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CPST (Clinical Problem-Solving Test)

AIM Of CPST

The purpose of the CPST is to ensure that the public is protected from practitioners not clinically competent to occupy training posts, whilst ensuring that the bar is not so high that it excludes those who do have the necessary knowledge and skills from being able to commence training. The standard of achievement expected will be that of a current intern.

This test assesses your ability to use your medical knowledge to solve real-world clinical problems. The scenarios in the test are based on the types of problems that you would encounter as a junior doctor. The test does not just test your ability to remember facts; it also tests your ability to think critically and apply your knowledge to make decisions.

Here are some specific things that the CPST assesses:

  • Your ability to gather and interpret clinical information
  • Your ability to generate differential diagnoses (a list of possible causes of a patient’s symptoms)
  • Your ability to develop a management plan for a patient.

CPST Exam Format

                     Feature                                                                                                   Details
               Total Questions                                                                                                97 

              Scored Questions                                                                                              86 

               Pilot Questions                                                                                         11 (not scored) 

                  Duration                                                                                                    75 minutes 

                   Format                                                                                                Online, single session 

              Question Type                                                                                    Single Best Answer (5 options) 

The CPST is completed after the Professional Dilemmas (PD) paper, with an optional break in between. Each question presents a clinical scenario, and you must select the most appropriate response.

Subjects Of Questions

     · Cardiovascular                                                                                                  · Pharmacology / Therapeutics
     · Dermatology / ENT / Eyes                                                                                · Psychiatry / Neurology
     · Endocrinology / Metabolic                                                                                · Reproductive (male and female)
     · Gastroenterology / Nutrition                                                                             · Renal / Urology
     · Musculoskeletal                                                                                                 · Respiratory

     · Infectious disease / Haematology / Immunology / Allergies / Genetics        · Paediatrics

Target Domains

Each question focuses on one of five core domains:

1. Investigation

Choosing appropriate diagnostic tests.

2. Diagnosis

Identifying the most likely condition.

3. Emergency

Recognising and managing life-threatening situations.

4. Prescribing

Selecting correct medication and dosage.

5. Management (Non-prescribing)

Recommending appropriate treatments such as referral, physiotherapy, or lifestyle changes.

Example

Question:           A 20-year-old man presents to the emergency department with a one-hour history of rash,
                            itch, swelling of lips and tongue and wheeze. Symptoms began within minutes of receiving a
                            Covid booster vaccine. Systolic blood pressure is 90 mmHg. Pulse is 100 per minute and weak.

Answer:             The most important drug to administer in this situation is:
                            A Hydrocortisone
                            B Chlorphenamine
                            C Salbutamol
                            D Atropine
                            E Adrenalin

Correct Answer: E – Adrenaline

This is a classic presentation of anaphylaxis, where intramuscular adrenaline is the first-line life-saving treatment.

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