GP trainees’ fears around exit exam as RCGP struggles to accommodate candidates

GP trainees are fearing their preparation for the ‘recorded consultation assessment’ part of their MRCGP exams will have gone to waste due to the college underestimating demand.

The RCGP changed booking slots at short notice for when candidates can apply and submit their assessments due to very high demand and ‘a logistics issue’.

It is now making ‘the most strenuous efforts’ to accommodate everyone who needs to register for the RCA in March and April but some trainees are reporting they have been told that the college has said they will not be able to accept their assessment.

This is the last window for trainees to take the RCA, as this will be replaced in September by the simulated consultation assessment, which will see trainees take the examination virtually in their own practice with actors playing the role of patients in standardised cases. This still needs to be approved by the GMC.

As a result, those who are not given slots to submit their RCA videos in March and April will be unable to take the RCA assessment at all.

In July 2020, the RCGP rolled out the RCA as the third component of the MRCGP in place of the clinical skills assessment (CSA) to enable trainees to complete their training programmes and enter general practice, given the restrictions and disruption caused by the pandemic.

While the CSA had required all trainees to be assessed in person at the RCGP in London, the RCA sees candidates having to submit recordings of 13 consultations, which cover a number of mandatory criteria, with marks given in three domains – data gathering, clinical management and interpersonal skills.

An RCGP spokesperson said: ‘We have only just become aware of the size of the problem, which is a logistics issue that must be resolved.

‘We are making the most strenuous efforts to accommodate everyone who needs to register for the RCA and will keep you appraised of what is happening.

‘Please do not worry, we are listening to you all, and aware of many individual cases that need addressing. We will address them.’

GPs argued that changing booking times and eligibility criteria at short notice was unfair on trainees who had already had stressful training periods due to the pandemic.  

Trainees on social media detailed the problems:

Dr Lucy-Jane Davis, a GP registrar and chair of BMA SW Regional Council, said: ‘What’s upsetting is asking for understanding when the impact for individual registrars is massive. So many, very understandably upset doctors out there and such an absence of support for them from their own college.’

Dr Ayesha Shafaq, an ST3, said: ‘This is utterly shocking. I along with countless other ST3 trainees have been working so hard in recording and attending courses for RCA, only to be told last minute, without any warning, this we will not be eligible for April RCA?’

Due to ‘very high candidate demand’ for the April RCA sitting, RCGP and COGPED have now agreed to increase capacity so those AITs with a CCT date before the end of September 2023 can register for the April examination.

The college has announced a list of changes for the March assessment (see box, below) and said it will be issuing an update imminently.

The college said: ‘The Exam Team is working really hard, and at the highest levels in the College, with our partners in the Deaneries, to find out exactly how many candidates are going to need to take the RCA before the SCA comes into being (it is currently awaiting accreditation by the GMC which is why we haven’t been able to tell you very much about it yet).’

It added: ‘We do understand though that trainees who sit the RCA in April will be concerned around resit opportunities and so we feel it is important to communicate that for any trainees who are unsuccessful in the RCA before the end of the 2022/23 academic year, there will be an opportunity for a final RCA sitting in autumn 2023.’