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RCGP faces legal threat over international GP trainee failure rates

Exclusive: The RCGP is facing the prospect of legal action unless it makes changes to rectify the high failure rate of international GP trainees in the MRCGP exam.

Pulse can reveal that the British Association of Physicians of Indian Origin (BAPIO) is in the process of taking advice on a group legal action with regards to the examination – including the possibility of a judicial review.

BAPIO says the RCGP is not doing enough to address the ‘huge’ differential pass rates between international and UK GP trainees in the new MRCGP, introduced in 2010.

The move comes as the GPC trainees subcommittee also began discussing the issue, after it had a rush of emails about it. The British International Doctors Association also told Pulse it was planning to hold a meeting about the issue.

The move reignites a long-running row over the MRCGP. The RCGP commissioned a review of possible racial and sex biases in the exam in 2010, after the college admitted that ethnic-minority candidates were continuing to perform ‘differently’ to other candidates.

The latest available figures show that, in 2010/11, the failure rate for international graduates taking the CSA component of the MRCGP was 63.2%, compared with 9.4% of UK graduates.

BAPIO is set to meet college representatives in the first week of December and will contact the NHS Confederation and the GMC, but is taking legal advice on what to do if the disagreement is not resolved.

Dr Ramesh Mehta, president of BAPIO and a consultant paediatrician, said: ‘The discrepancy is so huge. All these people have gone through the same training for three years. Only the bad apples – maybe 2% or 3%, not 70% [should fail].

‘We want to solve this problem. It would be best to sort it out by discussion. But if we can’t, then we have to go down the legal route.’

When asked whether this meant a judicial review or individual actions, Dr Mehta replied that BAPIO was looking at ‘all possibilities’.

Dr Krishna Kasareneni, chair of the BMA GP Trainees Subcommittee and a GP trainee in Sheffield, said it was also due to discuss the issue at its meeting next week.

He said: ‘We have been getting a lot more emails over the past few days.  We will speak to the college about what we can do.’

A spokesperson for the RCGP said it was constantly monitoring the performance of international GP trainees: ‘The RCGP/Kings College London project is due to report in the next few months, the aim being to provide an analytical framework for developing supportive educational resources.’

But Dr Kamal Sidhu, a GP trainer in County Durham and an international medical graduate, said: ‘The royal college stands completely detached from the situation on the ground.

‘It is time that the college woke up to this grim scenario and started a practical and fair review of the examination.’

Dr Una Coales, an MRCGP course provider and a member of RCGP Council, said: ‘I am concerned there is a large difference in pass rates between UK and international graduates sitting an exam after three years of UK specialty training.’