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Bradford VTS  ·  MRCGP & GP Training

Understanding MRCGP

"Think of this as the GPS for your GP training journey — everything laid out before you need to recalculate."

The MRCGP is the qualification that marks the end of your GP training and the beginning of your career as a qualified GP. It has three components — and all three matter equally. This page explains what they are, when they happen, and what you need to be doing right now in ST1.

🎓 For Trainees, Trainers & TPDs ⚡ High-impact learning in minutes 💎 Hidden gems they forget to teach
📅 Last updated: April 2026

⚡ One-Minute Recall

If you only read one section — make it this one.

What is MRCGP?
  • Your GP qualification — needed for CCT
  • Three components, ALL equally important
  • Runs across all 3 years of GP training
  • Awarded by the RCGP
The 3 Components
  • AKT — knowledge exam (ST3)
  • SCA — consultation skills exam (ST3)
  • WPBA — ongoing portfolio evidence (all 3 years)
In ST1 Right Now
  • Focus on WPBA — start CBDs early
  • Get to know your ePortfolio (FourteenFish)
  • Do your QIP in ST1
  • Don't panic about AKT/SCA yet
Key Rules
  • WPBA is your responsibility — no one chases you
  • NFD grades early on = completely normal
  • Hospital consultants can assess WPBA too
  • RCGP website always takes precedence
🧠 The simplest way to remember the whole MRCGP
"What is going on, and what should I do?" AKT tests your knowledge base
"Can I do the consultation properly?" SCA tests your consultation skills
"Am I doing this consistently in real life?" WPBA tests your development over time
Every GP consultation maps to the whole MRCGP. It is not three separate tests — it is one picture of the same doctor.
🎯
Why Does MRCGP Matter?
The bigger picture, quickly explained
The Short Answer

MRCGP is the professional qualification that lets you work as a GP in the UK. Without it, you cannot receive your CCT (Certificate of Completion of Training), and without your CCT, you cannot join the GP Performers List — which means you cannot legally work as a GP in the NHS.

In short: MRCGP isn't just an exam. It's the proof that you're ready to practise independently.

Three Years, Three Strands

Most hospital exams are a one-off event — sit it, pass it, forget it. MRCGP is different. It runs concurrently across your entire training period. The WPBA element starts on day one of ST1 and doesn't stop until you complete ST3.

That's why understanding it early — even in ST1 — matters so much. You can't make up for lost WPBA time at the end of training.

🔄 The Biggest Shift: GP Thinking Is Different From Hospital Thinking

One thing that surprises many new trainees is that success in GP training is not primarily about knowing more medicine — it is about thinking differently. Hospital medicine often rewards decisive action, definitive diagnosis, and specialist depth. General practice requires something quite different.

In GP you will face:

  • More uncertainty — many presentations in GP do not arrive with a clear diagnosis. Learning to manage uncertainty safely is a core GP skill.
  • Shorter consultations — gathering the most important information quickly, then making a sensible and safe plan in 10 minutes, is a skill that takes deliberate practice.
  • More explaining and negotiating — patients in GP often need to be involved in decisions, not just told what to do. Shared decision-making is expected, not optional.
  • Continuity and risk balancing — you will see the same patients over years. Learning to balance risk, safety-net appropriately, and know when not to act is as important as knowing when to intervene.

Both the AKT and SCA sit within the context of independent general practice in the UK. That means this shift matters from ST1 — not just when exam preparation begins. Trainees who make this mental shift early consistently find the exams and assessments more manageable than those who try to adapt late.

⚠️ The Most Important Thing Trainees Misunderstand

Many trainees assume that if they pass the AKT and SCA exams, the rest takes care of itself. This is wrong. The WPBA (including your ePortfolio, assessments, reflections, and supervisor reports) carries exactly the same weight as the exams. Neglect it, and you risk extension of training — regardless of your exam results.

📚
The Three Components of MRCGP
Each tests something different — and all three must be passed
Component 1
AKT
Applied Knowledge Test
"Do you know enough to practise safely in UK general practice?"
  • Computer-based exam at Pearson VUE test centres
  • Around 200 questions over 3.5 hours — question formats include best-of-five (single best answer) and extended matching questions (EMQs)
  • Content breakdown: the majority is clinical medicine, with a significant proportion on evidence-based practice and statistics, plus a practice management section
  • Practice management topics include: QOF (Quality and Outcomes Framework), safeguarding, prescribing rules, NHS structures, and administrative processes — this section regularly catches trainees who only revised clinical content
  • It is not "hospital medicine in GP clothing" — questions are primary-care focused and guideline-heavy. NICE CKS and BNF are the backbone
  • Held multiple times per year
  • Can be taken from ST2 onwards, but ST3 is ideal
Best timing: ST3-1
Component 2
SCA
Structured Consultation Assessment
"Can you run a safe, effective GP consultation?"
  • Replaced the old CSA exam from 2020 onwards
  • Remote, online exam — held from your own location via video
  • You consult live with trained role players acting as patients
  • Tests three domains: data gathering, clinical management, and interpersonal skills
  • It is NOT just about communication — clinical knowledge matters equally
  • Key consultation skills assessed: structured opening, exploring ICE (Ideas, Concerns, Expectations), clear explanation, shared decision-making, and explicit safety-netting
  • Multiple sittings per year throughout ST3
Best timing: ST3-1 or ST3-2
Component 3
WPBA
Workplace Based Assessment
"Are you consistently developing into a competent GP in real life?"
  • Ongoing throughout all 3 years — starts day one of ST1
  • Multiple tools: CBDs, COTs, CEXs, MSF, PSQ, and more
  • All evidence recorded on your ePortfolio (FourteenFish)
  • Tests you against the 13 Professional Capabilities
  • Reviewed at each ARCP panel (every 6–12 months)
  • If you leave it late, you cannot catch up — time-spread matters
  • Your educational supervisor (ES) guides but does not chase you
Starts: Day 1 of ST1
💡 About the Old CSA Exam

