This is one of the questions our registrars ask most often, and the honest answer is: it depends on the feedback.

Not a satisfying answer, we know. But the reason we can’t give you a number is that the number isn’t the point. What matters is what you’re learning each time you repeat a case — and whether there’s still something useful to learn from another attempt.

The instinct to move on

Most registrars attempt a case once, read the feedback, and move to the next case. It feels productive — you’re covering ground, ticking off scenarios, building breadth. And breadth matters. But there’s a cost: you’ve identified weaknesses in that case and moved on without addressing them.

Imagine you practise a COPD review case and the feedback tells you your safety-netting was vague and you didn’t explore the patient’s concerns about their breathlessness. If you move straight to a different case, those two weaknesses come with you — you’ll probably make the same errors in the next case too, because the habit hasn’t changed.

Repeating the case with a specific focus — “this time I’m going to safety-net with specific red flags” or “this time I’m going to ask what worries them about the breathlessness before I move to management” — is where the learning actually happens.

A framework rather than a number

Here’s how we’d suggest thinking about it:

First attempt: Do the case cold. Don’t overthink it — consult as you naturally would. Read the feedback carefully afterwards. Identify the one or two most significant things you’d do differently.

Second attempt (if the feedback flagged something specific): Go back in with those one or two things as your deliberate focus. Not “do everything better” — that’s too vague. Specific targets: “I’m going to explore ICE before the halfway mark” or “I’m going to safety-net with named red flags and a timeframe.”

Third attempt (if you’re still not satisfied): Sometimes a case is difficult enough, or touches a clinical area you’re unfamiliar enough with, that a third go is worthwhile. By the third attempt, you should feel that the improvements from your second attempt are becoming more natural rather than forced.

Move on when: The feedback shows improvement in the areas you were targeting, and you feel the consultation flowed rather than being mechanically performed. You don’t need perfection — you need progress.

Don’t repeat when: The first attempt went well and the feedback confirms it. There’s nothing wrong with nailing a case first time — it tells you that your skills are solid in that area. Move on and spend your practice time on the cases that challenge you.

The educational principle behind it

This isn’t a concept we invented — it’s called deliberate practice, and it’s been studied extensively in skill development. The research is consistent: improvement comes not from volume alone but from targeted repetition with feedback. A musician doesn’t play a piece through from start to finish ten times. They identify the bars they struggle with and work on those specifically.

The same applies to consultation skills. Repeating a case where you scored well everywhere is comfortable but doesn’t develop anything. Repeating a case where you missed something specific, with the deliberate intention of doing that thing better, is where growth happens.

How this relates to case library size

Some platforms offer large case libraries — 100 cases or more. That sounds impressive, but if you attempt each case once and move on, you’ve done 100 shallow practice sessions. A smaller library with unlimited attempts, where you repeat the cases that challenge you, can produce deeper learning.

Think about quality of practice rather than quantity of cases. Ten cases practised thoughtfully, with repetition where the feedback indicated a need, develops your consulting more than 50 cases done once each with a glance at the feedback.

That said, breadth matters too. You need to cover the range of presentations you might face — medical, mental health, paediatric, breaking bad news, safeguarding, chronic disease. The balance is: cover the breadth, but go deep on the cases where you have the most to learn.

What your feedback should tell you

The decision about whether to repeat a case should come from the feedback, not from a pre-set rule. Good feedback makes this easy — it tells you specifically what you did well and what you missed, so you know exactly what to target on a repeat attempt.

If your feedback only gives you a domain score (“data gathering: adequate”) without specifics, it’s hard to know what to target on a repeat attempt. Look for feedback that identifies particular moments or missed opportunities — that’s what gives you a concrete focus for the next go.

Cross-case patterns are useful here too. If your feedback across several different cases consistently flags the same issue — weak safety-netting, or not exploring the patient’s perspective, or rushing management — that tells you the problem isn’t case-specific. It’s a habit, and you’ll benefit from targeting it across multiple cases rather than just repeating one.

A practical suggestion

Keep a simple log. After each case, note the topic, the key feedback point (one sentence), and whether you want to repeat it and why.

After a week or two, review the log. You’ll see patterns — both in which topics you’re avoiding and in which feedback points keep recurring. Those patterns tell you exactly where to focus your practice time.

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ConsultMentor gives you unlimited attempts on every case, with feedback specific enough to guide your repetition. The cross-case analysis shows patterns across your consultations so you know what to work on. Try a free case and see how the feedback works.