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RCGP apologises to trainees after chaotic introduction of MRCGP equality reforms

Exclusive The RCGP has apologised to trainees, after plans to increase the number of sittings of the exam to fulfil its equality duties have left GP trainees missing deadlines and facing paying bills of £1,600 in two weeks.

The college has introduced more sittings throughout the year for the Clinical Skills Assessment (CSA) to make it more flexible, in an attempt to address differentials in pass rates between white UK graduates and black and minority ethnic graduates.

But the schedule changes to accommodate this have meant candidates have had deadlines for applications brought forward, and many GP trainees – and their trainers – have complained the RCGP did not give candidates proper notice of the change to the deadlines.

In a statement to Pulse, college chair Dr Maureen Baker said the college was ‘sorry for any confusion or inconvenience caused by the most recent changes to booking dates’, but added that the college would not be able to introduce a deposit system to allow trainees to pay the full amount of the fee later.

The increase in the number of CSA sittings was revealed in an RCGP council paper on the initiatives the RCGP is undertaking in response to recommendations made by the Judicial Review of claims of racial bias in the MRCGP exam, which cleared the college of any racial discrimination, but demanded the college take steps to address the ongoing disparity in exam pass rates between international medical graduates and UK graduates.

Dr Baker said that the college had ‘changed its exams schedule in line with requests from trainees and others for greater flexibility and we have expanded the number of sittings available from three to eight per year’.

However, trainees were making it clear over social media that the plans had disrupted their schedules, with reports that the sittings they were planning on taking were now full, while others had deadlines brought forward, which meant they were having to pay the exam fee within two weeks, rather than the months they had budgeted for.

Dr Baker added: ‘Monthly sittings of the exam started in October and will run until May 2015. This was intended to be beneficial to the candidates, as well as college examiners and the deaneries. There was wide consultation about the proposed timetable for examinations with a range of stakeholders but we are sorry for any confusion or inconvenience caused by the most recent changes to booking dates.’

She said that there had been undersubscription in November and December, adding: ‘Realising that it was going to be difficult to know exactly when trainees were intending to sit, we decided to amalgamate the booking periods for January and February examination and bring these forward to avoid possible capacity issues later in the year.’

However, she said it ‘was not possible to give as much notice of these changes as we would have liked and some trainees have expressed disappointment about this, for which we apologise’.

The college had considered a deposit option because candidates who were considering applying for February were being asked to move their payment forward by approximately one month, which would mean paying before Christmas.

However, she added: ‘The February diet has been completely oversubscribed so this does not appear to have been a major deterrent to booking. There are still a number of places available for the examination session scheduled for 19-31 January 2015 and over 900 places will be available for examination in March.’

The apology came after trainers and trainees took to social media to complain about the changing of the dates.

One GP trainer said on Facebook: ‘I see that you have, with no warning, moved the application date forward two months. So that candidates now have only two weeks to find £1,600, rather than the two months that they were budgeting. Congratulations, once again, on treating your prospective members like utter s***.’

Dr Shamriz Hussain, a GP registrar in Doncaster, said: ‘I have just found out, not via any correspondence from the RCGP, but by Facebook of all things that the exam booking date for January and February has changed now from two months to two weeks away.

‘That is quite a substantial amount of money to find in a small amount of time for people with things like a mortgage… bills… something called Christmas to prepare for.’

The increase in CSA sittings was revealed in an RCGP council paper on the initiatives the RCGP is undertaking in response to recommendations made by the Judicial Review of claims of racial bias in the MRCGP exam.

Under the heading ‘A strategic MRCGP plan to address differential performance: actions which the RCGP can take’, the paper said: ‘An increase in the number of CSA diets to increase flexibility for candidates and deaneries/LETBs from October 14 (GMC approved).’

In addition to the expanded CSA schedule, the college is taking a number of steps, including extending the Advanced Knowledge Test (AKT) by 10 minutes, to reduce time pressure, providing better resources for CSA preparation based on new sociolinguistic research and changing the methodology by which CSA standards are set.

Dr Ramesh Mehta, chair of the British Association of Physicians of Indian Origin, said he was pleased with the RCGP’s response to the judicial review so far.

Dr Mehta said: ‘We are very pleased with the actions points established for changes to be made to the MRCGP exam – it is a good move by the college. If we did not challenge the college with the judicial review, none of these changes would have happened, and we are pleased that the college is acting sincerely.