If you're reading older Bradford VTS resources or talking to GPs who qualified before 2020, you may hear the term CSA (Clinical Skills Assessment). This has been replaced by the SCA. The underlying principles are similar — it still tests your consultation skills — but the format is now remote (via video) rather than an in-person OSCE. Any page on this site still referencing CSA is being updated; the SCA pages contain current guidance.

🛠️
WPBA — What's Inside?
A plain-English guide to all the assessment tools

WPBA is not one thing — it's a collection of different tools, each assessing a different aspect of your development. Together, they build a rich picture of you as a GP trainee.

ToolFull NameWhat It InvolvesWhen / Where
📋 Consultation Assessment Tools (CATs) — the core of WPBA
CBDCase Based DiscussionA structured conversation with your supervisor about a real patient case — exploring your clinical reasoning, not just what you didST1ST2Hospital OK
COTConsultation Observation ToolYour supervisor observes (or watches a recording of) a real consultation and gives structured feedbackST1ST2GP post
Audio-COTAudio Consultation Observation ToolThe same as a COT, but using an audio-recorded consultation for review and discussionST1ST2GP post
📋 CATs — Extended Range (mainly ST3, also available in later GP posts)
RCARandom Case Analysis & ReviewA random selection of your cases reviewed — testing consistency of your clinical approachMainly ST3
Prescribing ReviewCAT: Prescribing AssessmentYour prescribing patterns reviewed for safety, appropriateness, and reasoningMainly ST3
Inv. ReviewCAT: Review of InvestigationsA review of your approach to requesting and interpreting investigationsMainly ST3
Referrals AnalysisCAT: Referrals AnalysisAnalysis of your referral decisions — appropriateness, communication, and patient safetyMainly ST3
DebriefsCAT: DebriefsStructured debrief conversations after challenging clinical events or sessionsMainly ST3
Leadership CATCAT: Leadership Activity / ProjectAssessment of your involvement in a leadership or quality-related activityMainly ST3
🩺 Direct Clinical Assessments
CEXClinical Evaluation ExerciseA supervisor observes a direct clinical encounter and gives structured feedbackHospital postsGP post
CEPSClinical Examination & Procedural SkillsSign-off of specific practical clinical skills (e.g. CV exam, respiratory exam, minor procedures)Ideal: hospital posts
💬 Colleague & Patient Feedback
MSFMulti-Source FeedbackA structured questionnaire completed by colleagues about your professional behaviour and teamworkAll yearsHospital or GP
PSQPatient Satisfaction QuestionnaireAnonymous feedback from patients about their experience of consulting with youGP posts only
📝 Supervisory Reports
CSRClinical Supervisor's ReportA structured end-of-post report from your hospital consultant — completed at end of each rotationHospital posts
ESREducational Supervisor's ReviewA 6-monthly review by your GP educational supervisor — assesses progress against Professional CapabilitiesAll years (6-monthly)
📖 Learning Events & Reflective Entries
NOENote of Entry (Log Entry)A brief reflective record of a learning event — anything you learned from. Must map to capabilitiesAll years, continuously
LEALearning Event AnalysisA more structured reflection on a significant learning event — what happened, learned, and would do differentlyAll years
SEASignificant Event AnalysisA detailed structured reflection on a patient safety event, near-miss, or significant professional learning momentAll years
🚀 Projects & Special Activities
QIPQuality Improvement ProjectA structured project to identify and improve a quality or safety issue — usually completed in ST1 or ST2Ideally ST1
Leadership ProjectLeadership & Management ActivityInvolvement in a leadership, management, or organisational activity demonstrating relevant capabilitiesST2–ST3
🔗 What Is Triangulation — and Why Does It Matter?

You may hear the word triangulation used in relation to WPBA. It simply means this: because multiple different WPBA tools assess overlapping capabilities, your portfolio builds up a picture of you from different angles — different tools, different assessors, different settings, different points in time.

This is deliberate. A single CBD that goes well is not very meaningful on its own. But a consistent pattern of CBDs, COTs, log entries, and MSF responses — all pointing in the same direction — gives your ARCP panel genuine confidence that you are developing into a safe GP. Triangulation is what turns a collection of individual forms into a coherent professional portrait.

In practice: aim for variety of assessors, variety of tools, and variety of clinical contexts. A portfolio assessed by only one person in only one type of encounter is not well-triangulated — and panels will notice.

