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Dr Maureen Baker: ‘We agree that further action is necessary’



We welcome the verdict of the Court that the Clinical Skills Assessment (CSA), run by the RCGP, is lawful and fair.

Patients have a right to expect safe care and it is our responsibility to ensure that all doctors who qualify as GPs meet the highest standards to ensure this safe care. That is the purpose of this exam, and the other requirements to become a practising GP.

As an organisation committed to equality and diversity, we take multiple steps to ensure that our exam is robust, but fair to all candidates. These steps include giving our examiners and role players equality and diversity training, and ensuring that our examiners and role players come from diverse backgrounds.

The RCGP has been at the forefront of identifying the differences in pass rates for some time, including that international medical graduates do not do as well in the exam as those from UK medical schools.

Indeed, we were the first of the Medical Royal Colleges to publicly raise this issue and have commissioned and supported extensive research to understand what is happening and to try and identify what the causes may be.

We have always been, and remain, concerned by this issue, and are determined to continue to work with all other interested stakeholders in both understanding it, and looking to remedy it.

This will include working with both the GMC, as our regulator, and also with the training deaneries / local education and training boards who have responsibility for the training of those who take the examination. We will also continue to work with BAPIO, the British International Doctors’ Association (BIDA) and the BMA in relation to this issue.

We agree that further action is needed, and we are already working hard to find the best way of supporting the small number of trainees who fail to pass the CSA component of the MRCGP licensing exam to give them every chance of passing the exam.

We are already developing further web-based learning resources and publications to help trainees and their trainers prepare for the exam and are reviewing how to improve the quality of feedback that candidates receive from the exam so that they can target any areas of underperformance with their trainer.

We are also committed to acting on recommendations made in recent reviews to ensure the MRCGP minimises any possible risks of unfairness and we are very keen to work with the GP training community to develop effective training strategies for those who might struggle with the exam.

Overall, around 95% of candidates will pass the CSA. Of the College’s 30,271 Fellows and Members, who have declared their ethnicity, 30% are from a BME background.

We hope that today’s judgment means we can now draw a line under the events of the past year and concentrate on delivering a robust and fair exam for future generations of GPs and for the benefit of our patients.