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RCGP requested £288k for costs towards judicial review case

The RCGP requested an international doctors’ group pay £288,000 towards legal costs incurred as a result of the judicial review into the college’s membership exam.

The GMC – which also had to face the judicial review – requested around £75,000 to £100,000 towards legal costs.

However, Mr Justice Mitting ordered the British Association of Physicians of Indian Origin to pay £50,000 of the costs incurred by the two organisations, after finding that the MRCGP exam was lawful.

BAPIO’s own costs came to around £175,000 – for which the BMA donated £20,000 - as well as £5,000 in legal fees, it was revealed in court.

The judge found that the exam was lawful, but said the ‘time has come’ for the RCGP to take action on the huge differences between UK and international medical graduates taking the exam.

He said that BAPIO had won a ‘moral victory, if not a legal one’ in his summing up last week.

In light of his comments, he ordered BAPIO to pay £50,000 in costs, despite the college and GMC calling on the international doctors’ organisation to pay greater costs.

A spokesperson for the RCGP said: ‘Matters in relation to the costs of the hearing are not yet finalised, and we are not able to comment further on them at this time.’

This comes as the BMA said that there was a ‘long way’ to go to resolve the causes of the differences in pass rates.

Dr Krishna Kasaraneni, chair of the GPC GP trainees subcommittee, said: ‘The best way to resolve these significant variations in pass rates is for all parties to now work together. Despite the ruling from the high courts, it is regrettable that we still have a long way to go to resolving the underlying causes for the disparity between the results for GP trainees from different backgrounds.’

‘While the ruling has dismissed claims of discrimination, the judge made it clear that the CSA does put certain groups at a disadvantage. This is what needs to be looked at immediately.  These trainees need to be identified at a very early stage and should be provided extra support and training.’

The RCGP said: ‘During the recent Judicial Review proceedings, Judge Mitting made it made it clear that GP training was the main area where action needed to be taken in order to address differential pass rates in the CSA.

‘He understood that GP training is not a function of the RCGP as determined by the College Charter, and that it is a function of the deaneries/LETBs.

‘Judge Mitting made it clear that the RCGP needs to co-operate with deaneries/LETBs to encourage them to address underperformance in Asian/black minority ethnic candidates in the CSA.

‘The RCGP welcomes any suggestions from BAPIO, BIDA and Professor Esmail that will help us to address this agenda.’

Readers' comments (19)

  • I am not an IMG, I however have a few suggestions for the RCGP to make the CSA fairer for everyone:

    1/ As a minimum please allow the video recording of the exam. There is no reason not to allow video recording of the exam, unless there is concern of the conduct of some examiners.

    If the proportion of IMGs/BMEs passing increases just as a result introducing video recording there will be major questions for the RCGP to answer.

    2/ The pass mark needs to be reduced. The mean mark for each cohort undertaking the CSA is very close to the pass mark, usually only a few marks higher, sometimes lower. The GP Registrar scoring around or just below the mean mark on the CSA in ST3 who has passed all other assessments should not be failing the final exit exam. I don't think many doctors are actually aware of this fact.

    Another option is to reduce the pass mark to allow someone to practice as a GP and to obtain CCT but not the MRCGP.

    This is not reducing the standard. Not many years ago there were no real standards, MRCGP was optional and most GPs have not taken the CSA yet are excellent safe doctors. When the CSA was first introduced you would only need to pass 8 out of 13 stations.

    3/ Allow some compensation from the AKT or other assessments. It is unfair that a candidate who has excellent work based assessments, passes the AKT who cannot pass the CSA at multiple attempts or just fails by a few marks. Some compensation from other assessments to allow these candidates to pass the CSA, ? lower the pass mark for them.

    If the RCGP is serious about patient safety and if the CSA represents the pinnacle assessment of patient safety in General Practice please introduce the CSA for existing GPs as part of their revalidation. If they fail they should not be allowed to practice as GPs. As a minimum 5% (I suspect much higher) of existing GPs will not be able to pass this assessment. The uproar that this will cause from existing GPs, patients and the department of health will cancel this exam.

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  • Dear RCGP please allow video recording ,so that we we know you are fair

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  • @8.04 JUST ELOQUENT !!
    Very logical and crisp suggestions to make this disgraceful situation a workable and fair solution to long overdue justice to the disadvantaged trainees. It is the way it should be in a decent civilised society. If CSA is the hallmark of safe GP, then make every GP in this country do this exam to prove that they are up to the mark. This is a public safety issue!!

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  • Looks like more and more BME candidates are going to fail the CSA in years to come...

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  • ..just explain how reducing the passmark doesn't reduce the standard....

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  • Do you think that BAPIO may have shot themselves in the foot? Once deaneries are pressurised to get better results, they may look rather critically at their selection processes, and we may see less IMG's admitted into GP training schemes in the future.

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  • @ 8:19, will all local medical graduates be applying for GP training places ?, as mentioned earlier thousands of new GPs are needed in next few years. where are they all going to come from ?. from the rest of europe where not many speak english ? so the best forward is to make csa more transparent - use video recording and 2 examiners for each station. and please a proper feedback on results, so a candidate knows his / her shortcomings and can work on them for next sitting.

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  • I would add to what has been said at 08.04 by adding a few more points..

    4/ Ensure that the training schemes of GPs have regular training sessions to help IMGs develop their communication skills throughout their GP traning rather than leaving it all till ST3. It is vital that trainees have these sessions even during their hospital placements rather than being used purely for service provision.

    5/ There should be a 'Proposer' for each candidate, just like MRCP PACES, where there is thus some amount of responsibilty on the deanery/trainer to ensure the candidate is ready.

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  • The deaneries have already done this and made selection process more rigorous, This has meant that there are fewer IMG in training though some of it is also because of work visa rules. The comment about earlier support of candidates is a issue which effects deaneries not RCGP. Deaneries are needing to make efficencies as there budgets are cut and are in practice going to find it diffcult to provide extra support without disadvantaging other trainees. The diffrential pass rate is true for all exams by the Royal colleges and a smaller diffrentail exists in medical schools as well.

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  • @ 12:21 '' The diffrential pass rate is true for all exams by the Royal colleges and a smaller diffrentail exists in medical schools as well '' - but the difference in the pass rates for CSA is very huge and just by saying reasons are complex, its not right to brush it under carpet. Using 2 examiners and using video for quality control can make it more transparent.

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