Frequently asked questionsFAQ 04 · What does the CASC exam test?
FAQ 04 · What does the CASC exam test?
4 min read
The College doesn't leave you guessing what the CASC will cover. It publishes a syllabus and a blueprint, and every sitting is built from them. I'd read them before you run a single practice station, and here's what I'd take from them.
The syllabus and the blueprint
One document holds both. The Royal College of Psychiatrists' CASC syllabus and blueprint was published in March 2023 and has applied since September 2023.
It follows the core curriculum. The skills are mapped to the high level outcomes of the 2022 Core Psychiatry Curriculum, at the level expected on entry to higher training.
Every sitting is built to the blueprint, which makes it the best map you've got for planning your practice.
The skills
Each station focuses on history taking, examination or patient management. Communication is marked in all sixteen.
Skill | Stations | What it covers |
|---|---|---|
History taking | 5 | Presenting complaint and psychiatric history; physical health history; developmental history; personal and social history; collateral history |
Examination | 5 | Mental state (cognitive, psychotic, non-psychotic); capacity assessment; physical examination; risk assessment |
Patient management | 6 | Formulation; biological management; psychological management; holistic management plan; safety planning; legal and ethical management |
Communication | All 16 | Personalisation and respect; recognising and responding to cues; empathy; giving clear and accurate information |
In the blueprint matrix, each communication strand is given one station as its emphasis.
Risk turns up in two places. The blueprint lists risk assessment under examination, while the College's format page says history stations include risk. My advice is to practise it in both.
Physical health can come up anywhere, in history, examination or management stations, according to the College's FAQ. Don't save it for the examination stations.
What every sitting must include
The blueprint sets floors that every set of sixteen stations meets. You'll always get:
At least one station on risk assessment or safety planning.
At least one on cognitive examination or capacity assessment.
At least one on physical health history or physical examination.
The blueprint matrix also gives each skill a minimum share of station line-ups. Some are in every line-up: presenting complaint and psychiatric history, collateral history, psychotic and non-psychotic mental state, formulation, biological management, holistic plans, and legal and ethical management. Others, such as capacity, developmental history and psychological management, appear in a set share of them. The matrix gives the exact figures, and it's worth a look.
The specialties
You'll get at least one station in each of seven areas: child and adolescent, general adult, intellectual disability, old age, forensic, medical psychotherapy and addiction psychiatry.
The matrix has sixteen columns: four for general psychiatry, one each for the other six named areas and six for any specialty.
General psychiatry is broad. The syllabus counts liaison and rehabilitation psychiatry within it, so don't leave those out.
Who the patients are, and where
The person in front of you can be of any age or developmental ability: a child, an older adult or someone with an intellectual disability.
They can have any condition relevant to psychiatry in the International Classification of Diseases, or need assessing for one. The syllabus names, among others, neurodevelopmental, psychotic, mood, anxiety, eating, substance use, personality, perinatal, neurocognitive and sleep-wake disorders, catatonia and gender incongruence.
The setting can be anywhere too: inpatient and outpatient care, emergency care, general hospitals, the community (a home, a care home or a day service), criminal justice and education.
Personalisation and respect stations might involve a person from a particular cultural background, someone with a neurodevelopmental condition, or a person facing several overlapping disadvantages, according to the College's FAQ.
On the law, think in principles. You're not expected to know a particular mental health or capacity act, since these vary by jurisdiction. You are expected to know the principles of involuntary admission and treatment, and of capacity to decide on treatment.
Planning your practice
This is how I'd use the blueprint.
Make a grid. Put the skill areas down the side and the seven specialties across the top, and mark each station you practise in its cell.
Fill the gaps before you repeat anything. Cover every skill area at least once, then every specialty, before you rehearse a favourite station again. It's tempting to keep running the stations you already enjoy. Resist it.
Weight your practice towards the guaranteed skills. I'd do the ones that appear in every line-up, and the three that every sitting must include, more often than the rest.
Vary the person and the place. Rotate age, ability and setting: a teenager at school, an older adult in a care home, a person with an intellectual disability, someone in custody, a worried relative.
Give communication its own turns. In some practice stations, pick one communication strand as the focus and ask your partner to watch only that.
Read the descriptors. The syllabus describes each skill in a sentence or two, and those sentences tell you what a competent performance in that skill looks like.
And recheck before you apply. If the College publishes a new syllabus or blueprint, plan from that one.
Official sources
[CASC syllabus and blueprint](https://www.rcpsych.ac.uk/docs/default-source/training/examinations/casc-syllabus-march-2023.pdf?sfvrsn=1fe04f2b_4)
[Preparing for the CASC](https://www.rcpsych.ac.uk/training/exams/preparing-for-exams/preparing-for-the-casc)
[FAQs about preparing for exams](https://www.rcpsych.ac.uk/training/exams/faqs-about-preparing-for-exams)