💡 Insider Tip: Numbers Matter — But So Does Spread The minimum numbers of CBDs, COTs, etc. are set by the RCGP and updated periodically — always verify on the RCGP website. More importantly: spread them throughout training. Doing all your CBDs in the last two weeks of a post is technically possible but deeply unpleasant, and ARCP panels notice clustering. Aim for roughly one meaningful assessment every 4–6 weeks.
💡 One thing trainees regularly miss: the difference between description and evidence Assessments that contain only a description of what the trainee did — without any examiner comment on how it demonstrated a capability — add very little to your portfolio. Push for specific, written feedback on every CBD, COT, and CEX. "Good" is not enough. Ask your assessor: "Can you say a word or two about which capability this demonstrated and how?" That sentence transforms a tick-box into genuine evidence.
🗺️
The 13 Professional Capabilities
The framework everything in GP training maps to

Everything in your GP training — every assessment, every reflection, every exam — measures you against the RCGP's 13 Professional Capabilities. Think of them as the 13 things a good GP needs to be able to do. Understanding them early is one of the most valuable things you can do in ST1.

The RDMp Framework — How the Capabilities Are Grouped

The 13 capabilities sit within four broad themes, sometimes called the RDMp framework: Relationships, Diagnostics & Decisions, Management & Complexity, and professionalism & Organisation. This grouping helps you see the whole picture at once.

🤝 Relationships (R)

  • Communication & Consultation Skills
  • Working with Colleagues & in Teams
  • Community Orientation
  • Fitness to Practise
  • Maintaining an Ethical Approach

🔍 Diagnostics & Decisions (D)

  • Data Gathering & Interpretation
  • Clinical Examination & Procedural Skills
  • Making Decisions

⚙️ Management & Complexity (M)

  • Clinical Management
  • Managing Medical Complexity
  • Practising Holistically & Promoting Health

📋 Professionalism & Organisation (p)

  • Maintaining Performance, Learning & Teaching
  • Organisation, Management & Leadership
⭐ Why This Matters For You Right Now

When you submit a CBD, a COT, or a reflective log entry, it must be mapped to specific capabilities. If you don't know what the capabilities are, you'll be mapping them blindly — and your ARCP panel will notice the difference. Spend 20 minutes reading the full descriptors (linked above). You'll refer back to them for three years.

📝 A Note on "NFD" — Needs Further Development

In early training, your grades will often say NFD (Needs Further Development). Please do not see this as a failure. It is expected. It is normal. If an ST1 or ST2 trainee is being graded as "Excellent" across all capabilities, that is actually more concerning — it suggests the assessor hasn't looked critically enough. NFD means: you're in training, doing exactly what you should be doing.

📅
The MRCGP Journey — Year by Year
What to focus on at each stage of training
ST1
ST1
Year 1
  • Set up FourteenFish ePortfolio
  • Start CBDs in hospital posts
  • Do CEX & CEPS in hospital
  • Start your QIP
  • Request MSF from colleagues
  • Write regular NOE / LEA entries
  • Learn the 13 capabilities
  • Community placement
  • Read a consultation book
  • 6-monthly ES review (ESR)
ST2
ST2
Year 2
  • Continue CBDs & CEPS in hospital
  • Begin COTs in GP posts
  • Complete / finish QIP
  • Leadership activity
  • PSQ in GP posts
  • Continue reflective entries
  • Build exam knowledge base
  • Consider AKT prep materials
  • ARCP panel review
ST3-1
ST3-1
First 6 months of ST3
  • AKT exam — ideal timing
  • SCA exam — first sitting
  • Intensive COT/CAT work
  • Complete 5 CATs minimum
  • Complete outstanding CEPS
  • SEA if relevant event occurs
  • Final MSF & PSQ cycles
ST3-2
ST3-2 → CCT
Final stretch
  • SCA resit if needed
  • ePortfolio completion check
  • Final ESR from trainer
  • Final ARCP — Outcome 6
  • CCT awarded 🎉
  • Apply to Performers List
  • Post-CCT planning
🕐 Timing Your Exams

The ideal approach is to take the AKT and SCA reasonably close together — within the same 6-month period if possible. The knowledge you build for AKT directly helps the SCA. Most trainees aim for AKT in ST3-1 and SCA in ST3-1 or early ST3-2. Don't rush either exam — being ready matters more than being first.

What to Focus On in ST1
Eight things worth doing before you're too busy to think
1

Set Up Your ePortfolio Properly — Then Use It Regularly

Your FourteenFish ePortfolio is the central record of your entire training. Everything gets documented here: assessments, reflective entries, supervisor meetings, projects. Log in early, understand how it works, and write something in it at least every two weeks. The trainees who struggle at ARCP are usually the ones who treated the ePortfolio as an afterthought.

2

Start CBDs Early in Your First Hospital Post

CBDs are available from your very first post — including hospital posts. Don't wait until you're in GP. Ask your hospital consultant to do a CBD with you within the first 4–6 weeks of each post. Hospital consultants can be unfamiliar with the format — politely brief them or bring the Bradford VTS guide. Getting a head start prevents the end-of-post scramble.

3

Complete Your CEPS During Hospital Posts

Clinical Examination and Procedural Skills (CEPS) sign-offs are far easier in hospital — where the clinical volume and variety is much higher. Get your respiratory, cardiovascular, abdominal, and other system examinations signed off while you're surrounded by patients with clear clinical signs. Trying to complete CEPS in a GP post is possible but much harder.

4

Do Your QIP in ST1 or Early ST2

The Quality Improvement Project takes time and planning. ST1 — especially during a GP placement — is the ideal time. In ST2, your hospital posts are busier. In ST3, you'll be focused on exams. ST1 gives you the breathing space to do it properly. Ask your trainer to suggest a suitable topic early in your first GP post.

