The BMA is taking legal action against the RCGP based on its ‘discriminatory’ exam policy for GP trainees who receive a ‘late diagnosis’ of their disability.
Yesterday, the union’s GP Registrars Committee wrote to the college to publicly call for a change to the ‘rigid’ policy, which it said disadvantages those who receive a disability diagnosis after one or more attempt at an exam.
The RCGP’s ‘failure to acknowledge the unfairness of its policy’ has led the BMA to pursue litigation, with ‘several’ individual legal cases being launched to challenge the ‘lawfulness’ of the policy.
According to the union, there have been several cases where the current policy ‘had a potentially devastating impact on individuals with a disability’.
The letter said: ‘The college currently applies a rigid policy which means that registrars who receive a late diagnosis of their disability do not get the same number of fair exam attempts as other registrars.
‘This is because the college does not allow any extra examination attempts where a candidate was diagnosed with a disability after one or more attempt, and would have been entitled to reasonable adjustments (such as extra time) had they known about their condition and been able to obtain a formal diagnosis before their attempt(s).’
GP Registrars Committee chair, Dr Malinga Ratwatte, and deputy chair, Dr Elliot Philips, also cited guidance from the Academy of Medical Royal Colleges in their letter to the RCGP.
This guidance, published in November, said that when ‘new information’ such as a new diagnosis is received by a college, it should consider ‘whether this information will have affected all previous attempts’ and ‘the number of remaining attempts calculated accordingly’.
The BMA’s statement said: ‘Regrettably, despite repeated attempts by the BMA to seek a resolution the RCGP’s resistance to changing its policy has led to several individual legal cases being launched challenging the lawfulness of the policy.
‘To assist with the BMA’s legal action, we are urgently seeking further information from those potentially affected by the RCGP’s policy.’
The union has asked any GPs who are or were a registrar after 2011 to complete their survey.
Dr Ratwatte and Dr Philips wrote: ‘It is abundantly clear to the GP Registrar’s Committee that the RCGP’s policy is unreasonable and discriminatory by unjustifiably disadvantaging disabled doctors wishing to become GPs simply because they weren’t aware of their condition earlier.
‘This cannot be right – urgent change is needed.’
In response, RCGP chair Professor Kamila Hawthorne said: ‘We strongly refute the allegations made in this letter and are committed to ensuring that the MRCGP examination is lawful, consistent, and fair to all trainees.
‘Patients and the public need to be reassured that doctors passing the licensing exams for UK general practice are competent and safe.’
GP trainees can request reasonable adjustments at any point in their training, according to the RCGP’s website, which also says it is ‘committed to equality of opportunity’ in the MRCGP exam.
The college policy states that trainees can get reasonable adjustments for any future exam attempts if they receive a diagnosis of a disability such as neurodiversity after an unsuccessful attempt at the applied knowledge test (AKT) or simulated consultation assessment (SCA).
But it highlights that those unsuccessful attempts cannot be discounted, and it also urges trainees who feel an unsuccessful exam result may have been influenced by an undiagnosed disability to seek medical assessment as soon as possible.
‘The RCGP is unable to grant additional attempts at an examination (above the standard maximum number of attempts) where there is a late disability diagnosis,’ it added.
The college was recently forced to apologise after GP trainees sitting a new component of the MRCGP examinations experienced a ‘temporary outage’ which affected their ability to complete the assessment.
This led to the BMA demanding financial compensation for those GP trainees affected.
i am a bit lost here : You cannot do your first attempt until you have completed at least 5 years in Medical school, surrounded by Professors, 2 years as PRHS, and 3 years minimum in specialty training, surrounded by doctors specially trained in educational issues and recognising problems with trainees, and the exams include close contact with the most expert specialists in examining trainees, so how can a candidate ‘not know’ about something that is present before several attempts at the exam, and significantly disadvantages them in that exam, without any of these specialist medically-qualified expert educators noticing it?
Have we sort of been here before?
The British Association of Physicians of Indian Origin (BAPIO) sought to challenge by way of judicial review the lawfulness of the continuing adoption and application of the Clinical Skills Assessment (CSA) by the first defendant Royal College of General Practitioners (RCGP) as assessors and the second defendant General Medical Council as regulators.
@David Church It’s perfectly possible not to know until GP training. I actually was diagnosed autistic after my GP exams, but it was certainly during GP training where everything started unravelling. Yes, the signs were there. The first OT to suggest I was autistic did so during my medical elective in my 4th undergraduate year (a colleague in the hospital) but it was a decade later I was diagnosed, after several severe depressive episodes and a crisis team referral. I was under the mistaken belief that because I was “managing”, everything was fine. As you suggest, there is a mistaken belief that if you can survive medical school then you have all the coping skills you need. In reality, you are swimming faster than everyone else to keep up. Medical educators and medical professionals are extremely bad at spotting neurodiversity, especially in those who are passing exams. I think it is right to insist they do better.
Many practicing doctors and other professionals have a neurodiverse traits mostly without a formal diagnosis . For many it may actually be advantageous.and they (we) have found a niche that works well .What i admit to fail to totally understand is that if you have managed to pass A levels and other exams with the same bar as other students how can this bar now need changing. Please can I also be educated as to what will happen in the post qualification world of acute practice if one struggles in an exam setting. Happy to learn. (I also find it annoying that 2 organisations i pay money to are spending it on lawyers against each other) I realise this is a politically incorrect post showing my ignorance
Nicholas –
I don’t think your post was politically incorrect. It was extremely insightful. This is such a controversial/confusing situation
(no confusion about the irony of us personally funding both sides of the litigation though!)
I know the local training scheme in York is very keen to encourage neurodiversity screening for trainees so hopefully “late diagnosis” (in this context) will become unusual.
Rcgp is racist and get were taken yo court in 2013.