The RCGP could allow struggling trainees to have a fifth attempt at the CSA and AKT exams in ‘exceptional circumstances’.
The college said it would be ‘receptive in principle’ to relax the strict cap of four attempts at either exam but only provided that the candidate had ‘undertaken appropriate additional educational experience’ since their previous attempt.
Increasing this cap was one of the options suggested by the BMA to make the CSA exam fairer to international graduates following the British Association of Physicians of Indian Origin (BAPIO) legal challenge against the RCGP.
Although a judge ruled the exam process did not directly discriminate against ethnic minority candidates, the judge told the RCGP it must work to address significant variation in pass rate between UK and international graduates and the college has said it is working closely with BAPIO to address race discrepancies.
However RCGP chief examiner Dr Pauline Foreman stressed that fifth attempts should be granted only ‘in exceptional circumstances’ or could potentially endanger patient safety.
She said: ‘The RCGP would be receptive in principle to a change to the current regulations to allow an exceptional fifth attempt at either the AKT or CSA provided that those sitting for a fifth time have undertaken appropriate additional educational experience since their last examination failure and sufficient progress has been made to merit a further attempt.
‘Analysis of examination data suggests that after four attempts at either the AKT or CSA a point is reached where further attempts at an examination are unlikely to be successful except by chance, and this has implications both for candidates and potentially for patient safety. Fifth attempts should therefore always be in exceptional circumstances.’