How is the CSA marked?

In the past to pass CSA you needed to get 8 clear or marginal passes out of 12 cases. The marking schedule has now changed. For each case you are given a mark between one and four on the three exam domains (data gathering, clinical management and interpersonal skills) and then an overall mark. One = clear fail, two = borderline fail, three = borderline pass and four = clear pass. The marks are then added up and you get a percentage score for the CSA exam.

The pass mark is set by averaging the score of candidates that CSA examiners have said are borderline. The RCGP then applies some magic number mystery stuff (borderline group method) to these average pass marks and a pass mark for the exam on that day is produced (this is what Richard Adams says if we have got it right!!)

In the past you could pass the CSA with 8 borderline passes and doing badly in the other cases. For example if you got 8 borderline passes, three borderline fails and two clear fails under the old system you would pass. Under the new system you would score 57% and fail. Richard Adams, our local tame CSA examiner, says that the pass rate is 60 - 70% (although the score to pass in the September CSA was 76%).

For each case you can get 16 points ( 1-4 per three domains, and 1-4 on the overall score). In order to pass, if the pass mark is 70%, you need to get on average 12 per case = 3 per domain overall.

So, in order to pass you need to do reasonably well in all the cases - if you do poorly in a few and get some ones and twos, you will fail. Which maybe one of the reasons why it is more difficult to pass.

Not wishing to panic you, but to prepare you need to do COTs and COTs and COTS, and be the doctor at HDR!