A glimpse behind the curtain: from pilot to progress

What if you had to sit the Final FRCA Structured Oral Examination (SOE) again tomorrow—how well would you fare?

When the Royal College of Anaesthetists (RCoA) invited volunteers to participate in the pilot of its new Clinical Performance Examination (CPE), I signed up—part curiosity, part a sense of academic adventure. What followed was an insightful journey into the evolving landscape of anaesthetic assessment. 

As part of an ongoing evolution driven by both internal and external reviews, the Final FRCA is undergoing significant transformation. By 2027, the traditional SOE will be replaced with the CPE: a dynamic, scenario-based assessment that tests clinical reasoning, communication and judgement in authentic situations.

A refreshing shift in examination style

Travelling down from Hull to London’s Kings Cross train station on 20 May 2025, I joined other volunteers, examiners and observers to trial this new format in a supportive, low stakes setting designed for feedback and insight.

The CPE pilot felt markedly different from a typical exam day. There was a buzz of energy, collaboration and professional respect. Standing before each station, reading the vignette and hearing the ding-dong bell brought back mixed memories from each part of my previous exams. 

The stations reflected real-world complexity across 10 stations (eight minutes each with two minutes for marking and feedback) across a wide range of scenarios - bariatrics, obstetrics, intensive care, decision making, demonstrating live sono-anatomy for regional anaesthesia, managing a deteriorating paediatric patient and ethically nuanced cases. 

Rather than solely testing recall, the CPE assessed judgement, communication and adaptability—skills at the heart of our everyday work. It felt more like a day in clinical practice than an exam. Less rote memory, more clinical insight; less pressure, more perspective.

Active partners, not passive participants

What struck me most was the spirit of partnership. Examiners and observers welcomed open dialogue, inviting feedback and reflections during a structured debrief at the end of the day with meaningful exchange of ideas rather than just a formality.

This wasn’t simply a test run—it was good teamwork and collaboration. I was not seen as a passive participant or token trial candidate in the traditional sense but as a valued contributor shaping the evolution of the Final FRCA for the next generation of candidates.

Lights, camera, reflection: a return visit

Due to limited recordings during the first pilot, I was later invited for a video recording of two CPE stations on 17 June at the Royal College of Surgeons in London. These recordings were intended to inform and support the training of new examiners ahead of the exam’s implementation.

Revisiting the scenarios in front of the camera felt less daunting than expected—it revealed the precision and thoughtfulness underpinning the CPE's development. 

The College's commitment to quality, fairness and authenticity was evident throughout the process and it was instantly clear to me that this wasn’t change for change’s sake—its progress driven by quality, integrity and realism.

More than a mock run

In our structured training world, rare are the moments where we help design what comes next. Participating in the CPE pilot gave me more than just a sneak peek behind the curtain—it gave me purpose and a chance to contribute meaningfully to a system that has trained and assessed generations of anaesthetists. 

It also wasn’t simply a simulation. It was a transformative experience—both personal and professional. It allowed me to reflect on the assessments that shaped my own training, while contributing to a version that’s even better aligned with real-world clinical practice.

Final thoughts: why you should get involved

To anyone offered the chance to take part in future pilot schemes—embrace it. You’ll gain a fresh perspective, play a role in driving standards forward and become part of something greater than your own exam story.

After all, assessment is not just about passing or failing—it’s about progress. And being part of that progress is genuinely one of the most enjoyable and valuable experiences in my postgraduate journey.