‘I think one of the key action points is to extend the length of the AKT timing by 10 minutes for all candidates, because this will help doctors whose first language is not English. This has already come into effect and we have said to the college that we will wait and see if it helps change the differential pass rate, as I believe it will.’

Readers' comments (20)

  • Seriously, The US does not do universal healthcare but it does health education brilliantly.

    its on a plate just copy the US system - it works in terms of quality

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  • Just about sums up the incompetence of the RCGP. I can't believe anyone would continue to be member and pay them any subscription fees.

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  • Trainee GPs have to pay for the RCGP.

    Get trained. Emigrate.

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  • Una Coales. Retired NHS GP.

    GP trainers could have told the RCGP that their trainees who started in August as registrars would not be ready to sit the £1600 CSA licensing exam until Feb.

    No brainer intake for the November and December sittings would be low. Historically the Jan-March sitting took the brunt of over 1000 GP registrars sitting CSA.

    To run out of places for the Feb sitting in a matter of days and before the closing date for applications November 24, is poor planning. I hope the RCGP open up emergency extra Feb dates as those who are forced to sit in March may not get their results in time to reapply for an April/May sitting if needed.

    Timing is crucial for registrars who are anxious to get their CSA, complete their eportfolio assessment and get their CCT. They only have a year to do it all at great financial cost to them and their young families.

    And no GP trainer that I know would have advised their registrar to sit in November or December. Their reputation is also on the line as a GP trainer with their respective deaneries. Safe bet it was always going to be a Feb sitting for the majority.

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  • I think you are spot on there Una Coales. Its financial worries that is causing this nonsense. As someone mentioned somewhere, and that dreadful Dr Meirion Thomas demonstrated with his stupid article in the DailyWail this morning, GPs are the laughing stock of the public, and even other RCs snigger at the RCGP. I am sorry, but just raising the bar for an exam that does not fully test a candidates full skills, and in fact can be biased against some, WILL NOT make the other RCs sit up and take note and give GPs respect. This fee fiasco only makes the RCGP look sillier , in my opinion. The only redemption would be for the RC tpo waive fees COMPLETELY for all the candidates on these 2 dates as an apology and an atonement . Will that be done though? Well, there is the matter re that expensive mortgage, so, brain wins over the heart and morals. Mega fail this time RCGP. Sorry.

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  • Sooner or later, the Chair and Chief Executive of the College have to be held accountable for their repeated incompetence. No excuses this time.

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  • Una Coales. Retired NHS GP.

    With 28% of GP trainees expressing a wish to emigrate, lifelong revenue for the RCGP may drop significantly as many see emigration as a loophole to avoid repaying their student government loans.

    With a recession that is hitting all sectors, including journalism (Daily telegraph journalists have just been culled), I wonder how many GPs will continue to pay the annual £500 RCGP subscription? Many will just add the year of qualification behind the MRCGP postnominal.

    The RCGP needs to work on customer service to keep its members happy and messing with GP trainees may ensure they stop paying fees once they secure their CCT, as paying the college is optional after CCT.

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  • Give folk extra time to do an exam to fudge it - other RC must be ******* themselves.

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  • This comment has been moderated.

  • In 2011 when I sat the csa I requested to pay in instalments to make it easier as I was part time and the main earner in the household. This was rejected by the exams office, so I appealed to the dean for postgraduate training this was allowed , although again the exams office tried to prevent it. I am surprised the college have no flexibility over payment structure still for their trainees and seem to take it for granted that trainees can cough up such a large amount at short notice.

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  • Una Coales. Retired NHS GP.

    @10:17 pm, we tried everything, suggested installments, suggested videotaping all stations for fair appeals, suggested 2 examiners per station to reduce intraobserver bias, suggested Harvard IAT testing to exclude examiners and actors with strong preference for one particular race, etc. Logic and reasoning are not what comes to mind when I think of the RCGP.

    Only last night did I hear that some trainees in Tower Hamlets now cannot afford to cough up this huge ransom in such a short time and thus cannot afford to sit in Feb so have to defer their exam to later. This means instead of making this exam more fair, they are forced to only have one sitting before they have to appeal at an ARCP panel for a 6 month extension if they fail! With a shortage of GPs and GP surgeries closing, this puts added strain on finding a GP placement and takes away from incoming GP trainees who also need placements.