5

Read a Consultation Book — and Start Building Consultation Habits Now

Communication skills are not just about being nice — they are the clinical tool that helps you gather better histories, make better decisions, and explain things clearly. Bradford VTS recommends The Naked Consultation by Dr Liz Moulton as a first read — it's warm, practical, and written with GP trainees firmly in mind. Other well-regarded options include Neighbour's The Inner Consultation and Silverman's Skills for Communicating with Patients. ST1 is the right time to read one.

But reading alone is not enough. Even in ST1, begin consciously building these habits in every consultation you do — in hospital or in GP:

  • Focused data gathering — gather what you actually need to make a decision, not an exhaustive clerking
  • Clear internal summaries — get into the habit of mentally summarising what you know before moving to management
  • Simple, patient-friendly explanation — a common blind spot is knowing the medicine but explaining it poorly; practise this from day one
  • Sensible shared plans — involve the patient in decisions rather than just telling them what will happen
  • Consistent safety-netting — always tell the patient what to watch for and when to come back

These are not "SCA skills" — they are core GP skills. The SCA tests them formally in ST3, but the trainees who do best started building them years earlier.

6

Remember You Are a GP Trainee in Hospital, Not a House Officer

It's easy to lose yourself in the specialty and forget why you're there. You are a GP trainee on a hospital rotation. That means: practise consultation skills with every patient, learn what will help you in general practice (e.g. managing heavy periods in O&G, not performing C-sections), and actively make time for your GP training assessments alongside your clinical commitments.

7

Learn the 13 Professional Capabilities — Properly

Don't just know the names. Read the descriptors. Understand what each capability actually means and what evidence might demonstrate it. When you know the capabilities well, mapping your assessments and log entries becomes quick and meaningful — rather than a guessing game at 11pm before your ES meeting.

8

Don't Revise for AKT Yet — But Start Building AKT Awareness

There is no value in starting intensive AKT revision in ST1. You'll likely forget most of it by the time the exam arrives, and you'll miss the genuine learning that comes from clinical immersion in your first year. Serious exam preparation belongs in ST2-2 and ST3-1.

However, ST1 is a good time to begin what might be called AKT awareness — not revision, but noticing:

  • How common GP decisions are made — what NICE recommends and why
  • How primary care prescribing works — thresholds, first-line choices, review intervals
  • How guidelines actually influence clinical decisions in real consultations
  • How risk is explained, balanced, and managed in a GP setting

Trainees who do this naturally throughout ST1 and ST2 find later AKT preparation much easier — because the exam is testing application of knowledge in a UK GP context, not isolated trivia. Building that context early makes the knowledge stick.

One additional habit worth starting lightly in ST1: try occasional AKT-style questions in small blocks — not to revise in earnest, but to get familiar with the question format (best-of-five, EMQs) and to identify areas of the curriculum where your knowledge is thin. Think of it as a compass for your learning, not an exam schedule. When you look things up in NICE CKS or BNF during the working day, mentally note the pattern — first-line choice, safety-net trigger, referral threshold. These patterns are exactly what the AKT tests.

💡 The One Thing Trainees Most Regret Not Doing Earlier Writing reflective log entries regularly — even briefly — instead of leaving months of entries to write in one panicked sitting the week before an ARCP. A short, thoughtful entry written the same day as the learning event is worth ten times more than a retrospective block-write. Five minutes at the end of a clinical day is enough.
💎
Insider Pearls
Things trainees wish someone had told them on day one

These insights come from recurring patterns in real trainee experience — the things that consistently catch people out, and the small adjustments that consistently make the biggest difference. None of this conflicts with official guidance; it's the practical layer on top of it.

