You have been called to a police station to assess Mr Ryan Churchill, a 47-year-old man who has been arrested for alleged indecent exposure.

This chapter aims to provide a brief overview of the Clinical Assessment of Skills and Competencies (CASC) examination whilst also offering aspiring candidates practical tips and advice collated from psychiatry trainees who have recently sat the examination. This firsthand information is intended to answer common queries candidates have about the CASC and will be provided in a question-and-answer format. The information contained in this chapter has been cross-referenced with advice from the Royal College of Psychiatrists (RCPsych) website and is up to date at the time of publication. However, we recommend that candidates review the RCPsych website periodically in order to keep abreast of any future changes.

You are working in an outpatient clinic and are about to see 23-year-old cricketer Mr Tommy Beans. Mr Beans presents with low mood following an unexpected mistake in a pivotal cricket match. He has refused to play for the team since this time and is expressing a number of cognitive distortions.

Ms Angela Russo is a 29-year-old woman with a background of bipolar affective disorder. She has been referred to the perinatal psychiatry team by her GP for advice regarding lithium use in pregnancy.

You have been asked to see Mrs Jane Cooper in the CAMHS outpatient clinic. She has some concerns about her 12-year-old son Harry, who has been underachieving in class.

You are working in liaison psychiatry. Mr Theophilus Grantley, a 21-year-old student, has been brought to the ED by his friends due to concerns that he is not eating. He has been isolating himself, and they fear he is depressed.

Psychiatry trainees (and others intending to sit the CASC) are a highly diverse group of people, and it is not our intention in writing this book to suggest to you that we know the “best and only” way to prepare. Some trainees may choose to read this book with many months to go and follow our advice religiously, whereas some may choose to pick it up the night before the exam, scouting for extra tips. You’ll find no judgment here! By this stage of your careers, those of you sitting this exam will have passed many exams before. It is our firm opinion that you know your strengths and weaknesses and will have a good idea yourself of how long you personally want and need to allocate for preparation. Trust yourself and trust your instincts. Still – in the interest of helping to shape those instincts, we would like to pass on some wisdom that we have gained whilst preparing for and sitting the exam, and to make some gentle suggestions about how we believe that you can best prepare for success. It is the collective experience of this book’s authors that a successful preparation should ideally bear in mind four primary considerations: fluency, criticism, momentum, and kindness.

You are working in an older adult community team and have been asked to talk to Miss Eva Selwyn, daughter of Mr Jacob Selwyn, a 68-year-old gentleman who has had some memory difficulties. Mr Selwyn has given his consent.

You are working in liaison psychiatry and have been asked to review Mrs Brenda Willows, a 64-year-old woman admitted to the orthopaedic ward. Mrs Willows is now in her third day of recovery following lumbar decompression surgery, and the ward nurses have expressed concerns that she has suddenly become confused, agitated, and tremulous.