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RCGP investigates racial bias in new membership exam

By Lilian AnekweThe RCGP is providing extra training for nMRCGP examiners after complaints that its new exam was discriminating against ethnic minority doctors, Pulse can reveal.The RCGP is providing extra training for nMRCGP examiners after complaints that its new exam was discriminating against ethnic minority doctors, Pulse can reveal.The British International Doctors' Association submitted a complaint to the college after an analysis showed Asian GPs and those who qualified abroad had substantially lower pass rates in a key component of the exam than white candidates.Some GPs warned that the clinical skills assessment part of the nMRCGP might be culturally biased, with concern that training practices in deprived areas could be hit by the unexpectedly high failure rates among ethnic minority doctors.The college's report of the 2008 results shows 93.3% of white candidates passed the CSA, which is essential for overall success, compared with only 63.9% of Asians and 71.6% of those from other ethnic groups.The key driver for the disparity appeared to be a marked difference between the performance of candidates who qualified at UK medical schools and those who studied overseas. Some 91.6% of UK graduates passed, compared with 72.0% for other European countries, 48.7% for doctors from India, 52.9% for those from Pakistan and 54.5% for those from Sri Lanka.An analysis of results from the old MRCGP exam, published in July 2007, showed that although there were differences between UK and Asian GP pass rates, they were not as striking – with an average disparity of 5.4 percentage points.‘There are differences in the performance of the two major identifiable ethnic groups of UK graduate,' a report by the college on the new exam states. ‘This finding might suggest the examiners could be being unfairly biased.' But it goes on to insist the college was satisfied that ‘although variations between performance of candidate groups were apparent', the ethnicity of examiners did not affect pass rates in those groups, and therefore ‘the indication is no unfair discrimination has been identified'.But Pulse has learned that despite those reassurances, the college has been alerted to the possibility of bias and is taking measures to redress the balance.Dr Nadim Fazlani, a GP in Liverpool and one of a handful of Asian nMRCGP examiners, said: ‘Some training was given by a professor of linguistics, as we're trying to assess a complex interaction between GP and patient that can be difficult to interpret in foreign doctors.'Dr Sabyasachi Saker, national chair of the British International Doctors' Association, told Pulse: ‘We have expressed our concerns to the RCGP through [vice chair] Dr Hasmukh Joshi and he said the college was looking into the matter.'South London GP Dr Una Coales, a GP trainer, said: ‘Language barriers cannot account for a 30% difference in pass rate. Cultural and gender difference can also affect how some doctors interact with patients.'Dr Una Coales: training in some countries is based on treating the condition, rather than the patient Dr Una Coales: training in some countries is based on treating the condition, rather than the patient

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Readers' comments (1)

  • This article suggest and give impression that improvement were attempted, so why is Rcgp in denial now that there is no problem.

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