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Independents' Day

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)

  • Why have any limits on the amount of times you can take these exams ?

    This would take the psychological pressure off candidates.

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  • Not the financial pressure

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  • If you cannot pass it in 5 sittings you aren't going to pass the 6th.

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  • why are non whites unable to pass this CSA. I still do not understand what the problem is.
    Can anybody please explain.

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  • We really are desperate for more GPs. If u allow someone to sit it that often, then what's the point.

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  • Cobblers

    Bit like a driving test. Six times has to make me think a bit whether the driver and the car are suited.

    And would I travel in the car with them?

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  • What is the reason for failing to pass that exam after 6 years of studies/training??!!
    Don't the initial formation during 6 years is correct??
    This last exam should be a formality if teaching done correctly....

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  • Peter Swinyard

    if you do what you always done, you get what you always got. Perhaps there are some 400 doctors who are never going to be good enough to be GPs. Perhaps there are 400 doctors who cannot cope with the exam format and should be enabled to another route to passing a test to be allowed to be GPs. Perhaps there should be a "staff grade" for those who have been through the training mill yet cannot pass the exam but who could work under supervision? How many doctors repeatedly fail FRCS or MRCP? What happens to these doctors? Do they all end up as staff grade in A&E? It seems such a waste of some good people.

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  • Complex issue requiring evidence-based solution. "Staff-grade" parallel attractive option Chairman wise to proceed carefully. High Primary Care standards must not be diluted.

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  • End of the line?

    Bring back the old CCT GP CERT
    Time and experience based entry into general practice

    General practice is about working smart you can always look up what you need to
    Real world pragmatic solutions are needed
    to resolve the workload and recruitment crisis

    Compulsory GMC Fee and RCGP exam is just a monopoly money earner for them

    Oh Yeah some of us got locked out of MRCG by the old exam changing to the new exam

    Anyway no regrets at not having payed membership fees for the privelidge of a few letters

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