📖 On Log Entries — The Most Underestimated Part of WPBA
💡 The two-part rule for every entry Think of every log entry as having two parts: what happened, and what it meant to you. Most trainees spend 80% of their entry on the first part. Flip that ratio. The ARCP panel already knows things happen in medicine — they want to see how you think about it.
💡 The "drive home" trick When a patient case is still on your mind on the way home, that is your cue to write a log entry. Not because it was complicated — because it meant something to you. Those are the ones that produce the most honest and useful reflections. Put a quick voice memo or phone note down immediately; write the full entry later when you have five quiet minutes.
⚠️ Don't write entries that criticise colleagues It is surprisingly common for trainees to write reflections that subtly (or not so subtly) criticise a colleague, a specialty team, or a management decision. Even anonymised, these entries look unprofessional to a panel that doesn't know you, and they are very hard to link meaningfully to your own learning needs. If something went wrong in a team context, frame the reflection around what you learned — not what others did badly.
⚠️ The "Organisation, Management & Leadership" blind spot Almost every trainee links their entries to Communication & Consultation Skills. Almost no one links enough entries to Organisation, Management & Leadership. This is one of the capabilities the ARCP panel is most likely to flag as under-evidenced. You don't need to be running a hospital department — chairing a ward meeting, adapting your consulting room setup, or improving a workflow in your practice all count. Look for these moments deliberately.
🎯 Check your capability coverage regularly — don't wait for the panic On your ePortfolio, look under "Review Preparation" — there is a curriculum coverage tool that shows you which capabilities and clinical experience groups you've evidenced so far. Most trainees only discover they have major gaps a week before ARCP. Check it every 4–6 weeks and you can fill gaps progressively rather than desperately.
💡 Simple cases often make better reflections than dramatic ones Trainees often feel they need a dramatic, complex case to justify a meaningful reflection. In practice, everyday encounters — a patient who seemed fine but wasn't, a consultation where you changed your mind halfway through, a mundane chronic disease review that made you think about something new — often generate richer reflections than the memorable emergency. Use what actually made you think, not what sounds impressive.
🔥 Aim for 4 log entries per month — and make them count A useful working target is four entries per month: around three on clinical encounters and one on anything else (a HDR session, a tutorial, a piece of reading). This is not a rigid requirement, but trainees who maintain this rhythm consistently arrive at ARCP with a rich, balanced portfolio — and never have to write fifteen entries in a panic the week before their panel.
⚠️ Don't forget to release your entries so your supervisor can read them Your log entries are private by default. Your Educational Supervisor cannot read them — or comment on them — until you release them. Trainees who release entries regularly get timely feedback that helps them improve. Trainees who release everything in one batch the day before an ES meeting get very little useful feedback. Get into the habit of releasing entries as you go.
📋 Start-of-post planning: map your assessments on day one At the very start of each placement, sit down with your supervisor and list the assessments required for that post — CBDs, COTs or CEXs, MSF, PSQ, CSR — and roughly schedule when you will do each one across the weeks ahead. This takes 15 minutes and prevents the end-of-post scramble entirely. Trainees who do this once describe it as the single most stress-reducing habit in their training. Those who don't consistently regret it.
🔥 Use challenging cases for CBDs and logs — not easy wins A very common pattern among trainees is to select "safe" cases for CBDs and reflective entries — straightforward presentations where everything went well. Supervisors and ARCP panels notice this immediately. The cases that actually demonstrate professional capability are the ones that involved uncertainty, managing risk, a difficult patient interaction, or a moment where you changed your mind. These are harder to write about — but they produce the richest reflections and the most convincing evidence of development.
🏥 In Hospital Posts — how to stay being a GP trainee
💡 The single best question to ask at every ward round When a patient is about to be discharged, ask yourself: "What would I need to do as this person's GP when they get home?" Think about the medicines, the follow-up, the communication with family, the safety-netting. This reframes every hospital encounter as GP training — without taking a single minute away from your clinical work.
💡 Outpatient clinics beat ward rounds for GP learning The chronic, stable, community-relevant conditions you'll see most as a GP are managed predominantly in outpatient clinics — not on the wards. Trainees in hindsight consistently say they wish they had attended more clinics. If you have any flexibility in your rota, ask if you can spend time in outpatient clinics in your specialty — the dermatology clinic, the rheumatology review, the cardiology follow-up. These are the patients you'll see in GP for the next 30 years.
💡 Ask supervisors for specific consultation feedback — not "be more empathetic" Ask your supervisor to watch one of your whole consultations occasionally — not just a snippet — and give you one or two specific, actionable points to work on. Vague feedback like "be more empathetic" or "good consultation" is almost useless for development. Specific feedback like "you moved to management before exploring the patient's concerns — try signposting before you explain" is something you can actually act on tomorrow. Ask for it by name: "One thing I could do differently in my next consultation?"
🔥 Book your skills courses early in ST1 — they fill up fast Study leave in ST1 and ST2 is more generous than in ST3 (when exam preparation takes over). Use it for practical skills courses: joint injection, intrauterine coil fitting, implant insertion, minor surgery, skin surgery. These courses often get booked up months in advance. If you don't plan early in ST1, you may find yourself completing training without these skills — which limits your scope as a GP. Check what's available in your deanery and book early.
⚠️ Briefing your hospital consultant: do it proactively Don't assume your hospital consultant knows how to run a CBD or CEX for GP trainees. They usually don't — not because they're unhelpful, but because they've never needed to learn it. A five-minute briefing at the start of your post — "here's what a CBD involves and what you'll be asked to assess" — transforms assessment quality. Bradford VTS has a downloadable guide specifically for hospital supervisors (see Downloads above). Print it. Bring it. Give it with a smile.
🧭 General Survival Wisdom
💡 Your ARCP panel may not know you at all — your portfolio is your voice In many deaneries, the ARCP panel reviews your portfolio before the meeting and may never have met you. Everything they know about you comes from what you have written, submitted, and evidenced. Write every entry, reflection, and PDP as if a thoughtful stranger needs to understand who you are, how you think, and how you're growing. Because sometimes, that is exactly who will be reading it.
💡 Aim for twice the minimum number of WPBAs — not just the minimum Minimums are called minimums for a reason: they're the floor, not the target. Trainees who consistently exceed minimums arrive at ARCP with a richer, more triangulated portfolio, and panels feel much more confident in their progress. Aiming for double the minimum isn't overachieving — it's standard good practice among trainees who sail through ARCP without drama.
💡 Your PDP goals need to be SMART — not aspirational Most trainees write Personal Development Plan (PDP) goals that sound meaningful but are impossible to measure: "I want to improve my communication skills" or "I'd like to learn more about diabetes." These cannot be ticked off, which means at your next ES review you can't demonstrate you've achieved them. Write SMART goals: Specific, Measurable, Achievable, Relevant, Time-bound. "By the end of this post, I will attend three rheumatology outpatient clinics and reflect on each" is something you can prove — and be proud of.
🎯 For IMGs: the ePortfolio and reflective culture can feel unfamiliar — that's normal Many IMGs come from training systems where competence is assessed through exams and clinical performance alone. The idea of writing reflective entries about your feelings, uncertainties, and growth can feel unusual or even uncomfortable at first. It is not weakness — it is the foundation of the professional culture in UK general practice. Embrace it early. The trainees who thrive most with the ePortfolio are often those who eventually say it made them a better doctor, not just a more compliant trainee.
