The Timeline Before Exam Day

The SCA runs four times per year: January, April, July, and October. Here is the standard timeline once you've booked your diet.

8 weeks before: You will receive a confirmation email from the RCGP with your exam date. At this point, confirm your exam venue (your GP surgery) and speak to your practice manager about room availability.

4 weeks before: You will receive your session allocation (AM or PM). You cannot choose or change this. Plan your day around it. AM sessions start at 08:45. PM sessions start at 13:20.

2 weeks before: The RCGP will send you access to the Osler Online platform. Log in, complete the onboarding tutorial, and run the tech check. Do not leave this until the day before.

1 week before: Run a full practice session using your actual exam setup: same room, same laptop, same internet connection, same whiteboard. Identify and fix any issues now, not on exam day.

48 hours before: Run the Osler tech check one final time. Confirm your room booking with the practice. Prepare your whiteboard, pens, eraser, and any permitted materials. Get your ID ready (passport or driving licence).

Setting Up Your Room

The SCA is sat in a private room at your GP surgery. The RCGP has specific requirements for the room, and an invigilator will verify these via video before the exam starts.

Room requirements:

  • Private room with a closed door. No one else can be in the room during the exam.
  • No clinical posters, drug charts, or reference materials visible on the walls or desk.
  • No mobile phone within arm's reach. The phone must be out of reach or in another room.
  • No paper, notebooks, or loose materials on the desk. The only writing surface permitted is a whiteboard.
  • Clean desk with only your laptop, whiteboard, whiteboard pens, eraser, water, and ID visible.

Camera and lighting:

  • Position your webcam at eye level. If using a laptop, raise it on books or a stand so the camera is level with your face.
  • Ensure your face is well-lit from the front. Avoid sitting with a window behind you, as this creates a silhouette effect that makes it hard for the examiner and patient to see your facial expressions.
  • Check the camera angle shows your head and upper body. The examiner needs to see your non-verbal communication.

Audio:

  • Built-in speakers and microphone are acceptable. Wired headphones with a microphone are also fine.
  • Bluetooth headphones and earbuds are not permitted.
  • Test your audio in advance. Make sure you can hear clearly and your microphone picks up your voice without excessive background noise.

Tech Requirements and Checks

The SCA runs on the Osler Online platform, accessed through a web browser. The technical requirements are specific and non-negotiable.

Hardware:

  • Laptop or desktop PC (not a tablet or phone)
  • Webcam (built-in or external)
  • Microphone (built-in or wired headset)
  • Minimum screen resolution of 1024 x 768

Software:

  • Google Chrome or Microsoft Edge (latest version). No other browsers are supported.
  • Close all other applications and browser tabs during the exam.
  • Disable pop-up notifications, system updates, and any screen overlays.

Internet:

  • Minimum 10 Mbps download and 4 Mbps upload speed
  • Wired ethernet connection is strongly recommended over Wi-Fi
  • If your surgery uses a managed network, ask IT to whitelist the Osler platform domains in advance

Run the Osler tech check at least twice before exam day: once 2 weeks before and once 48 hours before. The tech check tests your camera, microphone, internet speed, and browser compatibility. If any component fails, you have time to fix it.

If your surgery's internet is unreliable, consider using a personal mobile hotspot as a backup. Test the hotspot speed in advance and have it ready on exam day.

What Happens on Exam Day

On the morning of the exam (regardless of your session), log in to the Osler platform at least 30 minutes before your session start time.

Step 1: Identity verification. An invigilator will join your video feed before the exam starts. They will ask you to show your photo ID (passport or driving licence) and will verify your identity against the RCGP records. They will also ask you to show a 360-degree view of your room to confirm compliance with the exam conditions.

Step 2: Briefing. You will receive an on-screen briefing reminding you of the exam rules, timing structure, and what to do if technical problems occur. Read this carefully, even if you've read it before.

Step 3: Cases begin. You will be presented with 12 cases in sequence. For each case, you receive 3 minutes of reading time (the case brief appears on screen), followed by 12 minutes of consultation time. The patient (a trained actor) appears on video (or audio-only for some stations). An examiner observes but does not interact with you during the consultation.

Step 4: Between cases. There is a short buffer between each case while the next case loads. You cannot go back to a previous case. Use this time to take a breath, erase your whiteboard, and reset mentally.

Step 5: Exam ends. After the 12th case, the exam ends and you are shown a completion screen. There is nothing further to submit.

Session Timings and Breaks

The exam is divided into two sessions per day. The same 12 cases are used for both sessions, which is why AM candidates are quarantined until the PM session begins.

AM session:

  • 08:45 – Log in and identity verification
  • 09:00 – Cases 1 to 6
  • Approximately 10:30 – Scheduled break (15 minutes)
  • Approximately 10:45 – Cases 7 to 12
  • Approximately 12:15 – Exam ends
  • 12:15 to 13:20 – Quarantine period (you must remain in your room and not communicate with anyone about the exam)

PM session:

  • 13:20 – Log in and identity verification
  • 13:35 – Cases 1 to 6
  • Approximately 15:05 – Scheduled break (15 minutes)
  • Approximately 15:20 – Cases 7 to 12
  • Approximately 16:50 – Exam ends

During the break, you can stand up, stretch, use the bathroom, and drink water. You cannot leave the building, use your phone, or access any reference materials. The break is monitored.

