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Common sense approach to CSA must stay

‘There is nothing politically incorrect, racially motivated or immoral about this, it’s just good common sense’ says Dr Hamish Duncan

While it is laudable to ensure the CSA exam is rigorous and non-discriminatory, let’s not create a two-tier pass rate (‘Lawyers give RCGP three weeks to sort CSA, or face legal action’). 

Being a good doctor includes a certain level of understanding of the cultural and linguistic norms of the society you serve, the systems to deliver the service and the ability to work within a different cultural context. If someone is not good enough to do this, they should fail regardless of background. Multiple failings should lead to removal from training. There is nothing politically incorrect, racially motivated or immoral about this, it’s just good common sense. 

In the same vein, let’s ensure this challenge is rigorous and sensible and the outcome does not succumb to political correctness. If the verdict goes against the plaintiffs, they must accept it and move on. If it finds in favour, the RCGP needs to answer serious questions about its impartiality and conduct.

From Dr Hamish Duncan, Exeter

Readers' comments (2)

  • I understand Dr Duncan where you are coming from. You are genuinely convinced that IMGs are failing the CSA as they are not able to connect with their patients. You think they fail as they do not understand the British culture enough and this makes them dangerous drs who need to be weeded out of the system.
    Firstly I would like to stress that the IMGs are failing due to bias at a subconscious level. I don't think that the examiners or the actors are consciously biased. If you read some research by a noble laureate Dr Kahneman, you might understand where I'm coming from.
    Secondly it is not necessary to understand the culture to it's core to be a safe and good doctor. I've seen some white locally trained drs not being able connect with their patients very well. But they still pass easily in CSA. (Of course it's anecdotal)
    Thirdly failing 68% of the IMGs can't be shrugged off simply as lack of cultural awareness. You argued that there shouldn't be a two tier passing system. But unfortunately that is exactly what's in place right now. Everyone knows what I mean. This exam should be urgently sorted out just like recent FPAS fiasco that affected the local students.

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  • Dear Dr Duncan, Although I agree with your general idea, but I feel it does not apply to the CSA exam. There is assessments prior to joining the GP training and the selection with regards to cultural and linguistic ability should be done then. I am a UK gradute, educated in the uk since My ALevels. Been in the UK for 22 years and failed the CSA and lost my training number. I will be happy to give you details of my trainers to ask them about my cultural and language knowledge, and see my patients feedback. I feel you have put your case without showing any EMPETHY towards colleagues who are facing severe mental and social stress because of this exam. Hope you would accept my comments and happy to here back your opinion.

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