The Royal College of Psychiatrists first introduced the CASC in June 2008. It is based on the OSCE style of examination but is a novel method of assessment as it tests complex psychiatric skills in a series of observed interactions.

OSCE (Observed Structured Clinical Examination) is a format of examination where candidates rotate through a series of stations, each station is marked by a different examiner. Before they introduced the CASC, candidates appeared for OSCE in Part 1 and the ‘Long Case’ in Part 2 of the MRCPsych examinations. The purpose of introducing CASC was to merge the two assessments.3 The first CASC diet tested skills in 12 stations on one circuit.

Subsequently, 16 stations have been used in two circuits - one comprising eight ‘single’ and the other containing four pairs of ‘linked’ scenarios. They provide feedback to unsuccessful candidates as ‘Areas of Concern’.4 The pass rate has dropped from almost 60% in the first edition to around 30% in the most recent examination (Figure 1). I do not know the reasons for this. The cost of organizing the examination has increased and candidates will pay £885 to sit the examination in 2010 in the United Kingdom. 

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