How to prepare for the Psychiatry CASC

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.

Step by step

1. 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. 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. 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. 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. 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. 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. 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. 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

  The College's main CASC page: candidate guide, exam criteria, grade descriptors, pass mark rules and marksheets.

• MRCPsych CASC Syllabus and Blueprint

  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

  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

  Sample CASC stations on video, designed to help candidates and trainers prepare.

• 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

  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

  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
• 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
• A poor questioning style: repeated closed questions, or several questions at once, instead of funnelling from open to closed. source
• Not paying enough attention to physical health, such as medication side effects or physical causes of the psychiatric presentation. source
• 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
• 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

Questions candidates ask

Sources

• RCPsych: Preparing for the CASC
• RCPsych: MRCPsych CASC Syllabus and Blueprint (March 2023)
• RCPsych: Eligibility Criteria and Regulations, MRCPsych Examinations
• RCPsych: CASC guidance on feedback and generic statements
• RCPsych: FAQs about preparing for exams
• RCPsych: CASC videos
• RCPsych: Instructions to candidate (sample CASC station)

Checked on 27 September 2026.