The total exam time including reading time is approximately 3 hours. With identity verification, briefing, and breaks, expect to be in the room for approximately 3.5 to 4 hours.

The 3 Minutes of Reading Time

Before each case, you receive 3 minutes to read the case brief on screen. This brief contains the patient's name, age, presenting complaint, and sometimes relevant medical history or recent investigation results. It mirrors what you would see on a real patient's appointment screen in your GP system.

How you use these 3 minutes matters. Here is a structured approach:

First 30 seconds: Read the brief twice. The first read gives you the headline. The second read gives you the detail. Note the patient's name and use it in the consultation.

Next 60 seconds: Identify the likely clinical domain and any red flags you need to rule out. Form a mental differential diagnosis based on the brief. Think about what data gathering questions you'll prioritise.

Next 60 seconds: Think about management. What are the likely management options for the most probable diagnosis? What NICE guidelines are relevant? What safety-netting will be needed?

Final 30 seconds: Write key points on your whiteboard. The patient's name, the differential, and 2 to 3 management bullet points. This is your reference during the consultation.

Do not try to plan the entire consultation in advance. The patient will tell you things that change your approach. Use the reading time to build a framework, not a script.

Whiteboard Strategy

A whiteboard is optional but strongly recommended. It is the only writing surface permitted during the exam. No paper, no sticky notes, no notebooks.

The whiteboard serves two purposes: it helps you structure your thoughts during the consultation, and it prevents you from losing track of important details when the conversation moves quickly.

What to write during reading time:

  • Patient's name (top of the board)
  • Key differential diagnoses (2 to 3)
  • Red flags to exclude
  • Key management points

What to add during the consultation:

  • Important details the patient mentions (medications, allergies, social context)
  • The patient's ICE or LIIF findings as they emerge
  • Safety-netting reminders so you don't forget at the end

Whiteboard discipline:

  • Erase the board completely between cases. The invigilator may check.
  • Use shorthand. You don't have time to write full sentences.
  • Position the board so you can glance at it without obviously looking away from the camera.
  • Don't spend more than 2 to 3 seconds writing at any point during the consultation. Extended writing breaks eye contact and disrupts rapport.

Practise using the whiteboard during your MedTutor simulations. If you haven't used one before, the first time should not be exam day.

What to Do If Something Goes Wrong

Technical problems during the SCA are uncommon but not unheard of. The RCGP has a process for handling them.

If your internet drops: The Osler platform will attempt to reconnect automatically. If you reconnect within a short window, the case continues with time adjusted. If you lose significant time, the case may be voided and not counted against you. Do not panic. Wait for the system to reconnect, and the invigilator will guide you.

If your camera or microphone fails: Alert the invigilator immediately through the Osler chat function. They will attempt to resolve the issue. If it cannot be resolved, the affected case may be voided.

If the patient's video freezes: Continue consulting by voice. Treat it as an audio-only station. The examiner will note the technical issue and adjust the marking accordingly.

If you are interrupted: If someone enters your room during the exam, the invigilator will note it. Brief, unavoidable interruptions (e.g., a fire alarm) are handled on a case-by-case basis. An interruption by a colleague who didn't know the exam was happening may result in a voided case.

If you feel unwell during the exam: You can request a break between cases by informing the invigilator. In extreme cases, you can withdraw from the exam, though this typically means the attempt is counted.

The most important thing you can do to prevent technical issues is test your setup thoroughly in advance. The majority of exam-day technical problems are preventable with a proper tech check.

The Final 48 Hours

The 48 hours before the exam should be about consolidation and confidence, not cramming. Here is a practical checklist.

48 hours before:

  • Run the Osler tech check one final time on your exam laptop, in your exam room, using your exam internet connection.
  • Confirm your room booking with the practice manager. Put a sign on the door.
  • Prepare your whiteboard, pens (have a spare), and eraser.
  • Set out your photo ID.
  • Run 2 to 3 MedTutor simulations back-to-back to build stamina and rehearse the format.

24 hours before:

  • Do not start learning new topics. Review your notes on areas you've already covered.
  • Skim your whiteboard shorthand system so it's automatic on the day.
  • Get a good night's sleep. Sleep quality affects clinical reasoning and communication more than an extra 2 hours of revision.

Morning of the exam:

  • Arrive at your surgery at least 45 minutes before your session start time.
  • Set up your room. Check camera angle, lighting, audio, and internet one more time.
  • Have water within reach. Use the bathroom before logging in.
  • Log in to Osler 30 minutes before your session.
  • Take three deep breaths. You have prepared for this. Trust your preparation.

For specific advice on how to structure your final weeks of preparation, see our How to Pass the MRCGP SCA guide.