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GPs go forth

Lawyers give RCGP three weeks to sort CSA, or face legal action

Exclusive The RCGP is to be given three weeks’ notice before legal action will commence by lawyers representing an international doctors group, and also faces the prospect of being hauled up in front of employment tribunals in an escalation of the row over the MRCGP exam.

The British Association of Physicians of Indian Origin (BAPIO) has instructed its solicitors to write to the College and give it three week’s notice to ‘resolve the issue’ over the lower pass rates for international doctors and agree to its demands.

It has also asked legal representatives to write to trainees who have failed the clinical skills assessment exam four times and have been removed from training, to inform them that it will pay the legal fees for them to take the RCGP to an employment tribunal.

The legal action marks an escalation of the row over the pass rates of international medical graduates taking the clinical skills assessment (CSA) portion of the MRCGP exam, and comes despite ongoing negotiations between the RCGP and international doctors’ groups.

The RCGP said it was ‘disappointed’ that BAPIO had decided to proceed with legal action despite negotiations, and that it was seeking to work constructively with interested organisations.

The move comes after the GMC said it would launch an review into the failure rates of different groups of medical graduates taking the MRCGP and after the BMA also wrote to the College outlining its concerns.

BAPIO has already raised £33,000 for its legal fund to finance the tribunals and a possible judicial review.

In a letter to its members, BAPIO chair Dr Ramesh Mehta wrote: ‘BAPIO is supporting the launch of employment tribunal action for GP trainees who are already affected by the CSA issue.

‘BAPIO is continuing negotiations with RCGP and others. However our QC is writing to them with three weeks of notice to resolve the issue otherwise we will proceed with judicial review.’

BAPIO estimate that around 300 doctors have been kicked out of training for failing the CSA four times. However, the RCGP says it has identified 133 international medical graduates who have failed the CSA exam four times over the past five years.

Pulse has also received a letter from BAPIO to RCGP chair Professor Clare Gerada spelling out what changes it wants to see, which include replacing the CSA with evaluations of video encounters with real patients and pathways for doctors who have been removed from training.  

Professor Gerada said: ‘I am very disappointed that they have chosen to do this, rather than have a dialogue instead about how we can do the best for the next generation of doctors and our patients.

‘Overall very few doctors who start training fail to obtain the certificate of completion of training and only a very very small number of GPs - approximately 1% per year of those that sit MRCGP - are released from training because of a failure to pass CSA alone.’

A spokesperson for the RCGP said: ‘Discussions are ongoing between the RCGP, BAPIO and BIDA. Another meeting has been arranged for 21 February and the College is keen to work constructively and collaboratively.’


Readers' comments (339)

  • Well done BAPIO.
    Many doctors will be pleased to support and assist to fight this case.
    Support from GMC & BMA is very welcome.
    RCGP should assist rather then resist in this process.

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  • This is good news. I don't think MRCGP is fair to international graduates and am very happy that some action is being taken. Is there any way we can help?

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  • well Done Bapio,
    i think this is the only way to wake up RCGP from prolong sleep.

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  • Whilst it is laudible to ensure the exam is rigorous and non-discriminatory, lets also make sure we do not create a two-tier pass rate. Standards must be high, and being a good doctor (GP or otherwise) includes a certain level of knowledge and understanding of the cultural and linguistic norms of the society you serve, the systems in place to deliver the service, and the ability to work within a different cultural context. If someone is not good enough, they should fail regardless of background. Multiple failings should lead to removal from training. There is nothing politically correct or immoral about this, just good common sense. In the same vein, lets ensure this challenge is rigorous and sensible and not succumb to political correctness. If the verdict goes against the plaintiffs, then they must accept and move. If it finds in favour, the RCGP needs to answer serious questions

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  • Dear RCGP
    can you give some idea what is percenatge of IMG released from the traning from CSA faliure becuase of the CSA from Sep 2010. We do not want the figure for last 5 yrs or whole 5yrs.

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  • well done BAPIO and thank you so much for giving us a voice.

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  • RCGP still seems to be in denial; Hiding your head in sand wouldnt help.
    I thinks it will be important if RCGP acknowledges there is a problem and engage in constructive dialogue.
    I am a trainer myself and have raised it officially with college to no vain (Sadly)

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  • Dear RCGP, can you provide how many white graduates were kicked out of the training. None I believe.
    The demand is to be fair to everyone irrespective of colour or race. Unfortunately, RCGP has FAILED miserably in being fair and acknowledging the injustice that perhaps some examiners/actors have been doing using CSA.
    RCGP has been active in voicing opinions on other stuff recently. The main priority and focus of chair and college should be providing justice and fairness in its OWN house first. That should be NO.1 priority and job of the college.

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  • This is the second time RCGP manumpulate the date to support CSA. Last year RCGP said that only 40% IMG score highly in AKT to match with CSA pass rate 33%. we are not talking high rate CSA pass here. only pass we want. we do not know the overall failure of AKT for IMG after 4 attempts and realeasd from the training due to AKT.
    Again. less than 1% realaesed annually means what;what the percentage of IMG in each VTS-must be 10-30%
    In our VTS all the iMG failed in Nov2012 CSA. still 10-30% failure rate. Yes. for IMG 100%

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  • Dear all
    I am surprised by the very little activity on this very important topic. I am an IMG and I recently cleared the CSA in my 2 nd attempt.
    I also hold another Royal colleges membership.
    Having taken another college's practical exam, CSA looks more like a X-factor audition rather than a exit exam.

    Out of my GP reg year study group of 17, only one person knew that ESR is not an acute phase reactant , including the facilitators. Only the IMG's failed in the group!!!

    More to follow

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