100+ Free MRCGP SCA Practice Questions

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A 22-year-old student phones NHS-style triage with fever, a severe headache, neck stiffness, photophobia and a non-blanching purpuric rash that is spreading. What is the most appropriate immediate management in the community?

Give intramuscular or intravenous benzylpenicillin (if available and not allergic) and arrange emergency ambulance transfer

Reassure that a rash with fever is usually viral

Advise paracetamol and review tomorrow

Prescribe oral amoxicillin and discharge

to track

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Sample MRCGP SCA Practice Questions

Try these sample questions to test your MRCGP SCA exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1The SCA consists of how many simulated consultations, and how long is each consultation?

A.12 consultations of 12 minutes each

B.10 consultations of 15 minutes each

C.13 consultations of 10 minutes each

D.8 consultations of 18 minutes each

Explanation: The RCGP SCA comprises 12 simulated consultations, each lasting 12 minutes, giving 144 minutes of total consultation time. Candidates take the assessment remotely, usually from their own GP surgery.

2Across each SCA station, which of the three marking domains carries the highest weighting?

A.Data gathering and diagnosis

B.Relating to others

C.Clinical management and medical complexity

D.Professionalism and ethics

Explanation: Clinical management and medical complexity is weighted most heavily, carrying 4.5 marks per case versus 3 marks each for data gathering and relating to others. This reflects the central importance of safe, evidence-based, patient-centred management.

3A candidate's domain performance in the SCA is reported using which grading descriptors?

A.A, B, C, D

B.Distinction, Merit, Pass, Fail

C.Clear Pass, Pass, Fail, Clear Fail

D.Excellent, Good, Borderline, Poor

Explanation: Each of the three domains in each case is awarded Clear Pass (CP), Pass (P), Fail (F), or Clear Fail (CF), benchmarked against the standard of a newly qualified, independent GP. These grades feed the aggregated mark out of 126.

4How is the SCA pass mark determined for each diet?

A.Borderline regression standard-setting

B.A fixed pass mark of 60% set in advance

C.The top 66% of candidates pass

D.A norm reference against the previous year's cohort

Explanation: The SCA uses borderline regression, a criterion-referenced standard-setting method. The pass threshold is calculated from the performance of candidates judged borderline by examiners, so the cut score shifts slightly each diet rather than being fixed.

5The standard against which SCA candidates are judged is that of a:

A.Newly qualified, independent GP

B.GP partner with 10 years' experience

C.ST1 trainee at the start of training

D.Hospital consultant in general medicine

Explanation: All SCA grading descriptors are anchored to the standard of a newly qualified, independent GP, i.e. the level expected of a doctor on the day they complete training and begin practising independently. This is the licensing threshold.

6In the data gathering domain, which behaviour is most likely to earn a Clear Pass?

A.Asking a long fixed checklist of questions regardless of the presentation

B.Reaching a diagnosis quickly with minimal history to save time

C.Generating and testing focused hypotheses while exploring the patient's ideas, concerns and expectations

D.Ordering a wide panel of investigations before taking a history

Explanation: Strong data gathering is hypothesis-driven and patient-centred: the candidate forms differentials early, asks targeted questions to confirm or exclude them, and integrates the patient's ideas, concerns and expectations (ICE). This is more discriminating than rote questioning.

7Within the SCA, what does eliciting a patient's 'ICE' refer to?

A.Investigations, Comorbidities, Examination

B.Identity, Capacity, Eligibility

C.Inspection, Consent, Explanation

D.Ideas, Concerns and Expectations

Explanation: ICE stands for the patient's Ideas, Concerns and Expectations. Exploring ICE is a core consultation skill that helps the candidate understand the patient's perspective and tailor explanations and management, contributing to both data gathering and relating to others.

8During the SCA, what should a candidate do with the case briefing before each consultation?

A.Read it during the consultation while talking to the patient

B.Use the dedicated reading time before the case to plan their approach

C.Ignore it because all cases are undifferentiated

D.Request the full medical records from the examiner

Explanation: Each SCA case provides candidate notes that must be read in the dedicated reading time before the consultation starts. Effective candidates use this to anticipate the likely issues, note relevant past history and medication, and plan a structured approach.

9The SCA is most commonly delivered in which format?

A.Remotely, with the candidate consulting from their GP practice

B.In person at the RCGP examination centre in London

C.As a written multiple-choice paper

D.As an observed live clinic with real patients

Explanation: The SCA is a remote assessment. Candidates consult simulated patients (role players) over a secure video/telephone platform, typically from a quiet room in their own GP surgery. This replaced the in-person CSA format.

10The SCA case blueprint is built around how many RCGP Clinical Experience Groups?

A.6

B.8

C.12

D.20

Explanation: The SCA blueprint maps cases across the 12 RCGP Clinical Experience Groups, the same framework used in Workplace Based Assessment. This ensures each diet samples the breadth of UK general practice rather than concentrating on one area.

