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RCGP open to further re-sits of CSA exam

The RCGP could allow struggling trainees to have a fifth attempt at the CSA and AKT exams in ‘exceptional circumstances’.

The college said it would be ‘receptive in principle’ to relax the strict cap of four attempts at either exam but only provided that the candidate had ‘undertaken appropriate additional educational experience’ since their previous attempt.

Increasing this cap was one of the options suggested by the BMA to make the CSA exam fairer to international graduates following the British Association of Physicians of Indian Origin (BAPIO) legal challenge against the RCGP.

Although a judge ruled the exam process did not directly discriminate against ethnic minority candidates, the judge told the RCGP it must work to address significant variation in pass rate between UK and international graduates and the college has said it is working closely with BAPIO to address race discrepancies.

However RCGP chief examiner Dr Pauline Foreman stressed that fifth attempts should be granted only ‘in exceptional circumstances’ or could potentially endanger patient safety.

She said: ‘The RCGP would be receptive in principle to a change to the current regulations to allow an exceptional fifth attempt at either the AKT or CSA provided that those sitting for a fifth time have undertaken appropriate additional educational experience since their last examination failure and sufficient progress has been made to merit a further attempt.

‘Analysis of examination data suggests that after four attempts at either the AKT or CSA a point is reached where further attempts at an examination are unlikely to be successful except by chance, and this has implications both for candidates and potentially for patient safety.  Fifth attempts should therefore always be in exceptional circumstances.’

Readers' comments (14)

  • Going by the way in which General Practice in general as well as how these useless examinations are being held, medical students will very soon only join General Practice Training in exceptional circumstances.

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  • Anonymous | Salaried GP | 13 July 2015 4:57pm

    Shocking, but actually is true

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  • I fail csa 3 time already?
    does anyone know "what come in csa"??

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  • According to Chief Examiner GP can endanger patients if they are given 5th attempt of AKT or CSA, I can only laugh on her thought, so Physian assistants and non speciality doctors will not cause danger to patient care, I would like to tell chief examiner that the more you practice the more you learn and become perfect, so any trainee will CSA if they achieved level required, I do not think that number of attempts make any doctor an unsafe doctor, RCGP will need to come out of this myth, why then they let us see patients on our own before CSA if we were not able to manage patients.
    I don't think that RCGP can understand their training😏

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  • RCGP feels that their own trainees can cause danger to patients if they don't pass CSA.
    So it means WBA and AKT is nothing plus old GP who never took CSA are probably not safe as well according to RCGP.

    What a Joke!

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  • Dear Chief Examiner Pauline are you talking about trainee's exceptional circumstances for fifth attempt or RCGP's and GP land's.😳😳
    I don't think that you ever consider trainee's exceptional circumstances. You only stick to your rigid rules and regulations,you are allowing 5th attempt because you need GPs.Otherwise you never bend your rules for trainees.

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  • I can't understand how RCGP determines safety, CSA everyday cases and cut off is different so you might do well on one day if cases in your favour or you pass on other day.
    Also for example a doctor passing on 74 or 75 marks is thought fully competent and doctor getting 73 or 73.5 is the dangerous and incompetent.
    RCGP please change your criteria of assessment.Assess all doctors on same cases,then it will tell you who is competent and who is not!
    Just a suggestion

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  • This will also help RCGP fill its coffers with some extra money for an extra attempt at CSA

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  • Why have a limit? If you fail your driving test 4 times you can still improve and try again. And let's face it the RCGP could use the money!!

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  • I stopped my MRCGP direct debit payments today. Useless.

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