💡 Build little and often — it beats every burst of panic The most consistent pattern among trainees who sail through ARCP, pass exams without drama, and feel in control of their training is not brilliance — it is steadiness. Regular portfolio entries, regular assessments, regular revision touches, regular feedback-seeking. A small amount done consistently every week is worth far more than intensive bursts followed by nothing. This applies to portfolio work, consultation development, and later exam preparation equally.
💡 Learn to explain things simply — it is harder than it sounds A very common blind spot is knowing the medicine well but struggling to explain it to a patient clearly. This matters in every supervised assessment, in the SCA, and in every real consultation for the rest of your career. Begin practising patient-friendly explanation from ST1. Ask yourself after every explanation: "Would a person with no medical background have understood that?" If not — try again, simpler.
💡 Ask for help early — not when things are already going wrong The trainees who do best in GP training are not necessarily the ones who know the most. Often they are the ones who recognise their own uncertainty, ask for help promptly, and make good use of feedback. Asking your ES, CS, or TPD for support early — when a question is still manageable — is a sign of professional maturity, not weakness. It also directly fits the "Fitness to Practise" capability, which explicitly includes insight into one's own performance and limitations.
🧘 Wellbeing & Mindset in ST1
💡 Feeling slow or "behind" in ST1 is entirely normal — and temporary Many trainees describe the first 6–12 months of GP training as feeling like nothing is clicking: consultations feel clunky, everything takes longer than it should, and it is hard to tell if you are improving. This is not a warning sign — it is the normal experience of a doctor in an entirely new clinical environment. Almost universally, those same trainees describe a point somewhere in ST1 or early ST2 where everything suddenly starts to join up. Trust the process. Focus on steady improvement rather than perfection.
💡 You are not expected to function like an ST3 — or a partner As an ST1, needing close supervision, longer appointments, and regular guidance is not a sign that you are failing. It is exactly what ST1 is for. A very common source of unnecessary anxiety is comparing yourself to confident ST3s, qualified partners, or your own imagined version of "how good you should be by now." The only useful comparison is with yourself last month. Are you a little better, a little more confident, a little clearer in consultations? That is the right question.
💡 Impostor syndrome is almost universal in GP training — you are not alone Feeling like you are not good enough, that others have it more together than you, or that you got here by luck rather than ability is one of the most consistently reported experiences among GP trainees — including those who go on to pass all exams first time and become excellent GPs. Naming it matters: many trainees say that simply knowing this experience is near-universal would have significantly reduced their early anxiety. If you are feeling it, it almost certainly means you are exactly where you should be.
⚠️ Protect your non-work time — burnout in early training is real Burnout in GP trainees is not a rare or dramatic event — it is a common, gradual process that often starts with consistently sacrificing recovery time in the name of "catching up." Trainees who neglect rest, relationships, and personal time in ST1 consistently report that their learning, exam performance, and wellbeing all suffer as a result. Protecting time outside work is not self-indulgent. It is a clinical safety matter and one of the most evidence-based things you can do for your own training outcomes. If you are struggling, speak to your ES, your TPD, or your GP — early.
💡 Be honest with your supervisors when you feel out of depth A repeated regret among qualified GPs looking back at training is that they hid their struggles — from supervisors, from peers, from themselves — and only asked for help when things had become significantly harder than they needed to be. Your ES and CS are there specifically to support you through uncertainty. Being open about difficulty early is not a sign of weakness; it is a sign of the self-awareness that GP training is actively trying to develop in you.
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Common Pitfalls & Trainee Traps
Mistakes people make — so you don't have to
❌ "I'll do my WPBA assessments nearer the end of training" The ARCP panel reviews the timing and spread of your evidence, not just the total number. Doing all your CBDs in the final two weeks of a post is a red flag. Start from week one of every rotation and maintain a steady rhythm throughout.
❌ "My hospital consultant knows how to do MRCGP assessments" Many do not — or at least not well. Hospital consultants are excellent at their specialty but may not fully understand GP-specific capabilities. Brief them gently. Bring a guide. Help them to help you.
❌ "NFD means I failed something" No. It means you're a trainee with room to grow — which is the entire point of training. A handful of NFDs in ST1 is completely expected. Your ARCP panel will actively question a trainee who has no NFDs at all.
❌ Leaving the QIP until ST3 In ST3, you have exams to prepare for. In ST2, you have busy hospital posts. ST1 — particularly during your GP placement — is the natural time for a QIP. Don't kick it down the road.
❌ Thinking the AKT and SCA are the only things that matter They are not. WPBA is equally weighted. Many trainees who sail through the exams have an uncomfortable ARCP because their ePortfolio is thin, poorly reflective, or evidence is clustered into the final weeks of training.
❌ Writing reflective log entries without any actual reflection Entries that describe what happened without exploring what you thought, felt, or learned are essentially useless. "I saw a patient with chest pain and did an ECG" is a description, not a reflection. Your ARCP panel and ES will notice the difference immediately.
❌ Not getting CEPS done in hospital posts CEPS sign-offs are much easier in hospital — patients with clear clinical signs, consultants used to teaching practical skills. Many trainees leave CEPS to GP placements and struggle. Do them in hospital from ST1.
❌ Not knowing the 13 Professional Capabilities If you're mapping assessments to capabilities you don't understand, the work is going through the motions. Understanding the capabilities transforms your portfolio from a tick-box exercise into genuine evidence of professional development.
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For Trainers & TPDs
Teaching notes, discussion ideas, and common trainee blind spots
🟣 Educator Insights
  • The most common trainee misconception on day one is that WPBA is a box-ticking exercise and the "real" MRCGP is just the two exams. Address this directly in induction. Use the analogy: the exams test knowledge and one-off performance; WPBA tests consistent professional development over time. Both matter equally.
  • NFD anxiety is very real, particularly in IMGs and highly conscientious trainees who have excelled throughout their medical career. A tutorial specifically about the purpose and value of NFD in early training — separate from the general MRCGP induction — can be genuinely transformative.
  • The ePortfolio is often the biggest source of ARCP difficulty — not because trainees lack ability, but because they don't understand what good reflective writing looks like. A concrete before/after example of a log entry (poor reflection vs meaningful reflection) is one of the most useful single teaching tools in ST1 induction.
  • Hospital consultants need briefing. Their CBD and CEX quality is often weaker than that of GP trainers — not through fault, but through unfamiliarity. Providing a one-page guide for hospital supervisors at the start of each rotation significantly improves assessment quality.
  • Discussion prompts for tutorials: "Map your last clinical decision to the capability framework — which capability does it most test?"; "Tell me about the most useful assessment you've had — what made it helpful?"; "If your ARCP panel reviewed your ePortfolio today, what would concern them most?"
  • Common trainee blind spot: The difference between the "Organisation, Management & Leadership" capability and clinical management of patients. Trainees frequently mislabel case management log entries under this heading. Worth clarifying early and often.
Frequently Asked Questions
Honest answers to the questions trainees actually ask
What happens if I get a poor ARCP outcome?

