GP trainees practising for the Clinical Skills Assessment (CSA) often refer to various CSA case books, yet there is the concern of not getting enough practice with 'CSA type cases'. Over the last year or so, we have produced a series of articles on the CSA and how to prepare for it. In this article Dr Chawathey discusses CSA preparation with a focus on the CSA marking scheme, feedback areas and how trainees can generate their own cases for practise. The CSA is comprised of a series of simulated cases to analyse areas that cannot be uniformly assessed in other ways. These include assessment of communication skills with varied patient personalities (and emotional states), collecting and putting together various pieces of the clinic-psycho-social jigsaw puzzle, and negotiating shared management plans with the patient-all within 10 minutes. This is no mean feat and requires lots of practise, both during day-today work, as well as in study group sessions.