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RCGP reviewing whether MRCGP exam is ‘fit for purpose’

Exclusive The RCGP has drafted in consultants to carry out a ‘comprehensive review’ of its controversial MRCGP exam, which will look at whether the assessment is ‘fit for purpose’.

It is also looking at whether ‘fairness to candidates’ is sufficiently considered at ‘all stages of test design and delivery’, following controversy around the gap in pass rates between white and BME candidates.

The college said that it is undertaking the review now because the exam has been running for 10 years and is ‘therefore at an appropriate point at which to evaluate its content and structure’.

It is also ensuring that the exam is in line with the GMC’s revised standards for postgraduate curricula, published in May.

The Health Professional Assessment Consultancy has been appointed is to review the MRCGP assessment – including the Applied Knowledge Test (AKT), the Clinical Skills Assessment (CSA) and the Workplace Based Assessment (WPBA) - and suggest potential changes.

According to a paper presented at this month’s RCGP council meeting, the review is expected to include answers to the following questions:

  • Is the current programme of assessment fit for the purpose of a postgraduate medical license?
  • Are there emerging evidence-based assessment methodologies that the RCGP should consider to ensure that the MRCGP remains fit for purpose and adaptable?
  • Does the programme of assessment meet the requirements of the GMC’s Standards for Curriculum and Assessment Review, including the proposed General Professional Competences?
  • Is fairness to candidates sufficiently considered at all stages of test design and delivery?
  • Are the current standards appropriate to ensure patient safety?
  • What enhancements to test development, standard setting and quality assurance methodologies might be appropriate?

The MRCGP has come under fire in the past on a number of issues. In 2015, Pulse reported that the BMA had concerns over perceived high fees.

Meanwhile GP leaders have previously called on the RCGP to look at reforming the training process, with former college chair Professor Clare Gerada questioning the necessity of the CSA aspect of the exam.

And the exam has been the subject of a long-running dispute about the differences in failure rates between UK white and BME graduates and international medical graduates, which sparked a judicial review hearing instigated by the British Association of Physicians of Indian Origin (BAPIO) in 2014.

The review ruled that the exam was lawful but the judge stressed that the RCGP needed to ‘eliminate discrimination’ in the MRCGP and tackle the differences in failure rates between white and non-white medical graduates sitting the CSA.



Readers' comments (38)

  • IMGs here in Canada who haven't done a GP training definitely practice differently in some cases overinvestigating over treating. So I am also concerned about the GPs from the EU who have not done similar training coming to help.

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  • Well in the view of RCGP, EU doctors are obviously more suitable to practice straight away as they undertake a full 3 months period of training in a boot camp before joining. Fully trained doctors marked competent for licensing by RCGP trainers however are not, if they don't pass CSA. This says it all.

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  • Does it really serve the patient safety principle to discard from training 100 doctors every year and then go round looking for non medical professionals to fill the gap? If anything, this seems to be the very purpose. Is CSA fit for it? It certainly is.

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  • Would you really think, as a college, that you truly deserve to have the privilege of being considered a popular speciality when you treat some of your trainees the way you do? A very good example of what goes round comes round I suppose.
    Do you really think it serves the patients safety principle to discard from training 100 doctors every year and then go round looking for non medical professionals to fill the gap?

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  • Im also wondering why the RCGP have commissioned a review from a consultancy company of UK academics who have registered their company in Singapore rather than the U, no doubt to avoid tax. Corporate Social Responsibility? Who apparently cares. I just hope RCGP members consider where their membership fees flow to as well as come from.

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  • we need consultation if RCGP is fit for purpose. I have zero faith in RCGP.

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  • CSA is color coded.
    Alas! they cant see our colour for ASA theory exam.

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  • 100 discarded doctors every year - by the way, a small number. How many patients does a GP see every day? At least around 20 and supposedly the GP only works 5-6 sessions a week, that is approximately 60 patients weekly and 2700 yearly. If you have 100 doctors who despite training and resources spent by RCGP to train them, don't eventually become GPs, that is around 300000 patients added every year to the waiting club. Over the past 10 years it's 3 million more patients waiting longer to get a GP appointment if lucky enough to be registered with one .Go and tell those patients who struggle to get an appointment with their GP that 2700 or even 3 million of them is actually a small number. This is RCGP policy. Patient safety? Hmm...

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  • In answer to the hospital doctor who thinks an average gp sees 20 patients a day-the reality for me is 36 patients in clinic, plus visits and phone calls. Administration on top of this.
    Nearer 40 patients seen per day .

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  • Vinci Ho

    My curiosity and ignorance.
    Does anyone know whether the college ever had a non Caucasian(if that is the politically correct label) president or chair? If not , anybody's bet there will be one in the future?

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