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CSA: A trainee's tale

Pulse hears from one trainee and his trainer

Dr Qureshi/Dr Taylor

Source: N.O’Connor

‘I failed by one mark’

I’ve never been a bad trainee. My trainer spoke to my patients and did not hear any complaints. In fact, my patients’ feedback was above average.

I failed my fourth attempt at the CSA in 2012 by just one mark. I spent around £10,000 on the exams; £9,000 for the fees and £150 in expenses for accommodation and petrol every time I took the exam. What annoyed me was the college’s treatment of expelled trainees. What I learned from the college was to be kind to patients. But the college never replied to me when I wrote to it. It was only after my MP wrote that it replied.

I am seeing if I can move to the USA. I feel I have no choice left. I have a young family. Obviously it won’t be easy to move.

Dr Muhammad Kamran Qureshi (pictured, foreground) is currently working as a locum middle-grade A&E doctor in Rochdale

‘I never had a complaint’

My trainee saw 2,000 people over 18 months with us. I never had a complaint and his communication was fine.

At the moment, the college is using the CSA as its failure marker. Realistically, it ought to have a look at allocating a third of failures through the CSA, a third through the applied knowledge test and a third through workplace assessment. That would end up being a little fairer, especially to overseas graduates.

Dr Steve Taylor (pictured, background) is Dr Qureshi’s former trainer and one of 18 GP trainers who were signatories to an open letter claiming competent trainees were failing the exam
multiple times

Readers' comments (50)

  • In my opinion, Biggest failure of the CSA is that it is unable to discriminate between competent and the otherwise!!! The proportion of the competent doctors who fail the exam is simply unacceptable.
    Justice will only be served by an independent inquiry into the exam. There is so much of secrecy and denial around this exam. Proper independent investigation will shed some light into this fiasco which ruined so many good doctors lives.

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  • DR Taylor I am pleased to see you on the picture. I agree that there is no intentional bias, but suubconcious bias against IMG. I know the actor and examiner can find difficult to listen to the IMG, Unfortunately, this is the reality. We have to deal with all kinds of accent. I do find difficult to liten to EU foot ball coaches and EU doctors who are working here

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  • This trainee is fortunate to have a supportive trainer. Other trainees are not so fortunate. The survey results of GPs who never had to sit the CSA to become GPS shows the distinct lack of empathy they have for trainees. My advice to Bapio is that it must now campaign for IMGs to stop entering General Practice altogether in the first place. They simply dont want us and nothing has changed at all since this fiasco began. It would stop a lot of families and people's lives being destroyed

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  • This picture speaks volumes.... a supportive trainer and a concerned IMG!! Like a beacon guiding a ship through troubled waters....True...not all of us very lucky and none so brave to come forward. Hats off to you Dr Taylor and all the best Dr Qureshi...From another IMGs in the same plight.

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  • I missed by one mark in my 3rd attempt. Passed 9 cases, 1 borderline and 3 fail cases. In one station examiner gave me overall 1 mark. In one station examiner changed from Clear Pass to pass.
    I asked for the details sheet and Sue Randel said your score range from 1 to 8. . This is how CSA AND RCGP is biased against IMGs.

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  • Friends, brave, be strong...the time is coming soon.We will fight this injustice... we need to changes the double stds these people set.

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  • To 05 February 2013 2:50pm
    Very sorry to hear your and many other's stories. Alas, what is so special in that 1 mark which can make or break a hard-made career. Will the UK board please enlighten me on this.

    I shudder to think that about 6 years ago I almost entered this insaneness; but decided to come to USA and have no worries about any exit exams. If our program directors feel that we are competent physicians, the American boards have no further issues in allowing us to work in USA.

    Can't do much other than giving my best wishes to you and your family.

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  • Well the answer to this can only be had if the whole puzzle of MRCGP exit exam is dismantled.
    GMC has the certification responsibility not college.
    If RCGP finds nothing wrong in failing IMGs who have come after going through 3 qualifying exams to be registered with GMC and then entered GP Vts after going through various assessment then how do imgs fail and not White local graduates.
    Answer is simple if RCGP isn't willing to talk on changing or accepting responsibility then GMC needs to take over the exit process.
    Tax payer's money cannot go waste just because 13 examiners and actors did not feel the candidate was good enough!

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  • Dear ALL
    The question is not all about good or bad // fair or unfair. If there is a perceived notion about IMG 's being indifferent to British culture and British jokes - why are they taken into training ??? Is it only to make use of service provider aspect. Why IMG's are not trained as accordingly with focus to improve their communication and developing understanding of British values. Why at the end of their training they are subjected to racial prejudice. Why only IMG's are expelled and not White British graduates. RCGP // Deanary // Trainer all of them should be made accountable and not poor IMG - we are not refugees and it is only after hardships - IELTS // PLAB // COTS// CbDs // MSF // PSQ // DOPS // Reflective Log entries - You say we are not fit to be a GP. It is absolutely unacceptable - myself being an IMG have no other choice but to accept the insult. I think all the IMG's irrespective of Speciality or GP training should rise above , unite and give a beffiting response about this instituionalised racism.
    Poor IMG

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  • “To believe in something, and not to live it, is dishonest.”
    ― Mahatma Gandhi
    Genuine respect for Dr. Taylor. I am sure there are so many soles like Dr. Taylor are out there feeling the same but perhaps need more courage to come forward.
    I am truly surprised not very many trainers/PDs voice their opinions regarding CSA.
    Integrity and honesty should be a core value we all doctors must possess. If we do possess the very quality we should not turn the blind eye to an injustice for our convenience.

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