# Practising for Psychiatry CASC with MedMock

Canonical page: https://medmock.com/exams/psychiatry-casc

## What is the Psychiatry CASC OSCE, and how do you practise for it?

The MRCPsych Clinical Assessment of Skills and Competencies — the Royal College of Psychiatrists' final clinical exam: sixteen 7-minute role-play stations run in two circuits (five history-taking, five examination, six management), each a live encounter with a professional role player while a silent examiner marks analytic domains and a global judgement. MedMock runs all sixteen. The College publishes skill areas rather than fixed station titles, and each sitting samples them, so these practice stations are named by skill area. The blueprint requires at least one of physical-health history or physical examination in every running order, and MedMock takes the history form, so this is a complete circuit in a spoken format — the hands-on physical examination itself is not simulated. MedMock lets you practise it out loud against an AI patient, with examiner-style feedback on any station you finish.

An illustrative example station, written by MedMock with example feedback, is at https://medmock.com/exams/psychiatry-casc/example

## What happens in the real Psychiatry CASC (checked against the official source on 2026-09-26)

The CASC (Clinical Assessment of Skills and Competencies) is the clinical exam of the MRCPsych, taken after Papers A and B. It is an OSCE-style exam of 16 stations with professional role-players, taken in person in two circuits on the same day: five history-taking stations, five examination stations (physical and mental state, including capacity assessment) and six management stations. Every station lasts seven minutes, with 4 minutes of reading time before each station in the circuit that holds the management stations and 90 seconds in the other. At each station an examiner scores three to five domains and gives an overall judgement, and to pass you must reach the total borderline regression score and pass at least 12 of the 16 stations.

- **Circuit 1: six management, one history-taking and one examination station** (7 minutes): Eight stations. Before each one you have 4 minutes to read the instructions, then 7 minutes to perform the task.
- **Circuit 2: four history-taking and four examination stations** (7 minutes): Eight stations. Before each one you have 90 seconds to read the instructions, then 7 minutes to perform the task.

Marking: Each station is marked by one trained examiner, who gives two sets of scores: 5-point analytic domain scores from 1 (Poor) to 5 (Excellent) for between three and five domains, and one 6-point overall judgement of Excellent Pass, Pass, Borderline Pass, Borderline Fail, Fail or Severe Fail. There are separate marksheets for history, examination and management stations. Communication skills are assessed in every station, and each station's marking guidance allocates percentages of the mark to its tasks (in the College's alcohol-history example, 50%, 30% and 20%).

Passing: Each station's pass mark is set by the borderline regression method: the weighted domain scores are regressed onto the overall judgements, and the score of a borderline candidate on that line becomes the station pass mark. The pass mark for the whole exam is the average of that day's station pass marks, raised by the standard error of measurement. You must meet or exceed the total borderline regression score and pass at least 12 stations; high scores in some stations cannot make up for low scores in others. A candidate with two or more severe fail marks has their performance reviewed by the Examinations Committee and may fail, whatever their score.

Sources: https://www.rcpsych.ac.uk/training/exams/preparing-for-exams/preparing-for-the-casc https://www.rcpsych.ac.uk/docs/default-source/training/examinations/casc-syllabus-march-2023.pdf?sfvrsn=1fe04f2b_4 https://www.rcpsych.ac.uk/docs/default-source/training/examinations/exams-eligibility-criteria-and-regulations---may-2025.pdf?sfvrsn=83f28e63_62 https://www.rcpsych.ac.uk/training/exams/applying-for-your-exam https://www.rcpsych.ac.uk/training/exams/exams-news-and-updates
Full format page: https://medmock.com/exams/psychiatry-casc/format

## How to prepare for the Psychiatry CASC (facts checked against official sources on 2026-09-27)

The CASC is the MRCPsych clinical exam: 16 seven-minute stations with professional role-players, run as two circuits on one day, and you must pass at least 12 stations as well as reach the overall score. Prepare by mapping your practice to the College's CASC syllabus and blueprint, rehearsing history, examination and management stations aloud with observed feedback against the College's criteria and marksheets, and dropping the formulaic, stock-phrase consulting its feedback guidance warns against.