ARCP panels award different outcomes depending on what they find in your ePortfolio. Key outcomes:

  • Outcome 1: Satisfactory progress — continue training as normal
  • Outcome 2: Development needs identified — continue but address specific areas, sometimes with an additional review
  • Outcome 3: Inadequate progress — formal concerns, possible extension
  • Outcome 4: Released from the training programme
  • Outcome 5: Incomplete evidence — more evidence needed before a decision can be made
  • Outcome 6: Training complete — CCT awarded

Most trainees receive Outcome 1 or 2. Outcome 2 is not a disaster — it means focused work in a specific area. The key is: never surprise the panel. If your ES says things are fine in 6-monthly reviews, your ARCP should reflect that.

Can I do assessments in hospital posts?

Yes — and you should. Several WPBA assessments are specifically suited to hospital posts:

  • CBDs can be done by any approved clinical supervisor, including hospital consultants
  • CEXs are well suited to hospital settings with diverse clinical encounters
  • CEPS are ideally completed in hospital — the clinical volume and variety is much higher
  • MSF can be completed by hospital colleagues
  • CSR is specifically the hospital supervisor's end-of-post report

The key challenge is that hospital consultants may not be familiar with the MRCGP WPBA framework. Bring a brief guide to your first supervision meeting. Bradford VTS has a downloadable guide for hospital supervisors in the downloads section above.

How many assessments do I need to do?

The minimum numbers are set by the RCGP and updated periodically. Always verify current requirements on the RCGP website. As a general guide at the time of writing:

  • ST1: Minimum 4 CBDs (at least 2 per 6-monthly ESR period)
  • ST2: Minimum 4 CBDs (at least 2 per 6-monthly ESR period)
  • ST3: Minimum 5 CATs (can be CBDs or other CAT types)
  • COTs, CEXs, CEPS, MSF, PSQ: specific numbers on RCGP website

These are minimums. Spread matters as much as quantity — do them regularly throughout each post, not in a block at the end.

When should I take the AKT and SCA?
  • AKT best timing: ST3-1 (first 6 months of ST3). Some trainees do it in late ST2 if in a GP post — but most find ST3-1 optimal
  • SCA best timing: ST3-1 or early ST3-2. Not too early (you need clinical maturity), not too late (you need a buffer for a resit if needed)
  • Ideal approach: Take AKT and SCA within the same 6-month period — the knowledge overlaps significantly

Do not rush. Taking either exam before you are ready wastes money and can shake your confidence. Your ES and TPD can advise on readiness.

What is the difference between my ES and my CS?
  • Educational Supervisor (ES) — your GP trainer who oversees your entire training pathway across all three years. They hold your 6-monthly ES review meetings and complete the ESR. Primary point of contact for training concerns
  • Clinical Supervisor (CS) — the person supervising you day-to-day in each specific post. In hospital posts, usually the consultant. In GP posts, may be a supervising partner. They complete the CSR at end of post
  • In some setups (particularly long GP placements), your ES and CS may be the same person
What do IMGs find most confusing about MRCGP?
  • The WPBA concept: Many international training systems use written and practical exams only. Portfolio-based assessment as an equal component is genuinely new for many IMGs
  • NFD grades: In many training cultures, any grade below "excellent" implies failure. Understanding NFD is expected in early training takes adjustment
  • Consultation style: UK general practice values patient autonomy, shared decision-making, and ICE (Ideas, Concerns, Expectations) in a way that can feel unfamiliar. This is worth investing time in early — it is fundamental to SCA success
  • NHS organisational knowledge in the AKT: This section tests knowledge of NHS structures, legislation, and processes that UK-trained doctors absorbed gradually. IMGs need to study this deliberately
Does my trainer chase me to complete assessments?

