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400 potential new GPs trapped in MRCGP limbo as GP leaders call for reform

Exclusive The RCGP has estimated that around 400 doctors are stuck in limbo after repeated failures to pass its MRCGP exam, prompting GP leaders to call for the college to ‘look again’ at the exam.

The figures were revealed in minutes seen by Pulse of a meeting between the college and campaigners working on behalf of many of these doctors.

They have been in talks around potential alternative routes to registration, such as further training and an alternative licensing assessment.

GP leaders – including the former RCGP chair – have called on the RCGP to look at reforming the training process.

But the RCGP has said that developing an alternative assessment model would not be cost effective and would require an overhaul of the current regulatory framework.

It follows the row over the differential pass rates between white and black and minority ethnic doctors taking the CSA, which led to the college undergoing a judicial review.

The court ruled the MRCGP was lawful but urged the RCGP to take action around the number of BME doctors and international medical graduates failing the exam.

Candidates are given four attempts to pass the exam, after which they are barred from taking it again - unless there are exceptional circumstances.

GP Dr Narveshwar Sinha has been working on behalf of around 100 of these doctors, and minutes from his meeting with the college seen by Pulse, discuss the number of doctors ‘who have not attained the MRCGP’ - which the college estimates as ‘possibly around 400.’

Dr Sinha has been calling for these trainees to have further supported training time before undertaking an alternative assessment to the MRCGP.

However the RCGP has said many of these doctors already have difficulty providing robust evidence of their clinical skills and knowledge for the existing ‘equivalence’ routes to registration, such as the Certificate of Eligibilty for GP Registration (CEGPR).

The college’s minutes state: ‘CEGPR is generally not intended for doctors who had not managed to attain MRCGP and that it is usually for already trained and experienced GPs from abroad.’

But Dr Sinha told Pulse: ‘These 400-500 doctors who are already here, why don’t we use them rather than struggling to find doctors from Europe, or India or wherever else?’

This comes after Pulse revealed NHS England was in talks with recruiters about a ‘pipeline’ of nearly 600 European GPs, who could come to the UK in the next three years as part of GP Forward View commitments to recruit 500 GPs from overseas.

RCGP chief examiner, Dr Pauline Foreman told Pulse while the College was sympathetic to the problem faced by the GPs Dr Sinha represents, they couldn’t reasonably overhaul the exam.

Dr Foreman said: We explained to Dr Sinha that his proposal is not deliverable within the current legal regulatory framework, and that many of the changes required to enable it are not within the remit of the College.

She added ‘it would not be reasonable or proportionate’ for the College to develop a new licensing exam ‘for the small group of doctors who are unable to reach the standards’.

But former RCGP chair Dr Clare Gerada told Pulse she agreed the GPs could help the workforce crisis, and - while she didn’t think the CSA was discriminatory - the ‘whole process of working in the NHS disadvantages overseas doctors.’

Dr Gerada said: ‘I do think we should look again at alternative routes to MRCGP. Not letting people in who are not good enough, absolutely not. But we should be looking at alternative spaces where these GPs can work.’

Dr Krishna Kasaraneni, chair of the GPC’s education, training and workforce subcommittee, said: 'We’re set on the mindset that an exam proves somebody’s competence, the exam proves you can perform in that exam. Certain aspects overlap with competence, but because they’ve passed an exam doesn’t make them a good GP, and failing doesn’t make you a bad GP.'

'What we need to be able to do is to train GPs in an atmosphere where they get proper training in general practice from day one, rather than identifying problems when they’ve failed the exam a few times.'

Readers' comments (41)

  • Several investigations have cleared the RCGP of racial bias in the MRCGP exam and I have myself come across some of the people that have failed abd it would appear that the failure was amply justified.
    It is thus simple - if you fail then you have to accept a secondary role such as a "staff grade" or some equivalent.
    Maybe there should be such a level of posts created with the right to resit after a period of satisfactory performance in such a role.This would use the manpower so much needed at present.
    What do the other Royal Colleges do - do the appoint surgeons who have failed rcs 4 times? and so on.
    No more enquiries into the exam as it will be a waste of money.
    JRM Former Trainer : MRCGP 1972 and FRCGP by election.

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