1. **Check eligibility and your attempts** — You need passes in Papers A and B, 23 months' whole time equivalent post-foundation experience in psychiatry by the exam date, and a sponsor. You can sit the CASC no more than twice in a calendar year, and there is a maximum of six attempts at any one MRCPsych component.
2. **Revise to the syllabus and blueprint** — Every running order has at least one station on risk assessment or safety planning, one on cognitive examination or capacity, and one on physical health history or examination, plus at least one from each of child and adolescent, general, intellectual disability, old age, forensic and addiction psychiatry and medical psychotherapy. It helps to draw a grid of these areas against history, examination and management, and practise a case in every cell.
3. **Learn what examiners are told to look for** — The College's CASC exam criteria and grade descriptors set the standard at a newly appointed ST4: a systematic approach tailored to the task, active listening, no jargon, and management in line with current UK best practice, including NICE and SIGN guidelines. Read them alongside the College's three marksheets before you start practising.
4. **Use your clinical work and your supervisor** — The College says day-to-day clinical work is excellent preparation, and advises making full use of educational supervision so you are not reinforcing poor habits. Ask your supervisor to watch you take histories, do mental state and cognitive examinations and explain plans, and use workplace-based assessments for the physical health side.
5. **Train for the two reading times** — One circuit gives you 4 minutes to read before each station and the other 90 seconds. Tasks appear as bold bullet points, sometimes with a negative instruction such as not taking a risk history, so practise picking out every task and anything you must not do, then run the 7-minute station.
6. **Practise aloud in threes, timed and marked** — Run 7-minute role-plays with a candidate, a role-player and an observer marking on the College's marksheets, and rotate. Include relatives and carers, and practise explaining a formulation; the College's FAQ says a holistic, biopsychosocial approach is appropriate for many cases.
7. **Watch and mark the College's CASC videos** — The College publishes sample station videos, such as a history from a patient with alcohol dependence, to help you prepare; it flags that one video uses outdated language about suicide. Marking them with a colleague against the marksheets shows how the domains are applied.
8. **Know the day** — The UK CASC is held at the English Institute of Sport in Sheffield. You are given a notepad and pen, there are no linked stations, and the dress code is smart casual.

Official resources:

- Preparing for the CASC (https://www.rcpsych.ac.uk/training/exams/preparing-for-exams/preparing-for-the-casc): The College's main CASC page: candidate guide, exam criteria, grade descriptors, pass mark rules and marksheets.
- MRCPsych CASC Syllabus and Blueprint (https://www.rcpsych.ac.uk/docs/default-source/training/examinations/casc-syllabus-march-2023.pdf?sfvrsn=1fe04f2b_4): The syllabus mapped to the 2022 core psychiatry curriculum, with the minimum station mix for every running order; use it to plan your revision.
- CASC guidance on feedback and generic statements (https://www.rcpsych.ac.uk/docs/default-source/training/examinations/casc-feedback-instructions-and-generic-statements.pdf?sfvrsn=29c0b67d_7): The feedback statements examiners can give, each with advice on how to improve; read it while you prepare, not only after a result.
- CASC videos (https://www.rcpsych.ac.uk/training/exams/preparing-for-exams/casc-videos): Sample CASC stations on video, designed to help candidates and trainers prepare.
- FAQs about preparing for exams (https://www.rcpsych.ac.uk/training/exams/faqs-about-preparing-for-exams): The College's answers on physical health stations, formulation, note-taking, dress and classification systems.
- Instructions to candidate: sample CASC station (https://www.rcpsych.ac.uk/docs/default-source/training/examinations/exams-casc-candidate-instructions.pdf?sfvrsn=fec1491e_2): The College's example of a station brief, showing how the scene is set and how the tasks are bulleted.
- Eligibility Criteria and Regulations for the MRCPsych Examinations (https://www.rcpsych.ac.uk/docs/default-source/training/examinations/exams-eligibility-criteria-and-regulations---may-2025.pdf?sfvrsn=83f28e63_62): The rules on eligibility, sponsorship and attempts; check them before you apply.

Common mistakes examiners report:

- Formulaic consulting. The College's feedback guidance singles out pre-prepared phrases, some apparently from CASC courses, such as asking 'How does that make you feel?' repeatedly and then taking little notice of the answer. (source: https://www.rcpsych.ac.uk/docs/default-source/training/examinations/casc-feedback-instructions-and-generic-statements.pdf?sfvrsn=29c0b67d_7)
- A vague summary. If it is too vague, the examiner may not be sure you have made a diagnosis at all; state what you think and why, and say how you would resolve any uncertainty. (source: https://www.rcpsych.ac.uk/docs/default-source/training/examinations/casc-feedback-instructions-and-generic-statements.pdf?sfvrsn=29c0b67d_7)
- A poor questioning style: repeated closed questions, or several questions at once, instead of funnelling from open to closed. (source: https://www.rcpsych.ac.uk/docs/default-source/training/examinations/casc-feedback-instructions-and-generic-statements.pdf?sfvrsn=29c0b67d_7)
- Not paying enough attention to physical health, such as medication side effects or physical causes of the psychiatric presentation. (source: https://www.rcpsych.ac.uk/docs/default-source/training/examinations/casc-feedback-instructions-and-generic-statements.pdf?sfvrsn=29c0b67d_7)
- Running the same assessment in every station. The College's criteria expect you to tailor your approach to the specific task rather than a superficial one-size-fits-all assessment. (source: https://www.rcpsych.ac.uk/training/exams/preparing-for-exams/preparing-for-the-casc)
- Doing a risk management plan for the first time in the exam. The feedback guidance warns that an unpractised candidate is very obvious to examiners, and suggests role play with trainers and colleagues. (source: https://www.rcpsych.ac.uk/docs/default-source/training/examinations/casc-feedback-instructions-and-generic-statements.pdf?sfvrsn=29c0b67d_7)

