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Legal action commences over MRCGP exam failure rates

Exclusive An international doctors’ group has commenced legal action against the RCGP over the MRCGP exam, after a crunch meeting with the College, deaneries and the BMA failed to reach agreement about a way forward.

The British Association Of Physicians Of Indian Origin (BAPIO) told Pulse it was going ahead with a judicial review against the RCGP and the GMC over failure rates for international medical graduates in the clinical skills assessment of the MRCGP.

It was also revealed that the GMC will be appointing an independent party to review the fairness of the exam.

BAPIO also confirmed it is currently reviewing 60 potential claims for an employment tribunal for candidates who failed the CSA. It has said it will support the legal costs of the tribunals, which it hopes to hear as one class action.

A joint statement from BAPIO and the RCGP said that they had agreed to ‘work collaboratively towards a negotiated agreement’, and welcomed an independent review of the MRCGP commissioned by the GMC.

But BAPIO said it would carry through on its threat issued last month to give the College three weeks’ notice before legal action will commence by lawyers.

BAPIO met with College officers, including chair Professor Clare Gerada and chief examiner Dr Sue Rendall yesterday, as well as representatives from the British International Doctors Association, COGPED and the BMA.

The talks were planned to find a resolution to the issue outside of the courts, but failed to reach a consensus, although there were indications that a resolution may be found before the judicial review begins.

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Dr Ramesh Mehta, chair of BAPIO, told Pulse: ‘We are progressing with our judicial review. The college has agreed to keep on talking to see if we can resolve the issue in due course.’

A joint statement by BAPIO and the RCGP said: ‘We agreed to move forward together to clarify accurate numbers of doctors unable to obtain their Certificate of Completion of Training (CCT) because of CSA failure.

‘All parties welcomed an external review commissioned by the General Medical Council of the MRCGP, but despite the productive meeting, BAPIO explained that they will be proceeding with their legal action.

‘All parties agree that they will continue to work collaboratively towards a negotiated agreement.’

Readers' comments (259)

  • I am 56 years old and retire 6 weeks today. No revalidation, CQC or CCGs for me I'm afraid. Could have easily worked longer but want to hopefully have quite a few reasonable years left as an ex GP only being concerned about my own health and not that of the health consumers I see each day.

    In my time as a GP I can honestly say the RCGP has had NO RELEVENCE WHATSOEVER in my daily practice. I don't consider myself to be a great GP just an average one, doing my job to the best of my ability and treating people like I would like my kids to be treated in the future.

    I really couldn't care less about their role in General Practice it has little or no importance in day to day practice. It would be rather ironic if an organisation which claims to be putting medicine first was found guilty of being racist.

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  • Vinci Ho

    Here we go.
    Extraordinary time .Extraordinary events.
    As I said before ,together with everything happening to general practice at the moment, this is one hell of a critical time as far as history of general practice in this country is concerned.
    It is about benevolence ,fairness,impartiality ,justice ,courtesy ,wisdom to distinguish between right and wrong(black and white), and gaining trust through openesss ,honesty and transparency.
    Once JR is started ,these leaders from both sides will have to keep quiet in public.. Neither side is probably have full advantage to win the legal battle.
    I hope the reputation of the whole profession would not be too seriously damaged at the end. But then again ,if this could represent a revolutinary time in the history,let it be...........

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  • I am 57 and plan to soldier on doing 9 sessions a week for at least the next three years. So do enjoy your hard earned retirement. But like most of general practice, your own experience of it and perception of what it is is very much individually determined- you reap what you sow. You mention you don't see yourself as a great GP, just an average one. Modesty is always a essential trait for us, but for many their working lives have been transformed by a vision of what general practice is and what it can become by the efforts of 'great' GP's who contribute to the RCGP (of which i am not one), so my message to training GP's is that its your college, once you have passed the dreaded CSA and its your future. Good luck with your exams and to my retiring colleague thanks for sharing your thoughts.

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  • @rcgp , solution(s) are very easy to find and implement as long as 'sincere' and 'honest' intentions are present.
    If someone is unable to accept the flaws, then obviously there is no way other than JR.

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  • What a load of rubbish. This is sour grapes by those who cant pass the exam. Its clear the training period is 3 years and you have to pass the exam. Unfortunately those who havent been submerged in the UK culture for long enough say 6 years or so have a mountain to climb in 3 years. They have the same failure rate in the AKT and thats marked by a machine.Should we dscriminate in favour of them and dumb the exam down?
    I may not always have agreed with the college but it has raised standards. We dont want to continue having hospital failures in General Practice. This exam is much more exacting than previously and I suggest not as subject to bias as the other colleges.
    There will be failures. Otherwise dont bother lets just let everyone through and not bother with standards.

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  • I am a newly qualified GP and had gone through AKT and passed my CSA in first attempt. I happen to be a International Medical Graduate from Dow Medical College in Pakistan.
    In my personal opinion CSA exam is just simply based on how good actor you are and less in your clinical knowledge but it has an element of checking how safe you are at the same time. Many of my colleagues who failed this exam with whom I studied even is that this exam checks tour communication at its highest level and is lenient on check clinical knowledge. This exam in my opinion has some flaws and needs to have a video recording of stations to be assessed if in doubt for a second opinion as should be other exams. Racism doest exist in the profession overall from actual day to day clinical practice to assessments in exams ( which only the person who has been a victim of racism in their own life can feel and the same rule applies to bullying ).

    This exam should at least allow candidates to attempt exam again even if they have finished their training but are clinically active be it in hospital posts. Also at the same time duration of GP training needs to be increased to 5 years and if not possible due to financial reasons then shorter rotations in more relevant specialities like in USA. Most of the GP candidates end up doing rotation in specialities to fill rota gaps rather than their needs. Programme directors needs to have more involvement in the training and GP's who have gone through this exam and assessment need to be made associates with Programme directors

    I have faith in the justice system of UK and hope whatever is in the best interest of profession happens as an outcome of this legal battle.

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  • @stephen 9:48
    It seems that you have got a bit of knowledge gap regarding CSA issue.
    You said
    "There will be failures. Otherwise dont bother lets just let everyone through and not bother with standards"
    Exactly, you seem to be contradicting yourself. There are bound to be failures in any exam. So how come, one cohort of candidates has got 100% pass rate and the failure is just from the other cohort. As you said, why bother with the first group who are going to pass anyway no matter how they perform!!!

    No one is asking to lower the standards. Its about fair and equal treatment. Its about giving 9/9 to all candidates who have not made a mistake at a station, not giving 6/9 to IMGs and 9/9 to the other favorable group. Its about actors behaving the same way with all candidates and examiners marking you the same way. The issue is about fairness and equality, having the right to appeal when you know you are right!

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  • Like the saying goes "if you can't stand the heat in the kitchen then get out"

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  • Stephen McCarthy appears to be living in a cuckoo land.NHS has been sustained so far by overseas graduates for the last 50 years. At one time 42% of medical staff from overseas. I have been a GP for 33 years and had gone through MRCGP examination.I could see the approach of examiners differed when the candidate was overseas.I think I have been a much better GP WITHOUT MRCGP qualifications.RCGP appears more political than the eye meets as an educational establishment.

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  • Well done Stephen. You should stand for the next college chair. You will be more successful than Clare. I hope you have passed the CSA yourself (if you are a GP), I have no doubt in your ability but the way you have commented, have serious concerns about your thought process.
    Go to RCGP website and have a look at the annual reports again to improve the knowledge gap you have.

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