IOCA

What is an IOCA  

The Independent Observed Clinical Activity (IOCA) is a RANZCP-approved Workplace-Based Assessment (WBA) tool.

The processes and activities involved in assessing an IOCA are similar to those in the existing Observed Clinical Activity (OCA). However, the IOCA has some specific differences and enhancements that streamline the independent assessment process.

Differences between the OCA and IOCA  

The IOCA is different from the OCA in the following ways:  

• IOCAs are assessed by an independent assessor, not by the trainee’s principal supervisor.  
• The patient’s written consent is required to participate in the clinical assessment.  
• The IOCA is to be done in one session on a single day. 
• The trainee/Partially Comparable SIMG is not provided any patient information before the patient interview.  
• Feedback is only provided at the end of the assessment, not after the patient interview.  
• Thinking time / reflection is 30 minutes. 
• Patients will be asked to share their reflections on the performance of the candidate. This feedback plays a crucial role in enhancing training practices and promoting continuous improvement, without influencing the assessment outcome or rating.

Inclusion of IOCAs in the Clinical Competency Portfolio Review  

IOCAs are one of the essential components of the Clinical Competency Portfolio Review (CCPR), launching in September 2026. See detailed eligibility requirements for this assessment.  

Transition period   

There are transition arrangements for IOCAs to allow you enough time to meet the requirements of the CCPR. 

For trainees and Partially Comparable SIMGs who want to apply for the CCPR in September 2026:  

• You will only need to complete one Stage 3 IOCA.  
• You can complete a Stage 3 IOCA in any Stage 3 rotation, starting from August 2025.  
• The IOCA can replace the standard OCA requirement for the rotation. 

For trainees who finish Stage 2 before August 2026:  

• You will be exempt from the Stage 2 IOCA requirement for the CCPR. 

For trainees who are in, or enter Stage 2 after August 2026:  

• You can complete a Stage 2 IOCA in any Stage 2 rotation, starting from August 2026.  
• You will be required to have both a Stage 2 and Stage 3 IOCA to meet CCPR requirements later. 

Final implementation of CCPR 

• The Clinical Competency Portfolio Review (CCPR) will replace the CCA – MPR assessment.  
• Trainees will need to do an IOCA in Stage 2, and one in Stage 3.  
• Partially comparable SIMGs will need to do two IOCAs in Stage 3.  

For more detail on how the IOCA and CCPR relate to each other, and the rules around this please refer to the Frequently Asked Questions.  

Independent assessors  

IOCAs must be conducted by an independent assessor. The independent assessor provides feedback for each of the six domains in the assessment criteria. The feedback should focus on what aspects were done well and suggestions for improvement.  

Eligibility criteria  

An independent assessor must:  

• be an accredited RANZCP supervisor  
• have participated in the RANZCP OCA/IOCA supervisor training  
• not have been a principal supervisor of the candidate in the previous 12 months  
• not have any personal or professional conflict of interest with the candidate.  

Becoming an IOCA assessor  

To become an independent assessor, RANZCP supervisors will need to complete a formal training session, offered by the College.  

Organising an IOCA  

If you would like to do an IOCA during an upcoming rotation, you need to let your principal supervisor know at the start of the rotation.  

Your principal supervisor is responsible for sourcing an independent assessor, finding a suitable patient and coordinating when and how the IOCA will happen.  

Role of the principal supervisor  

Finding an independent assessor  

Principal supervisors are responsible for finding a suitable independent assessor, preferably from the same jurisdiction or an adjacent service.  

To help, the College provides:  

• access to a list of accredited independent assessors  
• the ability to submit a request to a pool of assessors  
• flexibility, so that independent assessors can conduct an IOCA remotely using Zoom/Teams.  

Please contact assesshelp@ranzcp.org for help with this process.  

Identifying a suitable patient  

Principal supervisors need to identify a suitable patient for the IOCA.  

• Select a patient not well known to the trainee.  
• Enter patient demographics into the IOCA form.  
• Obtain the patient’s written consent before the IOCA begins. 

Patient consent should be stored and maintained by the health service as part of their clinical documentation.  

Patient consent form [PDF; 121 KB]

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

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. 

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.  

For more detail on WBA requirements, please refer to the Workplace-Based Assessment Policy and Procedure.

Incident form

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