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GP trainees set for more chances to pass MRCGP after row over failure rates

Exclusive: The RCGP is considering extending the number of chances GP trainees are given to pass the MRCGP and extending the support given to international medical graduates in an attempt to defuse a growing row over their high failure rates.

Pulse has learnt the College said it will consider allowing graduates to take six attempts - rather than the four it currently allows – following a crunch meeting with the British Association of Physicians of Indian Origin and the British International Doctors Association yesterday.

The meeting came after Pulse revealed that BAPIO was taking legal advice over ‘huge’ differential pass rates between international and UK GP trainees in the new MRCGP, introduced in 2010.

The latest available figures show that, in 2010/11, the failure rate for international graduates taking the CSA component of the MRCGP was 63%, compared with 9% of UK graduates.

An internal email sent after the meeting by BAPIO – and obtained by Pulse – reveals the RCGP ruled out giving any further opportunities to trainees who have already failed the exam four times, and said there would not be an alternative to the clinical skills assessment method of examination, which has been largely responsible for the low pass rates of IMGs and BME doctors.

But the College did say it was ‘keen to collaborate with BAPIO in running courses and providing support to trainees’, it will look into the ‘accountability of trainers’ and has invited BAPIO to observe the CSA.

According to the email, the College also offered ‘continued discussion and possibly looking in to other demands in due course’.

BAPIO said that it was not ruling out legal action and will fundraise to ‘continue to have legal option’, in an email to members. It is also holding an emergency meeting to discuss the issue later this month.

The email said: ‘[The RCGP was] interested in what BAPIO‘s members have faced .There was a lots of civilised discussion for about three hours.

‘They are very keen to continue talking and we were interested in urgent action.’

 Dr Ramesh Metha, BAPIO chair and a consultant, told Pulse the discussions with the College were ‘robust’.

A joint statement by RGCP, BIDA and BAPIO said: ‘Representatives from the RCGP, BAPIO and BIDA have met to discuss matters of concern relating to differential pass rates in the MRCGP Clinical Skills Assessment. All three parties acknowledged that there were a number of factors contributing to the lower pass rates of candidates with overseas Primary Medical Qualifications.

‘The College recognises the seriousness of issues raised and some suggestions for further action have already been agreed. Another meeting will be held in the New Year to review the situation to which a senior representative of COGPED (Committee of GP Education Directors) will also be invited. At that meeting we hope to explore issues in more detail and agree the next steps in the future to support overseas doctors, ensure demonstrably transparent and fair processes and overall help to improve their pass rates in the CSA.’


Story updated 12pm Thursday 13 December

Readers' comments (487)

  • Offering more number of attempts seem to me as the carrot and the stick scenario WITH OUT OFFERING TRUE TRANSPARENCY TO THE CONDUCT OF THE EXAM!!!

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  • More money for the controversial college. Who the hell would support the trainees and take some accountability? The deaneries or the college or none? Where is a level playing field for the IMG's?

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  • Dear Colleagues
    Outcome of the meeting with BAPIO :
    As expected the RCGP has come up with some ideas:
    RCGP has offered the following :
    1- They will look into possibility of giving 6 attempts instead of 4.(money making scheme 2 more attempt £1525 x 2)
    2- They are keen to collaborate with BAPIO in running courses and providing support to trainees.(another money making scheme why not put those support in the deanery whilst the trainee is in the 3 years of VTS doing the donkey work)
    3- They will look in accountability of the trainers (which they have not till date)
    4- They have invited us to observe the examination ( and examiner will be warned that an observer will be there so behave)
    5- Agreed for informal impact assessment ( RCGP courses further fees and money making)
    6- Offer of continued discussion and possibly looking in to other demands in due course (Fib ...we love talking)

    Requests which were NOT acceptable to RCGP:

    1-All those who have been released from training should have further opportunities. (will make them accept their mistakes so this option does not exist)
    2-There should be video recording for all candidates for all attempts.( will leave them open for litigation hence not a good option to part with money they have snatched from poor trainees)
    3- There should an alternative method of assessment
    CSA should be carried out with live patients at GP surgery( Not an option as this will curtail there income source)
    Back to reality guys lets meet for the judicial review of this con industry.

    All CSA victims meeting
    BAPIO is calling an emergency meeting on 15th Dec 2012 Saturday
    Venue of the meeting Addison Park Centre, Kempston, Bedford MK42 8PN
    Time 14:00 PM
    Best wishes.

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  • Vinci Ho

    This is politics. The problem is how to address the fundamental 'reasons' explaining the discrepancies . Of course, somebody will lose face if he or she admitted something was really wrong with the examination .
    Yes, giving trainees more chances might seem to be a superficial answer . It is going to cost them more money.
    This is 21st century . So much is about transparency , rightly or wrongly . The college needs to be extremely careful on this matter . Credibility is the last thing it wants to lose , especially at a time when the whole profession has to stand up against the government messing around with NHS........

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  • RCGP pants down! why are you refusing to prove to the whole world why IMGs are failing your elite CSA exam.
    Video the examinations for prove.
    increasing the number of attempts is a way of making money for poor trainees.
    Trainers will now try to fail imgs on work base assessments. PLEASE ALWAYS KEEP YOUR VIDEOS FOR EVIDENCE OF YOUR COTS.
    Some of the trainers will not make a third of the CSA pass mark one. RCGP to look into trainer competency as well.
    Some trainees have been offered jobs,/partnerships by their trainers yet the fail CSA WHY?
    RCGP were so quick in changing the exam format, now they have to deal with the problems , either voluntarily or through the courts.

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  • RCGP , should make this exam transparent , by video recording all or by getting 2 examiners to mark each case . Why are they so hesitant in that ???
    They should be rectifying there Biased , Colour and Accent judging examiners , NOT the trainers .
    This was just another meeting , another discussion , another carrot for the donkey .....there is hope but you might never reach the end point, unless they are taken to court

    This comment has been moderated by the web team
    .Simply hate all of this and would have never joined this shit speciality , ......had I known earlier

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  • Good to see discussions being held on this and work being undertaken to help rectify the issue.

    It may be interesting to consider a Times of India piece on the similar issue of IMGs failing the Indian screening test ( which reports only 21% of students who received foreign medical degrees and appeared in the screening test qualified this year.

    It would be interesting to see more detailed data on failure rates by country of qualification as there could clearly be an issue with the training received in certain countries causing such a high failure rate for IMGs in both the CSA and Indian screening exams.

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  • The issue here is RCGP not being transparent about the CSA exam. This has affected a lot of trainees and of course is a very sensitive area. I find it a bit out of place if people have started to question origin of IMGs. To the RCGP those who did not train in UK are IMGs, who cares whether someone trained in north or south pole.
    Again I say this is a very sensitive issue to a lot of IMGs so I please make sensible comments or helpful suggestions about this issue.

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  • @3:07pm Apologies if my thoughts were unhelpful in anyway. I understand this is a difficult and sensitive issue and am keen to help understand the issue fully hence posing the question about more detailed data.

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  • For anyone who is interested in the information on origin of primary medical qualification it is on page 30 of this document -

    There's no clear pattern which helps to explain the issue further as far as I can see.

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