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RCGP vows to take action on MRCGP failure rates after High Court ruling

The RCGP has said it will take further action to support trainees who fail the MRCGP exam, after a High Court judge said ‘the time has come to act’ on differentials in the pass rates between white and non-white candidates.

The Mr Justice Mitting found in favour of the RCGP, adding that the clinical skills assessment was a ‘proportional’ way of deciding who can practise as a GP, despite differences between the pass rates of white and non-white medical graduates.

The claims against the RCGP and the GMC were wholly dismissed, but BAPIO has said it is considering appealing the verdict.

However, the court did says that ‘the time has come’ for the RCGP to address the differentials in the pass rates.

He said that the claim – made by the British Association of Physicians of Indian Origin – was made in ‘good faith by an organisation acting in the best interests of the public’, adding that BAPIO had ‘achieved, if not a legal success, then a moral success’.

The court did find that the RCGP had a duty to carry out an equality assessment under the Public Sector Equality Duty, but was satisfied that the 18 reviews of the exam that have been undertaken so far have achieved this aim.

He said the reviews showed ‘unavoidable unconscious bias’ due to the nature of the assessment, and that some of the significant differences in pass rates between racial groups could be put down to education and cultural differences.

However, the judge added that the college must now act upon the recommendations of the various reviews, and added that any failure to do so would leave it open to a future legal challenge.

He ruled: ‘The college needs to act to eliminate discrimination and has identified some of the means by which that need might be addressed and fulfilled.’

‘If it does not act, and its failure to act is the subject of a further challenge, it may well be held to have breached its duty.’

RCGP chair Dr Maureen Baker said: ‘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.’

She added that they agreed with Mr Mitting’s comments: ‘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.’

Niall Dickson, chief executive of the GMC, said: ‘We do understand that there are serious and complex issues at play here. International medical graduates have made a huge contribution to healthcare in this country and we will continue to do whatever we can to support these doctors who provide so much frontline care in the UK.’ 

Dr Ramesh Metha, president of BAPIO, said the result was ‘disappointing’, but there were positive elements for BAPIO.

He said: ‘We need to think about what our priorities are… We will be seeking a meeting with the college to see how we can move forward from here.’

‘We have to do what is good for the medical profession and the public, and we need to work together to find a solution to a problem – everyone has accepted there is a problem.’

He added BAPIO is considering an appeal.