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Clinical Competency Test (CCT) Modules

What is the CCT (Clinical Competency Test)?

The CCT is a test of clinical skills and ability assessed by performing several simulated consultations with mock patients.

What format will the CCT take?

***The below has been updated to describe the format of the Exam as updated in Spring 2023***

The candidate will be allocated a room which will simulate a consultation room. They will see 6 patients, played by actors.

Of the six patients, four will present two distinct scenarios (dual-scenario cases), while two patients will present with a single, more compled scenario (single-scenario cases).

Dual Scenario Cases (four):

In the four Dual Scenario cases, the patient will advise the candidate at the outset that they wish to discuss two distince issues. To open the consultation, the patient will say something like, "There are two issues I'd like to discuss..."

Bot of the issues withing the Dual Scenario cases are marked independently and carry equal weight in the exam.

Single Scenario Cases (two):

In the two Single Scenario cases the patient will have one significant issue that may touch on several areas of their health and/or life. These are longer, more complex cases.
The patient will start with an opening statement that as in General Practice could be anything for example "I just don't feel well doctor". 
It will then be up to the candidate to follow this up as they would in a standard GP consultation.

At the start of the examination, the candidates will receive a short summary of each of the 6 cases that they will be presented with.

Each of the six cases will last 17 minutes, with a roughly 3-minute break in between cases. Therefore, the entire exam will last about 2-hours.

A bell will sound at the start of the first case and the actor will enter the room with an examiner. The candidate should then engage with the actor/patient as if this was a real consultation and manage the case appropriately. At the end of the 17 minutes, another bell will sound and the actor/patient and examiner will leave the room.

The role of the examiner is to observe the candidate and score their performance. There should be no verbal interaction between the candidate and the examiner unless an examiner interjects to provide examination findings/details.

There will be no break during this exam, but if a candidate needs water or to use the toilet as a matter of emergency, they will need to communicate this to the invigilators outside of their consultation room, who will pause the circuit until the emergency is resolved.

The CCT is designed to reflect what GPs do in their day to day practice. As such, the more experience that candidates have in general practice, the better prepared they are likely to be in order to deal with the variety of cases that may arise.

What is the aim of the CCT?

The CCT aims to assess the competence of general practice registrars when dealing with the situations that may arise in every day Irish general practice. In doing so it seeks to examine the knowledge, clinical skills (assessment, treatment and communication) and attitudes displayed by registrars as they manage patients presenting in a simulated surgery, home visit or telephone consultation. It examines how they deal with clinical challenges, how they communicate with patients and whether they understand the principles of practice management as applied to the consultation.

The registrars must be able to place the challenge before them in the appropriate context for the patient, their family, the community and their culture, they must display appropriate attitudes based on their professional capabilities, values and ethics. Management decisions must be based on sound scientific evidence where possible.

During the CCT registrars must show that they have achieved the core competences of Irish general practice as outlined in the core curriculum. They must display a comprehensive understanding of primary care management, the ability to provide person centred care, specific problem solving skills, the ability to adopt a comprehensive approach within the consultation, a good awareness of the community orientation of many consultations and the ability to use a bio-psycho-social consultation model taking into account cultural and existential dimensions. They must also show that they can reflect on their practice and recognise their own limitations.

When can I take the CCT Module?

Trainees can only take the CCT Module in Year 3 or 4 of Training.

How can I prepare for the CCT?

CCT questions will be based on the core curriculum. The best preparation for the CCT will be gaining experience consulting in a General Practice setting. Extensive exposure over many months to a wide range of clinical cases and scenarios in the final years of their General Practice training should enable candidates to successfully address the challenges of the CCT.

It is recommended that candidates view the Online Orientation programme located on the ICGP Website.

Candidates are also advised that questions are based on the areas covered by the Core Curriculum.

Can I access training material?

Do I need to bring any materials with me for the CCT Examination?

You should bring your doctor's bag containing the usual diagnostic equipment with you, including:

  • BNF/MIMs
  • Stethoscope
  • Ophthalmoscope
  • Auroscope
  • Thermometer
  • Patella hammer
  • Tape measure
  • Peak flow meter and disposable mouthpieces (N.B. These must be EU standard)

Candidates should not bring any medicines or needles or syringes normally kept in their doctor's bag to the examination.

How is the CCT Marked?

An Examiner will accompany each role player and will play no part in the consultation, except possibly to hand you information at appropriate points. They will sit outside your line of vision, and you should ignore them. The Examiner will be looking at specific aspects of your clinical abilities, marking them on a pre-defined marking schedule. It is possible that an additional observer may be present. These may be performing a Quality Assurance exercise or merely observing the process. They will take no part in your assessment. It is not permitted to enter into conversation or discussion in relation to a specific case with an examiner. IF you do so you will be in breach of ICGP Exam Regulations and awarded a fail for that case.

When and where will the CCT be held?

The CCT Examination will be held on in the RCSI Simulation Lab at 26 York Street, Dublin 2. Candidates will be assigned an arrival time following registration. The ICGP aims to follow these times as closely as possible, however delays, whilst regrettable, are sometimes unavoidable and you should take this into account.

Once you have checked in at the registration desk, you will not be permitted to leave the candidate waiting room and briefing area. Please note that mobile phone use is strictly prohibited from the point that you enter the briefing room. If you bring any electronic devices to the examination your will be required to hand them over for safe-keeping prior to entering the candidate briefing room. Any candidate found to be using a mobile phone under exam conditions will be considered to be in breach of ICGP Examination Regulations and will be awarded a fail.

Mobile phones, and all other communcation devices: an important note.

It is recommended that you do not bring a mobile phone or other device for electronic or other form of communication to the examination area. However if you do bring any such device with you, you must ensure that it is completely switched off and unable to send or receive any voice calls, emails, texts, tweets or any other form of communication what-so-ever from the moment you arrive at the registration desk.

The college considers observation of the rule on mobile phone and communication devices to be a professional responsibility and will consider any breach of this regulation to be a most serious matter that is likely to result in disqualification from this examn and may compromise future membership of the college.

Preference for registration will be given to fourth year trainees and repeats as available places are limited for this examination.

Recording of CCT stations

For quality control purposes we video-record a random sample of CCT consultations. These videos are not be used as part of routine assessment processes and not, save in exceptional cases, used as evidence when considering complaints, appeals or cases of alleged misconduct. However, if an examination offence or other serious departure from examination conduct is recorded then that recording may be kept as evidence for use in any subsequent action. Candidates will not be permitted to choose not to be video recorded. You will be asked to confirm you acceptance of these conditions as part of your online registration for this module.

Further Information

Please the Examinations and Assessment Office at the ICGP on 01-6763705 or via email at