The 12 RCGP Clinical Experience Groups Explained

What Are the Clinical Experience Groups?

The RCGP defines 12 clinical experience groups (CEGs) that form the blueprint for the SCA. These groups represent the breadth of clinical practice that a newly qualified GP is expected to manage. Each SCA diet draws its 12 cases from across this blueprint, ensuring that candidates are tested on a representative range of general practice scenarios.

The 12 groups are not clinical specialties. They are broader categories that reflect how patients present in primary care. A single SCA case can span multiple groups. For example, a case involving depression in a teenager could fall under Children and Young People, Mental Health and Addiction, and Health Disadvantage and Vulnerabilities, depending on the scenario's emphasis.

Not all 12 groups appear in every diet. The RCGP aims for breadth across each exam sitting, but with only 12 cases per diet, some groups will inevitably be absent. However, over multiple diets, all groups are represented. The groups that appear most consistently are Gender, Reproductive and Sexual Health, Long-Term Conditions, and Mental Health and Addiction.

Understanding the blueprint helps you prepare strategically. Rather than revising by clinical specialty alone, audit your confidence across all 12 groups and prioritise those where you feel least prepared.

Group 1: Children and Young People

This group covers presentations from neonates through to young adults. In the SCA, these cases typically involve a parent or carer as the main communicator, which changes the consultation dynamic. You are managing two relationships simultaneously: the clinical relationship with the child and the interpersonal relationship with the parent.

Common SCA themes in this group include vaccine hesitancy, childhood infections, developmental concerns, safeguarding, and adolescent mental health. The Relating to Others domain is particularly important here, as parental anxiety often drives the consultation.

Key cases to practise:

• MMR Vaccine Hesitancy - a strong patient agenda case where the parent has concerns about vaccine safety
• Angry Parent Requesting Antibiotics - managing an angry parent who wants antibiotics for a viral illness
• Psychotic Features in a Teenager - safeguarding and mental health assessment in a young person
• Tonsillectomy Request for a Child - managing expectations around surgical referral

Group 2: Gender, Reproductive and Sexual Health

This is one of the most frequently examined groups in the SCA. It includes contraception, menopause, pregnancy-related presentations, sexual health screening, and gender-related care. The RCGP weights this area heavily because it represents a significant proportion of daily GP workload.

Cases in this group often test shared decision-making. Patients present with preferences about contraceptive methods, views on HRT, or requests for specific investigations. Your role is to provide evidence-based guidance while respecting patient autonomy.

Key cases to practise:

• Menopause and HRT Discussion - balancing patient expectations with evidence-based prescribing
• Post-Menopausal Bleeding - urgent referral pathway and breaking potentially bad news
• Bleeding in Early Pregnancy - acute management and safety-netting
• Termination of Pregnancy - sensitive consultation requiring non-judgemental communication

Group 3: Long-Term Conditions

Long-term conditions cases in the SCA test your ability to manage chronic disease in the context of a single consultation. This means medication reviews, treatment escalation, lifestyle advice, and monitoring plans. The Clinical Management domain is critical here, as examiners expect evidence-based management aligned with current NICE guidelines.

Common conditions in this group include diabetes, hypertension, COPD, asthma, and cardiovascular risk management. Cases often involve a decision point: whether to start a new medication, step up treatment, or address concordance issues with an existing regimen.

Key cases to practise:

• COPD Exacerbation: Telephone Assessment - acute-on-chronic management via telephone
• Statin Counselling and QRISK Assessment - shared decision-making around cardiovascular risk
• Depression and SSRIs in a Young Adult - initiating treatment within the stepped care model

Group 4: Older Adults, Frailty and End of Life

This group covers the specific challenges of managing older patients: polypharmacy, frailty assessment, capacity concerns, end-of-life conversations, and carer involvement. In the SCA, these cases frequently test your ability to manage complexity, as older patients often present with multiple co-morbidities and competing clinical priorities.

End-of-life and advance care planning cases are among the most emotionally challenging in the SCA. They test the same skills as breaking bad news cases but add the complexity of ongoing management and family dynamics.

Key cases to practise:

• Polypharmacy in the Elderly - deprescribing and medication review
• Dementia and Driving Concerns - DVLA notification, capacity, and difficult conversations

Group 5: Mental Health and Addiction

Mental health cases are consistently among the most common in the SCA and the most practised on MedTutor. This group includes depression, anxiety, psychosis, addiction, eating disorders, and self-harm. Cases frequently test risk assessment, as examiners need to see that you can identify and manage risk appropriately.

