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Gold, incentives and meh

30. Dr Una Coales

Education campaigner

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Dr Una Coales comes in at number 30 in the 2013 Pulse Power 50. She is a new entry in the list.

Dr Una Coales was nominated because she ‘takes risks for the wellbeing of all GPs’ according to the colleagues who put her name forward.

As a GP educator and a member of RCGP Council, she has been well placed to express concern over the difference in pass rates between UK and international graduates sitting the MRCGP – and has done so loud and clear. She has also been campaigning to reform the way RCGP Council members are elected.

Dr Coales also sits on the BMA’s sessional GP subcommittee and was until recently secretary of Conservative Health.

Dr Coales says her biggest challenge over the last 12 months was dealing with the explosion of anger over CSA: ‘Failing colossal numbers of ethnic GP trainees with the subjective CSA actor exit exam has had an adverse effect on GP partnership recruitment for our GP surgeries across the country, more profoundly so in rural areas.’

Readers' comments (9)

  • I wondered having read this list, not specifically after reading Una's however, how many of the people on this list are on as a result of self promotion???

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  • The final list was compiled from more than 500 nominations - you can read the full methodology here:

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  • to anon 10.31: Dr Coales is one of the few GPs in the public eye and certainly one of the few on RCGP council who actually reflects the groundswell of dismay among working GPs on several issues. She says it as she sees it and doesn't just play politics like most of the other bigwigs. This is why RCGP council refuses to elect her to the Chair. It is also why she keeps getting herself re-elected to Council by the membership. She challenges the white middle-class male status quo (and I write as a white middle-class male myself). We need more like her.

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  • There is no one more suitable than Una Coales to be on this list, She is an outstanding Medical Educationalist who has written numerous books that have helped people in their careers.She has also had an long running MRCGP course which has helped many doctors to pass the MRCGP.

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  • I think Una Coales tells it as it is, lifts up rocks and shines light under it to have many a critter hiding there scarper and has done more for Primary care than many fanciful title holders. She has survived many a witchhunt and is still carrying on the fight for justice for many who are unable to speak for themselves due to various reasons. Even if not number 1, in my book, she should be in the first 10.

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  • Whistleblowers have always been burnt at the stake in our dear NHS, but Una has braved all that and at great personal loss is fighting the fight for many. Good luck to her and God bless her effort.

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  • How are RCGP Council Members like Una, who are also Trustees, allowed to profit from vulnerable trainees? She pretends to crusade for us and all the time she is living off us by charging extortionate amounts for her courses.

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  • I <3 Una. She wears the best heels :)

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  • RCGP response to the Independent Review of the Clinical Skills Assessment of the MRCGP examination

    Publication date: 27 September 2013

    RCGP responds to Independent Review of MRCGP exam saying there is no evidence of racial discrimination and all International Medical Graduates are assessed equally to graduates from the UK

    The RCGP welcomes this independent report and its key findings which show there is no evidence of subjective bias due to racial discrimination and that IMGs are assessed in exactly the same way as those from the UK.

    It also finds that lack of preparedness of International Medical Graduates may be an explanation for the differences in pass rate, but that the method of assessment is not. The CSA examination and marking are based on internationally recognised methods.

    The RCGP is committed to equality and diversity and has always strongly refuted allegations of discrimination in the MRCGP, subjective or otherwise. All of our assessment procedures are designed with fairness in mind but also to ensure safe care for patients, and we are always looking to enhance and improve our processes.

    UK medical graduates have more exposure and training in general practice, both through medical school training and the foundation programme, than most International Medical Graduates whose home countries might not have health systems as dominated by primary care as the NHS is in the UK.

    In noting the recommendations, we recognise many of the issues raised - particularly around the diversity of MRCGP examiners and role players, the mix of cases used in CSA exams and candidate feedback - and have been working hard to address these for some time.

    For the past three years we have proactively approached doctors with primary medical qualifications obtained outside the UK and those from Deaneries currently under-represented on the panel of examiners to apply for examiner roles.

    The ethnic mix of those role-players trained for the CSA is now broadly similar to the ethnic composition of the population of the United Kingdom and the RCGP is also reviewing the ways in which it can improve the feedback provided to candidates. We have already consulted with experts in this area, conducted an online survey amongst GP trainees, and are arranging a focus group with International Medical Graduates who have recently sat the examination.

    Next week, a paper will be published in the British Journal of General Practice which looks at candidate and examiner gender and ethnicity in the MRCGP and finds no bias.

    The College has co-operated fully with the GMC and Professor Esmail throughout the independent review and notes that the findings reflect similar disparities in other medical specialties.

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