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At the heart of general practice since 1960

College reveals changes to MRCGP exam

By Gareth Iacobucci

The RCGP has announced a raft of changes to the MRCGP exam, which they say will make the exam more relevant to 'everyday working life'

After a ‘rigorous review' of the exam process, the College says it will change the Clinical Skills Assessment (CSA) and Applied Knowledge Test (AKT) components of the MRCGP exam.

The revamp will be implemented from September 2010 will mean candidates will be graded on more cases in the CSA.

In the CSA, the pass mark will be set using the borderline group method - where each case will have its own pass mark - rather than the current system of needing to pass eight cases out of 12.

RCGP examiners will also now mark all the cases on the circuit, so candidates will be evaluated on 13 cases instead of the current 12.

The cases will continue to be marked using the current three domains but candidates will now receive the total numerical score for all 13 cases instead of receiving individual marks for each case, and the pass mark will be set by the combined judgements of examiners for that day.

The RCGP said the borderline group method was being introduced as it was ‘an established and robust standard setting method', and would ‘allow the College to deal with day-to-day variability in the difficulty of case mixes'.

There have also been modifications and clarifications made on feedback statements, taking into account comments from Associates in Training (AiTs) and CSA examiners.

As a result, candidates will be given more information and advice on how to improve performance, as well as additional feedback on any particular areas of performance identified as deficient, linked to the Curriculum Statements of the cases in question.

The latest version of the computer-based AKT will also pilot new question formats such as free text answers, which will allow candidates to type in answers rather than selecting from a list of options, the opportunity to use short video or sound clips, and 'Hot Spots' where candidates can click on a graphic to indicate the site of a clinical sign.

The changes are in-line with suggestions made by Postgraduate Medical Education and Training Board - now part of the General Medical Council.

The College said the examples would be included in the tutorial preceding the exam, and pledged to evaluate the performance of the new formats.

Dr Sue Rendel, RCGP chief examiner said: ‘The proposed changes will serve to make both the AKT and CSA more relevant to the day to day working lives of our candidates and will ultimately improve the care that the next generation of general practitioners deliver to their patients.

‘Candidates should not notice any difference in their experience of the exam or the way in which they prepare for it.'

RGCP chair Professor Steve Field said: 'Having been an examiner for many years, I know how much work goes into developing the exam. I look forward to seeing these changes manifest in improving patient care.'

RCGP

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