July 10, 2026
N. Boeckx
16 years teaching experience for the RCGP consulting exams
Strong candidates don't just hear words... they notice:
π Hesitation
π Worry
π Avoidance
π€ Minimising
β€οΈ Emotion
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β¨ Examiner feedback repeatedly praises:
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Empathy
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Rapport
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Warmth
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Emotional engagement
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Active listening & responding to cues
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π© Missing cues is a common reason candidates lose marks.
Using silence π€« and summaries π helps build rapport and keeps your consultation structured.
π Common cues:
* "It's probably nothing..."
* "I've just been a bit off..."
* π’ Sudden tears
* π A change in tone
* π Avoiding eye contact
* π Changing the subject when something sensitive comes up
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π¬ Better responses:
π£οΈ "You say it's probably nothing, but it sounds like it's been playing on your mind."
π£οΈ "I noticed you hesitated thereβtell me a bit more about that."
π£οΈ "The ... Β you mention sounds really difficult."
π£οΈ "I can hear that ... has been a lot to deal with."
π― Why this matters in the SCA
β
A missed cue often means you've missed:
β ICE
β Risk
β Psychosocial context
β Empathy marks
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π« Don't rush to the next checklist question.
π‘ Sometimes the highest-yield move isn't another question...
It's a short reflective statement... π€
...and a pause. π€«
Examiner feedback specifically highlights that silence often leads to deeper disclosure and more sensitive discussions.
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πͺ This week's challenge
In your next consultation, deliberately respond to at least one emotional cue before moving on.
π The consultation usually gets better when the patient feels heardβnot just questioned.
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Author
N. Boeckx
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