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At the heart of general practice since 1960

Big chill for mad GP

This week is the 40th anniversary of the first MRCGP examination. Back in 1965 it was very much in experimental form. It took the form we know today in 1968. But I think we can say it all started in 1965.

The college now has 22,500 members. Thousands of us have begged, borrowed, fluked or passed one of the requisite assessments for the MRCGP. The exam is highly regarded outside the college and rightly so. Examiners are stringently monitored and the other colleges frequently pop round to see how things are done.

Why am I such a fan? I reckon that, because of its rigour, the MRCGP is the most useful evaluation process I have ever undertaken. And this is no mean assertion, since I don't usually back the college.

The exam comes in four chunks. First, the multiple choice questions. These are both tricky and robust, a great test for the all-rounder. They are much harder than the summative assessment quiz. They really are hard, people sweat over them, people fail ­ and that is why they are worth doing.

An afternoon of masochistic writing is the agreed format for the essay paper. Three hours of non-stop scribbling to answer 12 challenging questions.

Success requires no small measure of endurance. The beauty of the marking schemes mean there is no right answer; marks are awards for the range of issues covered.

An example might be 'Outline how you would set up a weight clinic'. Top marks would be offered for answers that consider everything from whether to bother at all, how to predict future QOF cash and whether it is ethical for a drug rep to take you out for a lobster lunch while you contemplate your patients' obesity issues.

The 'video' game is a special treat for registrars and trainers alike. Simple analgesia is often required to overcome tiresome opening gambits and repetition.

I managed to save my trainer a life sentence after I made the simple tweak from, 'right ok', to alternately using the two. An exam boffin later demonstrated to me that you get no marks for listening anyway. You might as well interrupt your patients as often as possible.

The viva format of 'guess what the examiner is thinking' completes the picture.

The art is to express a range of options before jumping off the fence just in time to show that you do have the capacity to make a decision. High-fliers will require a degree in Balint studies.

So it's a tough exam, a good exam, and I am a declared fan, and I wish the exam a happy anniversary.

Dr Andy Jones is a GP in Stamford, Lincolnshire

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