The SCA is not the CSA with a new name. The exam has evolved through three iterations — CSA (pre-2020), RCA (pandemic era, 2020-2023), SCA (2023 onwards) — and each iteration introduced meaningful changes that affect preparation strategy and tool selection.
The Key Changes
Format: The CSA was face-to-face with physical simulated patients in an exam centre. The SCA uses video-based delivery with actors appearing on screen via the Osler platform. This changes the communication dynamic — you are consulting through a screen, which affects eye contact, body language reading, and rapport building.
Marking criteria: The three domains (Data Gathering, Clinical Management, Relating to Others) remain, but the descriptors have been updated to reflect contemporary consulting expectations — including digital consultation skills, health inequalities awareness, and sustainability considerations.
Case distribution: The SCA cases are drawn from the 12 RCGP clinical experience groups with updated weighting reflecting the 2025 RCGP curriculum.
Which Tools Are SCA-Current
Built for SCA: MedTutor AI (launched post-SCA), SCA Prep (launched post-SCA), Clinitalk (SCA-native feedback). These tools were designed for the SCA format from the start.
Updated for SCA: SCA Revision (pivoted from CSA era, updated content and marking). RCGP Consultation Toolkit (updated for SCA format — confirmed current). Emedica SCA Casebook and courses (updated — verify current edition).
Potentially outdated: FourteenFish RCA package (check if updated to SCA). Older casebooks purchased secondhand. Pre-2023 RCGP resources.
The Trap
Cheap secondhand CSA casebooks are tempting — but the cases may not reflect SCA marking criteria, case distribution, or the video format. The cost saving is not worth the risk of preparing for the wrong exam.
Where iatroX Fits
iatroX's clinical content is continuously updated with current NICE/CKS/BNF guidelines — the knowledge underneath is always current regardless of exam format changes. The adaptive quiz maps to current UK curricula, not historical exam specifications.