FourteenFish's SCA package is a video-led teaching course for ST3 GP trainees preparing for the Simulated Consultation Assessment. It teaches consultation technique, exam strategy and clinical updates well, and its examiner-style analysis of sample consultations is genuinely useful. Its principal limitation is that it is a teaching product, not a practice engine: it explains how to perform, but it does not give you the volume of timed, live role-play that actually builds SCA competence, and it is not a scored consultation simulator.
What the FourteenFish SCA package offers right now
Vendor-reported, last checked 19 July 2026 — confirm on the FourteenFish product page:
- Format: an online video course, delivered as modules covering exam preparation, consultation technique and revision strategy.
- Sample consultations: a series of example consultations with examiner-style analysis — a strong teaching asset for seeing what "good" looks like.
- Clinical updates: over 100 clinical-update items on common examination topics, via the FourteenFish Library.
- Consultation toolkit: a structured toolkit, including a meta-analysis/reflection function to review your own consulting.
- Price and access: vendor-reported at around £180 including VAT for the first 12 months, then around £50/year to renew.
- What it is not: there is no large SCA question bank, no adaptive AI, and no automated domain scoring of your live consultations. It teaches and demonstrates; it does not mark you.
FourteenFish is also widely used across UK GP training for the ePortfolio and appraisal tools, so most trainees already have an account — which lowers the friction of adding the SCA course.
The exam anchor
The SCA is 12 remote simulated consultations of 12 minutes each (144 minutes), sat from ST3 across nine diets a year, fee £1,207 (RCGP, 19 July 2026). Marking spans three domains — Data Gathering and Diagnosis; Clinical Management and Medical Complexity; Relating to Others — and cases are chosen against a 12-category blueprint (patients under 19, reproductive and sexual health, long-term conditions, older adults, mental health, urgent care, health disadvantage, ethnicity and diversity, undifferentiated disease, prescribing, investigations and results, and professional conversations). The official RCGP guidance and consultation toolkit define the target; a course's syllabus is a claim about coverage, and this audit tests that claim against the blueprint.
Mapping modules to the blueprint
| SCA domain / blueprint area | FourteenFish coverage | Audit note |
|---|---|---|
| Relating to Others (communication, agenda, shared decisions) | Strong — core teaching focus | Well taught; still needs live practice to embed |
| Clinical Management and Medical Complexity | Moderate — clinical updates support it | Underpinning knowledge must come from elsewhere for weak foundations |
| Data Gathering and Diagnosis | Moderate — technique taught, less drilled | Needs timed case repetition to build speed |
| Timed 12-minute consultation practice | Light — sample consultations shown, not driven | The biggest gap; role-play required |
| Domain-level scoring of your performance | Absent by design | Requires an observer, trainer or peer |
The pattern is clear: FourteenFish is strongest where teaching is the answer (Relating to Others, exam strategy) and lightest where repetition under time is the answer (data gathering speed, live case volume). That is not a criticism of the product — it is a course — but it defines what you must add.
Passive assets versus active assets
Separate what you watch from what you do.
- Passive (watch/read): video modules, sample-consultation analysis, clinical updates. These transfer knowledge and models efficiently.
- Active (do): the consultation toolkit's self-review function is the one active element, and it depends on you actually consulting and reflecting.
The risk with any video-led course is that hours of watching feel like preparation while producing little retrieval or performance change. The fix is a strict ratio: for every hour of FourteenFish video, do at least an hour of timed role-play or real supervised consulting. Watching how to safety-net is not the same as safety-netting under a 12-minute clock.
Judging the teaching on fidelity, not testimonials
Evaluate the sample consultations against the real thing rather than on reviews. Are the cases the length and format of the live remote SCA? Do the examiner comments map explicitly onto the three domains? Are the clinical updates current against NICE, CKS and the relevant SmPC/eMC entries, and are they dated? A course earns trust when its models are demonstrably aligned to the current marking scheme and current UK guidance — not when it has many happy testimonials.
The component gap: what a course cannot give you
The SCA tests things a video cannot rehearse for you:
- Voice consultation under time — speaking, listening and thinking simultaneously in 12 minutes.
- Eliciting the patient's agenda and ideas, concerns and expectations — a live, responsive skill.
- Shared decision-making — negotiating a plan with a simulated patient who pushes back.
- Safety-netting — doing it, briefly and reliably, not describing it.
- Domain-level scoring — someone judging your performance against the three domains.
FourteenFish teaches all of these; it cannot test them on you. That requires role-play partners, a trainer, or a study group — and, for the medical-complexity underpinning, a knowledge layer.
Time-cost calculation for three schedules
| Candidate | FourteenFish video/reading | Active role-play/consulting | Balance verdict |
|---|---|---|---|
| Full-time trainee, 8 weeks out | ~1–1.5 hrs/week | ≥2–3 hrs/week timed cases | Course as scaffold, practice as engine |
| Less-than-full-time, 12 weeks out | ~1 hr/week, front-loaded | ≥2 hrs/week, ramped later | Watch early, practise heavily late |
| Retaker, 4–6 weeks out | Targeted modules only | ≥3 hrs/week on the failed domain | Minimal new video; maximal practice |
In every row the active hours should meet or exceed the passive hours. If your week is mostly watching, the plan is inverted.
Who benefits most
- First-time candidate wanting a clear model of exam-standard consulting: strong fit.
- Trainee who learns well from worked examples: the sample-consultation analysis is a real asset.
- IMG or candidate new to UK consultation norms: valuable for calibrating to UK expectations — but pair it with heavy role-play.
- Weak-foundations candidate: helpful for technique, but shore up clinical knowledge first with a dedicated layer.
