CASC MINDSET: Book by Oladipupo & Olayinka Omolabi

Many CASC guides concentrate on the mechanics of the examination: the types of stations that recur, and a candidate's ability to recall scenarios encountered before. Herein lies the difficulty.

Candidates who lean too heavily on such resources can become preoccupied with reproducing structures rather than demonstrating judgement. The result, at the examination itself, is often a performance that sounds rehearsed, even mechanical. For UK-educated candidates and native speakers shaped by years within the British healthcare system, this rarely poses much difficulty. For international medical graduates, the experience can be markedly different. We know this both personally and conceptually.

Personally, because we are IMGs ourselves. Having completed our psychiatric training in Nigeria, we relocated to the UK, where it became clear, within a couple of years of practice, that recognition as competent clinicians would require a further period of professional adaptation. This led us to the MRCPsych examinations. Papers A and B came without great difficulty. The CASC, despite nearly a decade of clinical experience between us, did not. In time, we came to understand that the difficulty lay not in our clinical ability, but in our mindset toward the exam itself.

Conceptually, this is partly explained by what the General Medical Council terms differential attainment: the persistent, unexplained gap in outcomes between different groups of doctors, a gap known to affect international medical graduates most acutely. A 2023 review led by Professor Jeremy Brown found pass-rate differences of roughly 11 to 41 percentage points between white trainees and their ethnic minority or IMG counterparts. The GMC has taken this seriously, and several initiatives have followed.

This book offers a further perspective. Years of medical training cultivate well-established habits of thought and clinical approach. The CASC examination, however, asks something subtly different: not a change in competence, but a shift in how that competence is demonstrated. Developing this CASC Mindset is, we believe, essential.

Our aim, then, is not to produce another CASC textbook, but a practical preparation guide, written principally for international medical graduates. Used alongside consistent practice and honest reflection, it is intended to help candidates approach the examination with greater clarity, structure, and quiet confidence.

We are proud to bring this guide forward as members of Nigerian Psychiatrists in the United Kingdom (NPUK). While this book is an independent work, it reflects the same commitment to mentorship and career development that underpins NPUK's mission: that the difficulties we face individually are often best resolved when shared with those who will face them next.

Available here: amazon.co.uk/dp/B0H7ZGX98N

Dr Oladipupo Omolabi is a Consultant in General Psychiatry & Dr Olayinka Omolabi is a Consultant in Old Age Psychiatry.