One of the most common questions we hear from registrars is also one of the hardest to answer well: how many cases do I need to practise before I am ready? People want a number. Fifty? A hundred? The honest answer is that the number matters far less than what happens inside each case, and chasing a total can quietly work against you.

Volume is the wrong target

It is easy to treat preparation as a tally. You feel productive ticking off case after case, and there is a reassuring sense that more must mean better prepared. But a registrar who races through forty cases without pausing to absorb the feedback often learns less than one who works through fifteen properly. The exam does not test how many scenarios you have seen. It tests whether you can gather information cleanly, reason through it, manage sensibly, and relate to the person in front of you, every time, under time pressure.

So the more useful question is not “how many have I done?” but “how many have I actually learned from?”

What “learned” actually means

A case is learned when you could meet a similar presentation cold and handle it fluently — not because you memorised that specific scenario, but because the underlying skill has become reflexive. You explore ideas, concerns and expectations without thinking about it. You safety-net without a checklist. You manage the clock without watching it.

That is competency, and it is individual. Some registrars reach it on a particular type of case after two or three attempts. Others need six. Neither is a problem; it is simply where you happen to be with that skill. The mistake is assuming everyone needs the same dose.

How to tell when a case is properly done

Rather than counting, watch for these signals that a case has been properly absorbed:

You can articulate why you scored as you did, not just what the score was. You can predict, before reading the feedback, where your weak points will be. When you reattempt it, the improvement is deliberate rather than accidental. And the skill is starting to show up in unrelated cases — your data gathering on a respiratory case sharpens your data gathering on a mental health one.

When those things are true, that case has done its job. Move on. When they are not, the case still has more to teach you, however many times you have already attempted it.

Why we built it this way

This is exactly why our course gives you up to 3 attempts on each case. We did not want a single shot at a scenario to be the whole of it, because one attempt rarely settles a case. Some registrars will pass a scenario first time and feel solid. Others will use a second or third attempt to try a different opening, until the consultation flows. Both are right. The point is that a case is done when it is properly learned, not when you have used a fixed number of goes.

So stop counting. Practise a case until it is properly learned by the signals above, then move to the next gap. Your total at the end will be whatever it needed to be, and far more useful than a round number you chased for its own sake.