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LMCs reject introduction of ‘intermediate’ grade for GPs who fail MRCGP exam

GPs threw out a proposal to introduce a new ‘intermediate’ grade for failed trainees in a hotly debated motion on the first day of the annual LMC’s Conference.

The motion – proposed by Dr Andrew Paterson from Hampshire and Isle of Wight LMC as a way to fill gaps in the GP workforce – was overwhelmingly rejected by conference after GPs warned it would create a ‘two-tier’ system and would be ‘dangerous and divisive’.

Dr Paterson urged for the new intermediate grade to keep trainees who failed the MRCGP in general practice ‘so that they may enjoy a safe and fulfiling career in a supervised capacity and their training time and effort is not wasted’.

Some GPs were sympathetic to the plight of GP trainees who they believed had proved themselves good and safe doctors, but repeatedly failed a part of the MRCGP.

Dr Peter Wiliams, from Derbyshire LMC, described the case of a registrar at his practice who ‘passed his AKT easily’ and who his partners felt ‘was an outstanding doctor’ but who he said ‘got stage fright in front of actors and failed his CSA five times’.

‘In my day, he’d have done a video and passed, but unfortunately he failed,’ said Dr Williams. ‘The system isn’t working and we’re not retaining some of the doctors we should be retaining – whether we should have a subgrade in general practice or need to examine differently I can’t be sure, but what I do know is we need to keep these people working in general practice.’

However, Dr Simon Minkoff from Hertfordshire warned delegates creating an intermediate grade would be ‘dangerous’, ‘set back UK general practice decades’ and ‘create ‘a two-tier post-code lottery of those practices wholly staffed by fully trained GPs and those not’ that would result in a ‘loss of patient trust and erosion of respect for the profession’.

It follows a long legal battle around the fairness of the Clinical Skills Assessment component of the MRCGP exam, after an international doctors group pointed to huge discrepancies in the number of international medical graduates failing the exam.