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GP trainees locked out of MRCGP exam could get 'sixth' attempt

Exclusive The RCGP is considering adding a further sixth attempt at its end of training Clinical Skills Assessment for doctors who have been locked out of general practice by being unable to complete the final exam.

The RCGP told Pulse it was considering the changes in conjunction with education bosses’ plans for a ‘Targeted GP Training’ (TGPT) programme to support doctors unable to pass the CSA or changing specialty.

Black and minority ethnic doctor representatives said requiring trainees to pay ‘almost £2,000’ for another retake did nothing to address fundamental issues with the exam which mean non-white doctors are much less likely to pass.

But the BMA’s GP trainee committee was more hopeful, saying that the individual education support package in the programme could be the difference, rather than ‘doing the same thing over and over again.’

Tthe RCGP only allows four attempts but in August 2016 began allowing a fifth ‘in exceptional circumstances’.

Dr Ramesh Mehta, chair of the British Association of Physicians of Indian Origin (BAPIO), said that College representatives were receptive to the idea of allowing failed CSA candidates toretake the exam after been locked out of training in a meeting last week. 

He told Pulse: ‘They said that there is a possibility that the number of attempts, which is four at the moment [with a fifth in exceptional circumstances], is going to go up to six.'

However, he said that the RCGP continued to insist that BAPIO's proposed changes to its exam, such as providing video feedback to unsuccessful applicants or using two examiners to correct for bias, were ‘too expensive’.

Dr Mehta added: 'The amount of money they charge for these exams is nearly £2,000 and these poor trainees pay every attempt. But they [the RCGP] are saying their exam is making a loss.’

RCGP chair Professor Helen Stokes-Lampard said changes to the exam are ‘unlikely to be implemented’ before it has heard back independent review of the MRCGP’s first ten years – as revealed by Pulse.

The College meets regularly met BAPIO and others to ensure ‘all elements of the assessment remain fair to all candidates’ and she added: ‘During our last meeting with BAPIO, the possibility of further attempts at the Applied Knowledge Test or Clinical Skills Assessment was discussed in the context of potential Targeted GP Training proposals being considered by HEE – but until these are published we are not in a position to make any decisions or comments.’

GPC education, training and workforce lead Dr Krishna Kasaraneni told Pulse that ‘simply adding more and more attempts isn’t going to serve a purpose’.

‘I’ve spoken against it before, because what's the point of doing the same thing again and again without extra support or added focussed training.

’But this scenario is looking at people who have been unsuccessful in the past and have used up all their attempts but putting them through the targeted training programme and giving them a chance to get through the assessment.’

The TGPT programme is working to identify how many GPs could benefit having failed before, but Pulse revealed last year that RCGP records showed around 400 doctors had hit the maximum attempt threshold.

The talks between BAPIO and the RCGP follows a High Court challenge by the association three years ago which ruled the College’s exam was lawful but that action was needed to address the gap.

But last week Pulse revealed that the College’s own figures show it is the widest ever recorded in the MRCGP qualification’s ten-year history.


Readers' comments (26)

  • Its all about color these days.Look whats happening in America.
    Its a shame on all of us in 21st century.

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  • doctordog.

    We should realise that possession of this Mickey Mouse exam from an irrelevant organisation is not a marker of quality, knowledge or ability .

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  • Why pay at all? This craze for a RCGP tail and having to pay a permanent levy for membership of an obsolete, damaging to GP organisation is incomprehensible.

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  • I have recently sat and passed this exam... It is not a test of medical knowledge, it is a test of communication according to the principles endorsed by the RCGP (not my position to comment whether these are correct or not).
    This makes it a game for which you can specifically train, recognising the balancing act between ultimate 'shared decision making' and the intricacies of working in the National Health Shambles of the 21st century.
    The patients are professional actors (another group with a huge underrepresentation of BME individuals) therefore the cases are limited by the actors available (attempting age / sex / gender / race appropriate for cases). Again this limits the likely cases which allows better preparation.
    This exam is stressful, all exams are stressful, but part of the day job involves dealing with stressful circumstances (even as a Reg I have these experiences daily) therefore if the candidate can't cope with the stress of the exam how will they cope with a busy surgery?
    Does this make the CSA a cultural exam, I suppose it does because the examiners are looking for a culturally sensitive and appropriate response to the difficult day to day decisions we need to make as GPs. Society expects doctors and specifically GPs to fit with local cultural 'norms' which I believe the CSA attempts to recognise. Does this make it a 'Racist' exam?
    I have huge respect for anyone practicing medicine, particularly a speciality with communication at its core, not in their first language. I am proficient in French, would probably pass a PLAB equivalent, but would never dream of taking post graduate exams there unless I had spent many years immersed in their culture and health care service.
    Apologies for my rambling, rest assured that post CCT the RCGP will not receive a penny more from me!

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  • The strange thing about all the statstestics regarding BME failing mrcgp is in stark contrast to other royal college exams.Secondly how many white doctors will be able to pass the exams in India,Pakistan,Africa,if the exam was more social base then medicine based.....yes they learn the British etiquette but it is never enough.......the base of the exam is flawed........

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  • I clearly cannot understand why these ex trainees be given another way to prove their every building to have mandatory fire exit....why can't there be other ways....some people are definitely not cut for this exam format.....and surely these trainees are a better bet then being seen by a nurse or physician assistant. Dr.Lampard... please change the exams.

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