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Experience on passing the CASC

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I passed the CASC in my 3rd attempt- Passed 15/16 on the Tuesday, the 9th Sept.


Things (I think) I did differently compared to 2 previous attempts:


1. Read around the topic of each past stations and discussed with my consultant in detail as far as possible.

2. Had a general structure in my mind for all the different style of stations for eg: h/o taking, risk assessment etc.. and adapted them to the scenario.

3. Even though I could not cover all the questions, I made sure I managed to cover the tasks asked for by asking at least  2 or 3 questions each.

4. In the last half minute, rounded up the task by saying things like , "I get a better understanding of whats going on with you. This can definitely be treated and we will make sure you we can help you get over this." 

5. A digital stopwatch helped me keep track of time in the single stations. I didn't bother timing the paired ones!!


I definitely believe good luck plays a part in passing the exam as we all have the knowledge thats required for CASC.


We all pass one day with some tweaking of our style of approach.


Good luck everyone.

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I've not received a letter so I don't know how many stations I passed yet, but here are a few things I did...


- A consultant I know from work emphasised that the attention span of the examiners won't be 100%, so to remember primacy and recency - start with a friendly greeting and end by saying something supportive. I tended to start with "Hi there, I'm.... one of the mental health doctors - how can I help today?" (or a variation on that, depending on what the task was), and end by saying "We've been quite pressed for time today, so I'd like to arrange to meet with you/the patient again for a longer appointment" (with or without involving another clinician/service).


- Rather than practising in a big group, I practised scenarios with 2 colleagues. We met 3 times per week, for about 2-3 hours at a time, and we were brutally honest in feedback. The makeup of the group helped with that - we were from different specialties and backgrounds, at different stages of our careers - that meant we each had a different perspective for things.


- I read the ICD-10 criteria so many times that I probably recited them in my sleep, and made sure that if a station was to do with history taking, that I asked a question about each of the main diagnostic criteria. If someone described a feature, I commented on it so I was still stating it for the examiner - eg. "would I be right in thinking that you've been needing less sleep than usual?" (a consultant helpfully told me that if a candidate doesn't either ask about it or comment on it, he'll assume they haven't picked up on it and so mark them down for that).


- On the day, I knew I'd panic, so at the start of every pre-station time I'd jot down the key areas to cover in that type of station (eg "ICE, SBAR") and as I asked about each one during the station, I commented that we were going to talk about that area ("The situation is... The background is..." etc), and crossed it off on the paper so I wouldn't go back to it without finishing the other bits.


- For every history station, I made sure I asked about: HoPC, any relevant ICD-10 criteria, other components of the MSE, past psych and med history, medications, substances/alcohol, forensic, family history, current social circumstances and risk. For risk, I asked about harm to self, harm to others, driving and work if relevant. If the bell went for the final minute before I'd got to risk, I stopped what I was doing, asked a single question about any key things left and then spent the remainder of the time asking about risk. Even in stations that were asking a specific thing like "explore psychopathology" rather than taking a full history, I still stuck to the formula - as above, I wrote down the areas to cover and crossed them off as I went through them.


- Just before the end, I asked "And is there anything else you think it's important for me to know at the moment?" (a last minute tip from an SpR).


- Because the CASC was so tight for time, I was pretty ruthless with myself about keeping to structure, as IRL I tend to let things be a bit more freeflowing - which doesn't work that well in CASC... I tried it in a few practice stations and after 5 minutes the consultant told me "You do realise you've not done any of the tasks - there's no point showing how good a listener you are if you can't tick the other boxes too".


- I made sure that one night per week, I put everything away and focused on the other things in life, and on the other nights, never studied during dinner or past 10pm. That way I still had time to do the things that mattered outside of work and to remind myself that people in my life cared about me regardless of what happened on one day in Sheffield.

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