What is a COT?

The COT is an expanded version of the MiniCEX and considers your face-to-face consultations with real patients in real time during your primary care placements. It assesses the clinical skills and professionalism necessary for good clinical care within your consultations and this includes your performance of the more holistic judgments needed to consult in General Practice.

How the COT works

During training, you are encouraged to video record and then review your consultations as these are an essential way of improving your consultations. The COT assessment can then be carried out using a recorded consultation; or you can arrange for your supervisor to observe you consulting directly.

Selecting consultations

Any consultations you video record will require the patient’s consent. A sample consent form is available on the RCGP website.

The choice of consultations should cover the full breadth of Clinical Experience Groups and be in different settings, such as surgery consultations, home visits and Unscheduled urgent care / Out of Hours.

When you are selecting a recorded consultation, it is natural to choose one where you feel you have performed well. Complex consultations, or consultations that you found challenging, are more likely to generate learning.

Collecting evidence from the consultation

You will review the consultation with your supervisor, who will relate their observations to the WPBA Capability framework and COT criteria. The performance criteria for the COT can be found on the RCGP website. Your supervisor will grade each section of your consultation, make an overall judgement on your performance and provide formal feedback with recommendations for further development.

When to use the COT

COTs are only completed in primary care placements. MiniCEXs are completed during non-primary care placements. The total number of COTs required in ST1 and ST2 will therefore very much depend on your placements. A total of 4 MiniCEXs/COTs are required in both ST1 and ST2. The COT is used solely in ST3.