IOCA structure, format and assessment criteria

IOCAs are one of the essential components of the Clinical Competency Portfolio Review (CCPR), launching in September 2026.

IOCA structure and timings 

An IOCA takes approximately 2.5 hours. It consists of two parts, with 30 minutes of ‘thinking/reflection’ time in between.  

Both parts should take place in a single session on the same day. 

Confirm patient consent

• The patient must be informed of the IOCA process and fill out a consent form [PDF; 121 KB] prior to the IOCA.
• Patient consent should be stored at the health service and be accessible to the College upon request.

Note: Principal supervisors should not supply patient information to the candidate before the IOCA. 

Part 1

1. The independent assessor observes the trainee while they conduct a comprehensive interview with a patient (50 minutes).
   • The trainee should not provide feedback regarding diagnosis or management to the patient during the 50-minute IOCA period, except where specific risks are identified in the interview that require an immediate initial management response.
   • If the patient is one for whom the trainee will be the treating clinician, the trainee should advise the patient that their assessment findings and management plan will be discussed at a subsequent consultation or appointment.
2. After the interview, the trainee has time to think and reflect (up to 30 minutes).
   • To better reflect real-work practice, trainees are permitted to access relevant resources during this time.
   • If the patient is willing, the independent assessor gathers feedback from the patient during this time for the purpose of supporting the trainee's learning.

Part 2 

1. The trainee presents their clinical assessment of the patient followed by a viva of clarification questions from the independent assessor (20 minutes).
   • The trainee’s clinical assessment presentation should be a summary of the salient features, an assessment of gaps in the history, other essential information required, a formulation, diagnosis and differential diagnosis.
2. The trainee presents their proposed comprehensive management plan, followed by a viva of clarification questions from the independent assessor (20 minutes).
3. The independent assessor rates the trainee’s performance using the IOCA 5-point rating scale [PDF; 300 KB] and provides feedback to the trainee (20 minutes).
   • The independent assessor can take up to 15 minutes break between the viva and feedback session to formulate constructive feedback for the trainee (if needed).
   • This section is intended for the independent assessor to provide initial, verbal feedback to the trainee on their IOCA performance. It may also be an opportunity for the IOCA assessor to fill out the InTrain form with the scores and written feedback for the trainee.
   • The independent assessor should make their judgements on competencies and behaviours observed during the IOCA assessment.
   • Feedback should be provided about each domain of the assessment criteria.
4. The IOCA is concluded. The indepenedent assessor should complete inputting the scores and feedback into the InTrain form and submit it no later than 3 business days after the IOCA is conducted.
5. The trainee can discuss their IOCA feedback with their Principal Supervisor later and agree on the next steps to progress learning.

If the patient leaves

If the patient walks out within the first 20 minutes of the clinical interview, the IOCA will need to be rescheduled. If the patient walks out after this point, the trainee / partially comparable SIMG will be assessed with what has been conducted.

Assessment criteria and feedback  

You will be assessed on a series of competencies and given immediate verbal and formal written feedback.

In the same way as the OCA, you will be provided with structured feedback on each of the following six domains:  

• history taking process  
• history taking content  
• mental state examination skills  
• physical examination skills  
• data synthesis  
• management plan development skills.

 The feedback should focus on what aspects were done well and suggestions for improvement.  

IOCA scoring guide

Download the new IOCA and OCA 5-point rating scale and scoring guide [PDF; 300 KB].

Incident form

If an incident occurs during your IOCA assessment that could affect your performance or the outcome of the assessment, please complete an Incident Report form within 5 working days of the assessment.

Help with IOCAs 

Contact assesshelp@ranzcp.org for help.

• View step by step guide to arranging an IOCA.
• View frequently asked questions about the IOCA.