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New CSA figures reveal widening gap in first-time pass rates between IMGs and UK graduates

Exclusive The gap between the pass rates of UK graduates and international medical graduates (IMG) taking the clinical skills assessment (CSA) exam for the first time widened in 2011/12, official RCGP figures show.

The latest statistics show that 65.3% of IMGs failed their first attempt at the CSA exam in 2011/12, compared with 9.9% of UK graduates. In 2010/11, 59.2% of IMGs failed at the first attempt, compared with 8.2% of UK graduates.

But the overall failure rates between the two groups slightly narrowed, with failure rates for IMGs rates decreasing from 63.2% to 62.6% from 2010/11 to 2011/12, compared with an increase in failure rates from 9.4% to 11.5% for UK-trained graduates.

Although the RCGP says comparisions based on demographic variables should be done on the basis of ‘first attempts’ only: ‘Otherwise re-sitters will bias the results’.

The results come as the British Association of Physicians of Indian Origin confirmed it is pressing on with a judicial review against the college over the differential pass rates, which mean UK graduates are six times more likely to pass the CSA than IMGs. It also comes after the GMC commissioned an independent review into the MRCGP exam failure rates.

The differentials between white UK graduate and black UK graduate failure rates remained high, with 5.8% of white UK graduates failing the exam compared with 24.4% of black UK graduates.

The gap between the number of IMGs and UK graduates passing the applied knowledge test also widened. Half – 50.6% - of IMGs failed the AKT exam in 2011/12, compared with 46.5% in 2010-11. The number of UK-trained graduates failing the exam remained at 16%.

Chief examiner Dr Sue Rendel wrote: ‘Like most postgraduate medical exams, there are variations in their performance of various candidate subgroups in both the AKT and the CSA. Exploring and trying to understand the reasons for this has been a priority for the RCGP for the last few years.

‘Having taken the lead on a cross-specialty review of postgraduate examination data, we are pleased that the GMC have decided to require all colleges to report the results in a similar way to our previous years’ reports and anticipate that this will provide a rich and useful data set for investigating this issue across all specialties in the future.’

She also said that the King’s College analysis of the CSA exam results was due to be published in the spring. ‘Early results indicate that there will be considerable amount of material that can be used to develop a tool kit for helping trainees prepare for this module,’ she wrote.

Dr Kamal Sidhu, a GP trainer from County Durham, said: ‘While the college ought to be applauded for leading the way in providing these detailed figures, it is extremely sad and disappointing that it has failed to take any corrective steps. It is of utmost concern that trainees belonging to certain ethnicities continue to struggle in disproportionate numbers.The college cannot wash its hands of the matter by sticking to its stand that the examinations have no flaws.

‘The fact remains that many trainees continue to fail these examinations multiple times despite being competent in other assessment modalities. If they are unsafe after three years of training, something very fundamental is wrong with the process. Nevertheless, I remain extremely optimistic that the college will work towards reducing this disparity. The training community remains extremely worried about these trends and their impact on all concerned.’

Readers' comments (36)

  • Sathyameva jayathe - "Truth will Prevail"

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  • I can understand why there is such a difference between international medical graduates and UK graduates given the cultural differences between UK and many overseas countries which isn't anything to do with race - but odd that there are differences between white and black UK graduates. But why are there differences between latter - there are obvious differences when it comes to communication skills between women and men - are more of the black UK graduates male and most of white UK graduates women? that might explain some of the differences?

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  • If - after just how many years of training?!? - they need to "develop a tool kit for helping trainees prepare for this module" (God give me strength!!!), then the training is obviously inadequate.

    Not the trainees.

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  • Vinci Ho

    The bottom line is an ' explanation ' , no matter how bizzare it is , will have be presented to the public . JR is about whether this explanation is acceptable or not.
    The figures are too extraordinary to be ignored. The design of the examination must be analysed by independent party . Because it is the ONLY test to give permission to a doctor to practice as GP in this country , it must demonstrate its fitness to be implemented .

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  • IMG's please dont consider Genral Practice untill CSA fiasco sorted; Apply for different speciality If you are already in GP scheme

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  • @15:07 you are spot on. IMGS must be told clearly what is happening and be dissuaded from joining General Practice until the CSA situation is taken seriously and sorted out. How many years has it taken to get to this point? very sad.....

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  • We can understand that an issue that started as noise over the internet is gathering momentum and storm through JR, the umpire called RCGP mentioned is still trying to understand and explore reasons for the differential in failure rates between IMGs and local graduates for the past few years, the years are 2010, 2011 and 2012, yet people's careers are ruined, they face huge debts through repeated attempts in csa exams, they are even referred to GMC for patient safety over actors' exam for their names to be stricken off the register, even about 300 IMG doctors have been released from GP trainings but RCGP is still exploring, is it not in this same country that we had MTAS issue, MTAS was cancelled because it did not favour local graduates for specialty training and it did not take up to 6months before Mtas was cancelled, These same doctors are asking RCGP to videotape so that appeal process will be more opened and possibly reveal whether the over 96percent of local graduates passing the csa exam actuall did pass.?How can will build a just and fair society that represents one nation in all RCGP a right wing organisation? Judicial Review will surely reveal so much. So how many years will it take RCGP to complete their exploration most especially since it is only IMG graduates that are affected. Can we honestly say that CSA is an exam that is fair for all?

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  • iam sorry to so say that there is no freedom of speech in pulsetoday. why have you removed my comments ,what is offensive in it ??

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  • Leaders are tested in crisis time. Unfortunately, the chair of RCGP, chief examiner & co have failed miserably to sort this unholy mess. Their stance and stubbornness has been extremely disappointing.

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