- Candidate who mainly needs reps and timing: lower marginal benefit — you need practice partners more than more video.
Three mistakes this audit is designed to stop — and one it cannot
Even a strong teaching course fails the candidate who uses it passively. Three mistakes recur, and all three are avoidable:
- Mistaking watching for practising. Completing every module produces a comforting sense of readiness that a first timed role-play often demolishes. The sample consultations are there to be studied and then imitated under the clock, not merely admired; if you have never spoken a consultation aloud in 12 minutes, you have not yet started SCA practice.
- Front-loading theory and starving the reps. Candidates who watch all the video early and leave role-play until the last fortnight peak too soon on knowledge and too late on performance. Interleave from the start — one module, then immediate application in real surgery or a timed case — so technique and delivery mature together.
- Treating examiner-style analysis as a verdict on themselves. The analysis of a sample consultation tells you what good looks like; it does not tell you how you score. Only an observer watching your own live consultation can judge your data gathering, management and relating against the three domains.
The mistake the course cannot stop for you is the absence of a person to judge your performance. FourteenFish can model the standard superbly and still leave you unmarked, because scoring a live 12-minute consultation across three domains is inherently a human, real-time task. Build that observer into your plan — trainer, peer or study group — from week one, and use the course to define the standard they hold you to.
A worked seven-day plan for a busy trainee
Four clinical days, short evenings, one free weekend session. Give FourteenFish one job: teaching the model.
- Monday: one FourteenFish module on your weakest domain (about 30–40 minutes). Note two concrete behaviours to try.
- Tuesday: apply those two behaviours in real surgery consultations; reflect using the toolkit.
- Wednesday: a fresh, unseen clinical-knowledge block in iatroX on a medical-complexity topic — to shore up the knowledge that management decisions rest on, measured on items you have not seen.
- Thursday: one timed 12-minute role-play case with a peer; get domain-level feedback.
- Friday: rest or a ten-minute review of the week's feedback.
- Saturday: two to three timed cases back-to-back to build stamina and pacing.
- Sunday: watch one sample-consultation analysis and compare it with your own Saturday performance.
No proprietary-algorithm claim is involved: FourteenFish supplies the model, role-play supplies the reps, and iatroX supplies an uncontaminated knowledge check. The unseen block is the second-bank measurement that keeps you honest about the medicine.
Decision checklist: continue, supplement, switch or stop
- Continue if the teaching is measurably changing your consultation behaviour and your domain feedback is improving.
- Supplement with timed role-play (always) and a knowledge layer if medical complexity is your weak domain.
- Switch to a case-bank-led plan if you have absorbed the teaching but lack case volume — more video will not help.
- Stop re-watching modules once you can reproduce the model live; watching a good consultation again is not practising one.
Frequently asked questions
Is FourteenFish enough for MRCGP SCA on its own? No, and the product does not really claim to be — it is a teaching course, and the SCA is a performance exam. FourteenFish will teach you what an exam-standard consultation looks like and give you examiner-style analysis to calibrate against, but it cannot supply the timed role-play repetitions that build the skill, nor score your own live consultations. Used as the teaching layer alongside regular role-play and a knowledge source, it is a strong contributor; used alone, it leaves the practical core untrained.
Which MRCGP SCA component does FourteenFish not reproduce well? The live, timed 12-minute consultation itself — and the domain-level scoring of your performance. FourteenFish shows and analyses sample consultations, which is teaching, but it does not put you under the clock with a simulated patient and mark you across Data Gathering, Clinical Management and Relating to Others. That gap must be filled by role-play with a trainer, peer or study group.
How many FourteenFish questions should I complete per day for MRCGP SCA? This question assumes a question bank, and FourteenFish's SCA package is not one — it is video-led with sample consultations and clinical updates rather than a daily-quota MCQ bank. The more useful daily target is behavioural: watch no more than one module, then convert it into at least one timed practice case or several real consultations applying the technique. If you want a daily question count for the underlying knowledge, run that on a dedicated bank, not on the course.
When should I stop using FourteenFish and move to mixed mocks? Move to predominantly full, timed practice — back-to-back mock cases that mimic the 12-consultation exam — once you can reliably reproduce the taught model in a single case. For most candidates that is the final three to four weeks. Keep the odd module in reserve for a specific weakness, but by the closing fortnight your time should be dominated by timed case circuits, not video.
How should I combine FourteenFish with iatroX without duplicating practice? Give them non-overlapping jobs. Use FourteenFish to learn the consultation model and calibrate to examiner standards, and use a free UK-core iatroX block to measure the underlying clinical knowledge that your management decisions depend on, on unseen items — remembering that iatroX is a knowledge and MCQ layer, not a consultation simulator. There is little risk of duplication because one product teaches performance and the other tests knowledge; the shared discipline is that neither replaces timed role-play.
Editorial notes and references
Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 19 July 2026; FourteenFish figures and prices are vendor-reported and change, so verify on the product page. Disclosure: iatroX operates a competing question bank, but its MRCGP SCA case bank is not live, and this audit positions iatroX only as an underlying-knowledge and unseen-MCQ layer — not a consultation or OSCE-style simulator and not a replacement for FourteenFish's teaching or for role-play. Corrections are welcome via the feedback route on iatrox.com.
References: RCGP, Simulated Consultation Assessment (format, domains, blueprint and consultation toolkit), rcgp.org.uk/mrcgp-exams/simulated-consultation-assessment; FourteenFish SCA package, fourteenfish.com/aboutthescapackage; iatroX, "Your Q-Bank Percentage Is Not Your Exam Score"; iatroX comparison hub.