Sources: https://www.rcpsych.ac.uk/training/exams/preparing-for-exams/preparing-for-the-casc https://www.rcpsych.ac.uk/docs/default-source/training/examinations/casc-syllabus-march-2023.pdf?sfvrsn=1fe04f2b_4 https://www.rcpsych.ac.uk/docs/default-source/training/examinations/exams-eligibility-criteria-and-regulations---may-2025.pdf?sfvrsn=83f28e63_62 https://www.rcpsych.ac.uk/docs/default-source/training/examinations/casc-feedback-instructions-and-generic-statements.pdf?sfvrsn=29c0b67d_7 https://www.rcpsych.ac.uk/training/exams/faqs-about-preparing-for-exams https://www.rcpsych.ac.uk/training/exams/preparing-for-exams/casc-videos https://www.rcpsych.ac.uk/docs/default-source/training/examinations/exams-casc-candidate-instructions.pdf?sfvrsn=fec1491e_2
Full guide: https://medmock.com/exams/psychiatry-casc/prepare

Upcoming sittings: 8–11 December 2026 (Singapore); 19–27 January 2027 (UK); 1–4 June 2027 (Singapore) (source: RCPsych, checked 2026-09-23).
All Psychiatry CASC dates: https://medmock.com/exams/psychiatry-casc#dates

## Stations you can practise

- **History‐taking (Presenting complaint)** — Seven-minute focused psychiatric history from a Virtual Patient — elicit the presenting complaint and its course, screen the key differentials and risk, and close with a clear next step. Depression, psychosis, anxiety, PTSD, OCD, eating disorders, perinatal and substance-use presentations all rotate here.
- **History‐taking (Physical health)** — Physical-health history in a psychiatric context — medical comorbidity, medication effects (metabolic syndrome, lithium, clozapine), smoking, alcohol and lifestyle, linking the physical story to the mental-state picture.
- **History‐taking (Developmental)** — Developmental and early-life history — pregnancy and milestones, school and friendships, adversity and attachment — the backbone of adult ADHD / autism assessments and personality-difficulty formulations.
- **History‐taking (Personal & social)** — Personal and social history — relationships, housing, work and finances, alcohol, drugs and forensic history — taken with tact and woven into risk and support planning.
- **History‐taking (Collateral)** — Collateral history from a relative, carer or friend of the index patient — first-episode psychosis, dementia, mania and safeguarding pictures — balancing the informant's distress with confidentiality.
- **Examination (MSE – Psychotic)** — Live mental state examination of a psychotic Virtual Patient — elicit hallucinations, delusional beliefs, first-rank and passivity phenomena, thought interference and insight, with phenomenological precision.
- **Examination (MSE – Non-psychotic)** — Mental state examination of mood and neurotic presentations — depressive cognitions, anxiety and panic phenomenology, obsessions and compulsions, suicidal thinking — eliciting and naming the psychopathology.
- **Examination (MSE – Cognitive)** — Bedside cognitive examination done conversationally — orientation, registration and recall, attention, language and executive screening — pitched to a possibly confused or apprehensive patient.
- **Examination (Capacity assessment)** — Capacity assessment on a live decision — testing understanding, retention, weighing and communication under the Mental Capacity Act while keeping the patient's trust.
- **Examination (Risk assessment)** — Seven-minute risk assessment with a Virtual Patient — elicit and weigh risk to self, to others, from others and of self-neglect, probing intent, plan, preparation, means and protective factors as explicitly as risk, and reach a defensible formulation. NICE NG225-aligned: no risk-stratification scores.
- **Management (Formulation)** — Explain your formulation to the patient or a relative — predisposing, precipitating, perpetuating and protective factors in plain language — and agree what happens next.
- **Management (Biological)** — Explain and agree drug treatment — starting clozapine or lithium, switching antidepressants, depot antipsychotics, side-effects and monitoring — Montgomery-standard information giving with teach-back.
- **Management (Psychological)** — Explain psychological therapy — what CBT, DBT, EMDR or family therapy actually involves, what it asks of the patient, realistic timelines and interim options.
- **Management (Holistic plan)** — Build a whole-person management plan — social prescribing, occupational and carer support, physical health, follow-up and crisis contacts — co-created rather than dictated.
- **Management (Safety planning)** — Co-create a personalised safety plan after self-harm or a suicidal crisis — warning signs, coping strategies, means restriction and crisis contacts, NICE NG225-aligned (no risk scores, no contracts).
- **Management (Legal & ethical)** — Explain the legal and ethical position — Mental Health Act detention and tribunal rights, Mental Capacity Act and best interests, confidentiality limits, DVLA duties — accurately and without jargon.

