not everybody would like this idea and to each his own.

Good luck to those taking the exam. May the force be with you!!!