The appropriateness of the Simulated Consultation Assessment requires re-examination given the current disparity between assessment methods and clinical reality. Despite technological advances, recent data from February 2025 show that face-to-face (F2F) appointments remain the dominant consultation method in general practice, comprising 64.3% of all appointments,1 while video consultations represent only a small fraction (2.1%) of patient interactions.2
The principle of constructive alignment in medical education demands that assessment methods mirror the skills required in actual practice.3 This alignment ensures fidelity of experience, appropriately preparing candidates for the clinical environments they will encounter. When assessment frameworks prioritise skills rarely utilised in daily practice, we risk both producing GPs unprepared for the realities of clinical work and incorrectly evaluating candidates’ readiness for authentic general practice.4
We must transparently debate whether our assessment methods accurately reflect the realities of general practice. While preparing trainees for technological evolution is valuable, the disproportionate emphasis on video consultation assessment compared with its actual utilisation deserves scrutiny. Without comprehensive studies examining the alignment between consultation modalities in practice and their representation in assessments, we cannot safely conclude on appropriateness of an exam. Any high-stake summative examination should undergo rigorous testing of the proxies for a real consultation (F2F, video, and telephone) prior to wholesale adoption of an examination method. Such research would provide an evidence base for curriculum decisions and ensure assessment authenticity.
Until such evidence exists, we risk skewing training priorities away from the F2F skills that remain the foundation of general practice.
- © British Journal of General Practice 2025
