Enjoyable and valuable: my experience as an exam 'guinea pig'
How much of the Primary FRCA do you remember? If you had to face the OSCE/SOE again tomorrow, would you pass? When the College put out a call for volunteers to do exactly that, I found myself, perhaps through some peculiar form of academic Stockholm syndrome, volunteering as tribute. This is my short journey of professional déjà vu.
Following both internal and independent reviews of RCoA assessment processes, the Primary FRCA clinical performance exam is changing. The Clinical and Anaesthetic Sciences Exam (CASE), due to be implemented in 2027, will replace the current OSCE/SOE format. It will feature a mix of 5- and 10-minute stations and will assess both clinical performance and the application of basic sciences. To help shape the format and develop new questions, the College hosted a CASE pilot in February 2025, calling for volunteers to serve as 'guinea pig' candidates.
Getting off the train at Euston and walking the familiar mile to College HQ, re-invoked a flutter of pre-exam anxiety; a sensation I earned the right to escape some six or so summers ago. Amazingly, twenty colleagues had placed themselves in the same boat; though this time by choice. After brief introductions and the gentle persuasion of a RCoA-branded water bottle, it was eyes down and exam conditions.
A refreshing evolution
The new CASE format proved to be a refreshing evolution of the traditional OSCE/SOE. Gone were the somewhat artificial separations between clinical scenarios and basic science questions. Instead, the stations offered a much more immersive experience, weaving scientific principles naturally into clinical contexts.
While most served as exam candidates, some lucky volunteers were assigned as observers (definitely the easier role!), surveying proceedings from an alternative perspective. Others channelled their inner thespian as simulated patients or clinical colleagues. But for those of us in the hot seat, it felt remarkably authentic. Whether we were demonstrating live sonoanatomy for regional anaesthesia, managing a deteriorating intensive care patient or taking handover from a colleague, the examiners guided us through the stations with the same measured professionalism I remembered from my Primary, complete with those hauntingly neutral expressions that never quite give away whether you're on the right track.
Perhaps the most significant improvement of CASE is the introduction of formal written feedback. Though the post-hoc email did highlight some rather conspicuous gaps in my knowledge (apparently, some things do fade after several years), the constructive criticism provided clear, actionable points for improvement. In true medical education fashion, we were asked to provide feedback on our feedback; I wait in anticipation for my feedback on my feedback on their feedback... but I digress.
An enjoyable and valuable experience
As the day drew to a close, I found myself surprisingly energised despite the intellectual workout. The experience was not just enjoyable but genuinely valuable; both for my own professional development and, hopefully, for shaping the future of our specialty's assessment process. The new format feels more aligned with real-world practice while maintaining the rigorous standards we expect from the College.
To any colleagues wondering whether to volunteer for future pilot events: do it. Yes, it might momentarily resurrect those exam-day jitters, but it's a unique opportunity to contribute to the evolution of our training pathway. Plus, there's something oddly satisfying about facing those fears again; this time without your career hanging in the balance! Thank you to the event’s organisers, the FRCA examiners and my fellow ‘guinea pigs’ for giving your time to help improve the future of anaesthetic training.
Read more about why and how the new Clinical and Anaesthetic Sciences Examination is being developed in this companion blog by FRCA Examinar Dr Jo Budd.