    A trainer was told the College needed to know how many would be sitting in Jan/Feb as the reason why they moved the application dates forward 2 months so that examiners could book their leave. Perhaps they could have asked for an expression of interest first? Why the need for your £1600 now and not a month before? Why should they also benefit from the bank interest accumulated on your payments paid 3 months ahead of the exam?

    I remember pre October 2007 when the MRCGP exam cost £190 a module and £300 for simulated surgery. I paid £190 to submit a video for MRCGP as a GP reg. Even a video module option has also been rejected by the RCGP. Believe me I tried as council rep to make this exam cost effective for trainees. I have watched the CSA fee go up in price year on year in spectacular fashion from £1100 to now a whopping £1600 a go. Perhaps the RCGP should stop reading the Daily Mail?

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  • Una Coales. Retired NHS GP.

    PS. It is a flimsy excuse to say we had to move forward the application by 2 months because we needed to know how many examiners would be needed for Jan/Feb as every year the exam has had sittings in Jan-Feb (what happened the year before, or the year before that, etc.) and never before have trainees been so badly treated as now to have the window period for applications made so tight, so urgent and so inflexible.

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  • Una Coales. Retired NHS GP.

    Correction: not Tower Hamlets but some Newham GP trainees now not able to afford the Feb sitting due to the sudden notice for payment.

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  • Una Coales. Retired NHS GP.

    My advice to GP trainees is to max out your credit card now to sit in January as there are still places I hear, and then repay monthly on your cards. Better to pass CSA now, then to be jobless if you sit and fail in March which would make you too late to apply for May. Remember in a subjective human marked exam with actors, it is less about what you know and more about how you come across.

    Some GP trainees out there have been unemployed for months waiting for a GP placement for their extension as they ran out of time in their GP reg year to pass CSA having put off the exam to the last sitting of the year!

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  • Una Coales. Retired NHS GP.

    'Than' to be...

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  • Fairly obvious that the RCGP Xmas bash went a little over budget this year and they had to claw few grand back.

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  • Seems to be the same old story in medicine. Contempt for juniors. Medicine seems to be run by completely the wrong people. The behaviour of the RCGP can't just be down to ineptitude and incompetence alone they just don't seem to care about their members.

    Don't think many be people with be bothered either if the college folds. The profession would be better off without them. Perhaps less of a laughing stock. The RCGP seems to be a major part of the problem. Has helped create a recruitment crisis by its own buffoonery, exam failings and failure to stand up for members.

    Get trained. Emigrate. Get out.

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  • My PDP (not in my RCGP ePortfolio)

    1. Pass the CSA
    2. Complete training
    3. Resign my membership of the RCGP
    4. Emigrate

    I'm Asian so step one may be difficult - even though I've got distinctions in pretty much every under and post-gradate examination I've ever sat.

    My colleagues and I are worth much more than what the RCGP is able to offer.

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  • Una Coales. Retired NHS GP.

    @5:54 pm I agree with emigration as the best plan B for Generation Y GP trainees. Just heard from a lead appraisor that GPs are failing revalidation because they are not reflecting enough. How's this. Reflecting on the present economy of the UK and the way healthcare is headed, your best option in life is to get your MRCGP, translate this into FRACGP, emigrate and stop paying optional membership old boys club fees.

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  • It just sucks. RCGP needs to change otherwise soon is going to lose lots if it's members. I had a lucky escape not to pass the CSA by low margin and on my last attempt by 1 mark. Now I am my own boss doing middle grade posts in AE and I am treated with respect and even I don't have CCT I am respected by colleagues in AE as qualified GP as I am signed off competent for licensing in my last ARCP and passed AKT with high percentage and had excellent eportfolio. It is so rewarding when hear my patients in AE telling me I wish I was their GP. Or how wonderful doctor I am etc. Although it was hurtful when I did not manage to get my CCT at the end of my GP training I am happy where I am now, can chose my hours as locum, paid for every hour I work, no paper work hassle after work. I have to say it is RCGPs loss. They have lost lots of competent doctors. Above all RCGP has lost the respect of many ....

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  • 8.47
    The whole thing is a farce. Medicine is run by institutionalised people who are simply not up to job. They are from an era when put bluntly, things were a lot less competitive. They don't realise how priviledged they and the damage they are doing to the most vulnerable in society. Many of their victims are doctors who are resilient and bright enough to move on and do other things. Emigration being just one option. Not sure what some of these people would be doing.

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