FAQ 05 · How is the CASC marked?

Once you know how the CASC exam is marked, you'll practise differently. The College publishes its marksheets and explains how the pass mark is set, and it's worth half an hour of your time. Here's how it works, in plain terms, and what I'd do with it.

The short answer

You pass on two counts. Your total score has to reach the exam pass mark, and you have to pass at least 12 of the 16 stations. Miss either and you fail: a high total won't carry you if you pass fewer than 12. If you remember one thing from this chapter, make it that.

The standard is a newly appointed ST4. Safe, structured and respectful work is what scores.

What the examiner marks in the room

One examiner marks each station on one of three marksheets, for history, examination or management. Each sheet asks them for two kinds of mark.

The first is a set of domain scores. Each station has three to five domains, each scored from 1 (poor) to 5 (excellent). The domains are written for that station and weighted towards its core task. In the Royal College of Psychiatrists' worked example, an alcohol history, eliciting dependence carries 50% of the marks, its physical, psychological and social consequences 30%, and interview and communication skills 20%. In other words, most of the marks sit with the core task.

The second is one overall judgement. The examiner picks one grade from six: Excellent pass, Pass, Borderline pass, Borderline fail, Fail or Severe fail. The College describes each grade against what a newly appointed ST4 should manage. A Severe fail can include a lack of respect, attention or empathy towards the person in the room.

Each marksheet also lists twelve feedback statements: six on the station's skill and six on communication. The examiner can tick the ones that apply. They feed your feedback only, never your score.

How the pass mark is set

Your station score is your weighted domain scores added together.

Each station then gets its own pass mark. After the day, everyone's station score is plotted against the overall judgement they were given, and a line is fitted through the points. The score the line predicts for a borderline candidate becomes that station's pass mark. This is the borderline regression method.

The exam pass mark is the average of the day's station pass marks, raised by an allowance for measurement error (the standard error of measurement), so that only clearly competent candidates pass.

A common misreading is that the grade decides the station. It doesn't. The overall judgements are used only to set the pass marks. You pass a station if your score reaches its pass mark, so a candidate graded Borderline fail can still pass the station.

Why 12 stations

The College explains its reasoning. The ten history and examination stations test core clinical skills, and a borderline candidate is expected to pass 8 of them. The six management stations test higher-level reasoning and decisions, and a borderline candidate is expected to pass 4. Eight plus four gives twelve.

Any 12 count. Stations differ in difficulty, so the College sets one total across the exam rather than separate counts by station type.

What this means for you is breadth. Your strong stations can't make up for weak ones, so I'd make sure every station gets a safe, complete attempt at the core task.

Severe fails and review

If you get two or more severe fail judgements, the Examinations Committee reviews your whole performance. You may fail whatever your total or station count.

The final criteria are set after the exam. The Examinations Committee takes account of station difficulty and of how candidates and examiners performed, and results are ratified before they're published.

Your sponsor may see the letter. If you fail having passed four or fewer stations, or with two or more severe fails, the College sends a copy of your results letter to your CASC sponsor or supervisor and recommends you discuss it with them. I'd take that recommendation.

Feedback if you don't pass

The College sends detailed feedback only to candidates who didn't pass, to help with the next attempt. Its guidance on feedback shows the layout:

• A summary first: your total score as a percentage, the mean total score of everyone on your day, the day's pass mark and your result.

• Every station at a glance: a table and chart of your score in each station against that station's pass mark, grouped by skill.

• Up to 12 general statements. These are released when enough of your examiners flagged the same area, so they show patterns rather than one bad station.

• A page per station with its skill and specialty, your score, its pass mark, the statements your examiner ticked and any written comment. The College cannot add to these comments.

The CASC is for accreditation, not training, so the College notes the feedback is necessarily limited. Don't expect a teaching session from it.

Using this in practice

Read the three marksheets once, so you know what each type of station rewards.

Do what the bold points ask. The weighting follows the core task in the instructions.

Practise against the feedback statements. I'd ask a practice partner to tick the ones they saw. If the same ticks keep coming up, that's where to work.

If you do get feedback, take it to your supervisor and match each statement to the kind of station it came from.

Official sources

• [Preparing for the CASC: pass mark, criteria and grade descriptors](https://www.rcpsych.ac.uk/training/exams/preparing-for-exams/preparing-for-the-casc)

• [History marksheet](https://www.rcpsych.ac.uk/docs/default-source/training/examinations/exams-casc-history-marksheet.pdf?sfvrsn=799913fa_2)

• [Examination marksheet](https://www.rcpsych.ac.uk/docs/default-source/training/examinations/exams-casc-examination-marksheet.pdf?sfvrsn=bf10442c_2)

• [Management marksheet](https://www.rcpsych.ac.uk/docs/default-source/training/examinations/exams-casc-management-marksheet.pdf?sfvrsn=9ca5f46e_2)

• [Guidance on feedback](https://www.rcpsych.ac.uk/docs/default-source/training/examinations/casc-feedback-instructions-and-generic-statements.pdf?sfvrsn=29c0b67d_7)

• [Applying for your exam: sponsorship and results letters](https://www.rcpsych.ac.uk/training/exams/applying-for-your-exam)