About the MRCGP SCA Exam

The SCA is the clinical skills component of the MRCGP, sat in the ST3 year of GP training. Candidates complete 12 simulated 12-minute consultations remotely, usually from their own GP surgery, with trained role players. Cases are drawn from a blueprint mapped to the 12 RCGP Clinical Experience Groups.

Assessment

12 remote simulated consultations of 12 minutes each, each scored across data gathering and diagnosis, clinical management and medical complexity, and relating to others.

Time Limit

12 minutes per case; 12 cases (144 minutes of consultation time)

Passing Score

No fixed pass mark; the cut score is set each diet by borderline regression. Each domain is graded Clear Pass, Pass, Fail or Clear Fail against the standard of a newly qualified, independent GP, giving an aggregate out of 126.

Exam Fee

£1,207 per attempt (inflationary increase from August 2025); staged payments introduced from April 2026 (Royal College of General Practitioners (RCGP))

MRCGP SCA Exam Content Outline

Marking domains and consultation skills

Data gathering and diagnosis, clinical management and medical complexity (weighted highest), and relating to others, plus consultation structure, time management and safety-netting.

Children and Young People

Paediatric and adolescent presentations, including acute illness, safeguarding, Gillick competence and Fraser guidelines.

Gender, Reproductive and Sexual Health

Contraception, emergency contraception, menopause and HRT, sexual health and early pregnancy assessment.

12%

Long-term Conditions

Diabetes, COPD, asthma, atrial fibrillation, CKD, cardiovascular prevention, thyroid disease and chronic-disease drug monitoring.

Older Adults, Frailty and End of Life

Falls, polypharmacy and deprescribing, delirium, dementia, advance care planning, DNACPR and palliative care.

Mental Health and Addiction

Depression, anxiety, panic disorder, psychosis, suicide risk assessment and alcohol, opioid and tobacco dependence.

Urgent and Unscheduled Care

Recognition and safe management of emergencies such as ACS, anaphylaxis, meningococcal disease, DKA, TIA and surgical emergencies.

10%

Health Disadvantage and Vulnerability

Safeguarding, mental capacity, domestic abuse, learning disability, homelessness, veteran health, interpreters and health inequalities.

Ethnicity, Culture and Diversity

Culturally sensitive and inclusive care across ethnicity, religion, gender identity and belief.

New Presentations of Undifferentiated Illness

Structured assessment of vague symptoms and recognition of red flags and suspected-cancer pathways.

Prescribing Decisions

Safe, evidence-based prescribing, drug interactions, prescribing in pregnancy and antimicrobial stewardship.

Investigations and Results Handling

Appropriate use and interpretation of investigations and safe communication of and action on results.

10%

Professional Conversations and Ethical Dilemmas

Probity, consent, confidentiality, fitness to drive, duty of candour, de-escalation and shared decision-making.

How to Pass the MRCGP SCA Exam

What You Need to Know

Passing score: No fixed pass mark; the cut score is set each diet by borderline regression. Each domain is graded Clear Pass, Pass, Fail or Clear Fail against the standard of a newly qualified, independent GP, giving an aggregate out of 126.
Assessment: 12 remote simulated consultations of 12 minutes each, each scored across data gathering and diagnosis, clinical management and medical complexity, and relating to others.
Time limit: 12 minutes per case; 12 cases (144 minutes of consultation time)
Exam fee: £1,207 per attempt (inflationary increase from August 2025); staged payments introduced from April 2026

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

MRCGP SCA Study Tips from Top Performers

1Use the dedicated reading time before each case to identify the likely issues, relevant history and medication, and to plan a structured consultation that reaches a shared management plan within 12 minutes.

2Practise hitting all three domains in every case: gather data with focused, hypothesis-driven questions and ICE, deliver safe evidence-based management with safety-netting, and build rapport by recognising and exploring cues.

3Prepare across all 12 RCGP Clinical Experience Groups using a timer and simulated patients, since cases are blueprinted across paediatrics, women's and men's health, mental health, long-term conditions, older adults, urgent care, vulnerability and professional dilemmas.

Frequently Asked Questions

How many cases are in the MRCGP SCA and how long is each?

The SCA consists of 12 simulated consultations, each lasting 12 minutes, giving 144 minutes of total consultation time. It is sat remotely, usually from the candidate's own GP surgery.

How is the SCA marked?

Each case is scored across three domains: data gathering and diagnosis (3 marks), clinical management and medical complexity (4.5 marks, weighted highest), and relating to others (3 marks). Domains are graded Clear Pass, Pass, Fail or Clear Fail, giving an aggregate out of 126.

What is the SCA pass mark?

There is no fixed pass mark. The cut score is set for each diet using borderline regression, a standard-setting method referenced to the standard of a newly qualified, independent GP, so it shifts slightly each sitting.

How much does the SCA cost in 2026?

The SCA fee is £1,207 per attempt following an inflationary increase from August 2025. From April 2026 the RCGP introduced staged payments, with a deposit at reservation and the balance closer to the exam date.