## Sample Psychiatry CASC questions

- *Examination (MSE – Psychotic):* A 35-year-old woman with chronic schizophrenia presenting with persecutory delusions. Perform a focused MSE elicitation.
- *Examination (Capacity assessment):* You are the duty doctor on an acute psychiatric ward. A 45-year-old man with schizophrenia has been brought in by the crisis team and says he is willing to come into hospital. Assess his capacity to consent to informal admission.

## Example scenarios

- *Management (Biological):* Explain the common and serious side effects of clozapine, and the monitoring it needs, to a patient whose psychosis has not responded to two other antipsychotics.
- *Management (Safety planning):* A 19-year-old was brought to the Emergency Department after an impulsive paracetamol overdose. Co-create a personalised safety plan with her before discharge.
- *Examination (MSE – Psychotic):* A 25-year-old man has been referred by his GP after four months of hearing voices commenting on his actions. Elicit the psychotic phenomenology and assess his insight.
- *History‐taking (Collateral):* The mother of a 20-year-old university student has brought him to the Early Intervention Service. Take a collateral history of the changes she has seen over the last few months.
- *Examination (Risk assessment):* A 24-year-old woman with emotionally unstable personality disorder has been brought to A&E after her third overdose in six months. Assess her risk — intent, plan, preparation, means and what protects her.

## How a practice session works

1. **Choose a station** — Pick from the Psychiatry CASC stations — all 16 that MedMock runs, or let MedMock surprise you the way exam day will.
2. **Have the conversation** — Speak naturally, out loud. The AI patient responds in real time — with emotions, cues and unexpected turns, just like a real encounter.
3. **Get instant feedback** — The moment you finish, you get specific, examiner-style feedback and a score — what you did well, what cost you marks, and precisely what to fix before the next attempt.

## Price

Start with a one-off £5 taster: 30 credits (30 minutes of speaking practice), not a subscription. After that, or instead, £69 per month for 350 credits. One credit is one minute of spoken practice, or two typed exchanges, and where the examiner or patient speaks first, that opening line is free. Examiner scorecards, mark schemes and model answers for finished sessions are included at no extra credit cost. Cancel at any time. Full details: https://medmock.com/pricing

## Frequently asked questions

### How does the feedback work?

When you finish a station you can have it marked, and the scorecard comes back in seconds — what you did well, what cost you marks, and exactly what to work on next. Scorecards, mark schemes and model answers are included at no extra credit cost.

### Can I practise specific Psychiatry CASC stations?

Yes. You can pick any of the 16 stations to drill a weak area, or run a mixed set to simulate the real exam.

### How much does it cost?

You can start with a one-off £5 taster: 30 credits, which is 30 minutes of speaking practice, with no subscription. After that, or at any time, you can choose a monthly plan, which includes a monthly credit allowance. Current prices are on the pricing page.

## About MedMock

MedMock is a web app for practising the spoken parts of UK medical and dental exams and interviews out loud. The candidate talks; an AI patient, examiner or interview panel answers in real time by voice; and when the station ends MedMock marks the performance against that exam's assessment domains and shows the model answer.

It covers 104 spoken exams and interviews — OSCEs, vivas, structured oral exams, simulated consultations, and specialty-training and consultant interviews. It does not cover written or multiple-choice papers, and it is not a question bank.

It was founded by Mr Sam Nahas, MBBS BSc MEd FRCS (Tr & Orth), a practising consultant orthopaedic surgeon in the UK, with co-founder and CTO Arjan Jandu. It is operated by VirtualPatients Ltd (company no. 16303492).

Pricing: a one-off £5 taster of 30 credits to try it (not a subscription, one per account), and a monthly subscription from £20 to £129 depending on the exam (student exams cost least, fellowship exit exams and consultant interviews most), or £199 to £275 for the Intensive plans, which carry more credits. One credit is one minute of spoken practice, or two typed exchanges, and where the examiner or patient speaks first, that opening line is free. Examiner scorecards, mark schemes and model answers for finished sessions are included at no extra credit cost. Subscriptions can be cancelled at any time.

It runs in a web browser on a laptop or phone; spoken practice needs a microphone. There is no public demo: practice needs an account with credits, usually from the taster or a monthly plan.

MedMock is for adults aged 18 or over. Sign-up asks every new account to confirm it.

MedMock is a revision tool. The patients, examiners and cases are fictional and AI-generated; it is not clinical guidance and is not affiliated with or endorsed by any Royal College, the GMC, the GDC or any examining body.

Start with the £5 taster: https://medmock.com/auth/signup