No — and this is one of the most important cultural shifts from medical school and foundation training.

In GP training, the responsibility for completing assessments, keeping the ePortfolio up to date, and requesting feedback lies entirely with you. Your ES and CS are there to support and guide you — but they are not responsible for reminding you that you need to arrange your next CBD.

This mirrors independent professional practice. Qualified GPs must organise their own appraisal, revalidation, and CPD without prompting. Build a system that works for you — a calendar reminder, a monthly self-check-in, whatever suits your style.

Has the exam booking process changed recently?

Yes — the RCGP updated its booking process for 2026. Exam booking is now managed through MyRCGP, the RCGP's online portal, rather than the previous booking system. This applies to both the AKT and SCA.

Because operational processes like this can and do change between sittings, always verify the current booking window, deadlines, and exact process directly on the RCGP website before acting. Do not rely on older guides, scheme handbooks, or word of mouth for booking details — these go out of date.

What if I need reasonable adjustments for my exams?

The RCGP has a reasonable adjustments process for trainees with disabilities, health conditions, or other circumstances that affect their ability to sit exams under standard conditions.

  • Applications have published deadlines specific to each exam sitting — these are not open-ended requests you can submit at any time
  • You must apply well in advance of your intended sitting — do not leave this until close to your exam date
  • Supporting evidence (e.g. from an occupational health assessment or specialist report) is typically required
  • Your TPD or deanery can advise on the process and support you in preparing an application

For current deadlines, eligibility criteria, and the application process, go directly to the RCGP website — these details are updated each sitting cycle and must always be verified at source.

📖
GP Training Glossary
Key terms you'll keep hearing — explained plainly
TermWhat It Means
MRCGPMembership of the Royal College of General Practitioners — the qualification awarded at the end of GP specialty training
CCTCertificate of Completion of Training — the formal certificate awarded when you complete GP training, needed to join the Performers List and work as a GP
ARCPAnnual Review of Competence Progression — a panel review (usually every 6–12 months) where your ePortfolio evidence is reviewed. Outcome 1 = satisfactory; Outcome 6 = CCT awarded
ePortfolioYour online training record (currently on the FourteenFish platform). Holds all assessments, reflective entries, supervisor reports, and evidence. The ARCP panel reviews this
ES / ESREducational Supervisor (ES) — your GP trainer overseeing your whole training. ESR = Educational Supervisor's Review — a 6-monthly structured summary of your progress
CS / CSRClinical Supervisor (CS) — your day-to-day supervisor in each post (often a hospital consultant). CSR = Clinical Supervisor's Report — an end-of-post report they complete about you
WPBAWorkplace Based Assessment — the umbrella term for all the ongoing assessment tools (CBDs, COTs, MSF, PSQ etc.) recorded on your ePortfolio
NFDNeeds Further Development — a grade in assessments. Completely normal and expected in ST1 and ST2. Does not mean failure — it means you are a trainee who still has things to learn
VTS / TPDVocational Training Scheme (VTS) — your local GP training programme. TPD = Training Programme Director — the senior GP educator who runs the VTS
HDRHalf-Day Release — the protected educational sessions that all GP trainees attend (usually half a day per week). Counts as part of your working hours
AKTApplied Knowledge Test — the computer-based knowledge exam (approx. 200 questions; clinical, statistical, and NHS organisational knowledge). Usually taken in ST3
SCAStructured Consultation Assessment — the remote video consultation exam that replaced the old CSA in 2020. Tests clinical and communication skills through simulated patient consultations
CSAClinical Skills Assessment — the old OSCE-style exam replaced by the SCA in 2020. If you hear this term from older GPs or older resources, they mean what is now the SCA
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Final Take-Home Points
The things worth remembering before you close this page

🏁 The Bits To Carry With You

MRCGP has three components: AKT, SCA, and WPBA — and all three are equally important. Passing two out of three is not enough.
WPBA starts on day one of ST1. You cannot compress three years of evidence-building into the final few months.
The ePortfolio (FourteenFish) is the engine of MRCGP. Keep it alive, keep it real, keep it current.
NFD is not failure — it is training. If you have no NFDs in ST1, something has gone wrong with the quality of your assessment.
You are responsible for your own assessments. No one will chase you — by design.
Start CBDs from your very first hospital post. Brief your consultant if needed. Don't wait for them to offer.
Do your CEPS and QIP in ST1 — before life in ST3 becomes all about exams.
Learn the 13 Professional Capabilities properly. Everything maps to them. Understanding them transforms how you approach all your WPBA work.
Don't rush the AKT and SCA. The ideal time is ST3-1, when your clinical knowledge and consultation skills are fully developed.
When in doubt about anything MRCGP-related, the RCGP website always takes precedence. It is updated regularly and is your definitive source.

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How IT ALL STARTED
WHAT WE'RE ABOUT
WHO ARE WE FOR?

Bradford VTS was created by Dr. Ramesh Mehay, a Programme Director for Bradford GP Training Scheme back in 2001. Over the years, it has seen many permutations.  At the time, there were very few resources for GP trainees and their trainers so Bradford decided to create one FOR EVERYONE. 

So, we see Bradford VTS as  the INDEPENDENT vocational training scheme website providing a wealth of free medical resources for GP trainees, their trainers and TPDs everywhere and anywhere.  We also welcome other health professionals – as we know the site is used by both those qualified and in training – such as Associate Physicians, ANPs, Medical & Nursing Students. 

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