The Relating to Others domain is heavily weighted in mental health cases. Patients presenting with mental health concerns are often distressed, reluctant to disclose, or ambivalent about treatment. Your ability to create a safe space for disclosure and to explore sensitive topics directly (including suicidal ideation) is what separates a pass from a fail.

Key cases to practise:

• Gambling Addiction - addiction assessment with suicidal ideation
• Diazepam Request for Flight Anxiety - strong patient agenda with benzodiazepine request
• Insomnia and Sleeping Tablet Request - managing expectations around prescribing
• Health Anxiety: Brain Tumour Fear - health anxiety driving a presentation

Group 6: Acute and Unscheduled Care

Acute and unscheduled care cases test your ability to triage, risk-assess, and make safe management decisions under time pressure. These include presentations that require same-day action: possible TIA, chest pain, acute abdomen, and paediatric emergencies. The Clinical Management domain is critical, as examiners are assessing whether your management plan is safe.

In the SCA, these cases are often delivered as telephone consultations, which adds the challenge of remote assessment without visual or physical examination findings. You need to gather enough information verbally to make a safe disposition decision.

Key cases to practise:

• TIA Emergency Management - urgent assessment and same-day referral
• Cauda Equina Syndrome Emergency - red flag recognition and emergency management

Group 7: Health Disadvantage and Vulnerabilities

This group covers patients who face barriers to accessing healthcare or who are at increased risk of poor health outcomes. It includes homelessness, domestic violence, safeguarding (both children and adults), learning disabilities, asylum seekers, and substance misuse. Cases in this group often intersect with other groups, particularly mental health and children and young people.

The SCA tests your awareness of these issues and your ability to respond appropriately. This means knowing when to ask about safeguarding, how to screen for domestic violence, and how to adapt your communication style for patients with learning disabilities or language barriers.

Key cases to practise:

• Domestic Violence: Wrist Injury - screening for abuse in an acute presentation
• Psychotic Features in a Teenager - safeguarding considerations in adolescent mental health

Groups 8 to 12: Less Frequently Examined Areas

The remaining five groups are examined less frequently but can still appear in any diet. They are:

• Group 8: Promoting Health and Preventing Disease. Includes screening discussions, lifestyle advice, vaccination counselling, and health promotion. Cases might involve explaining a screening result, discussing smoking cessation, or counselling about alcohol intake.
• Group 9: Urgent and Emergency Care in the Community. Overlaps significantly with Group 6 but focuses specifically on the community setting, including out-of-hours presentations and remote triage.
• Group 10: The Needs of the Community. Covers public health, population-level thinking, and the GP's role in community health. This is rarely examined as a standalone case but may feature as a component of other scenarios.
• Group 11: Ethics, Values and Legal Frameworks. Includes capacity assessment, consent, confidentiality, fitness to drive, and ethical dilemmas. These themes often appear within cases from other groups rather than as standalone stations.
• Group 12: Leadership, Management and the NHS. Covers teamwork, delegation, complaints handling, and working within NHS systems. Again, rarely a standalone case but may feature as part of a broader scenario.

While you should not ignore these groups, they are less likely to appear as dedicated cases. Focus your preparation on Groups 1 to 7, then ensure you are comfortable with the themes from Groups 8 to 12 as they may arise within other case types.

How to Use the Blueprint in Your Preparation

The most effective way to use the clinical experience groups is as a preparation audit tool. Go through each of the 12 groups and honestly assess your confidence level. Most trainees find they are comfortable with groups that align with their clinical interests (often mental health and women's health) but underprepared for groups they find less engaging or more uncomfortable (often safeguarding, end of life, and health disadvantage).

Once you have identified your weak groups, prioritise practice in those areas. A common mistake is spending all your preparation time on cases you enjoy rather than cases you find difficult. The SCA does not let you choose your cases, so your weakest group is your biggest risk.

Practical steps:

1. List all 12 groups and rate your confidence from 1 to 5.
2. Identify the 3 to 4 groups where you scored lowest.
3. Practise at least 2 to 3 full cases from each of those groups under timed conditions.
4. Get structured feedback on your performance in each domain (Data Gathering, Clinical Management, Relating to Others).
5. Revisit the groups you initially felt confident in to check for blind spots.

MedTutor's 100 SCA simulations cover all 12 RCGP clinical experience groups across 10 clinical specialties. Each case page shows both the clinical specialty and the relevant RCGP group, so you can target your preparation precisely. For a broader preparation strategy, see our How to Pass the MRCGP SCA guide.