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GPC to investigate MRCGP exams

Grassroots GPs have backed a GPC investigation into the controversial MRCGP exam and raised questions about the exam’s validity following an impassioned debate on the first day of the annual LMCs conference.

The conference agreed that the differential pass rates between UK and international medical graduates raised concerns about the exam’s validity and demanded that feedback from the exams is improved immediately. It also called on the RCGP to set up career guidance for trainees who have had to leave training after multiple failures of the exam.

The BMA’s intervention will pile the pressure on the RCGP, which is currently the subject of a possible judicial review from international doctors groups and an ongoing GMC review.

The RCGP recently revealed that the gap in first-time pass rates for the Clinical Skills Assessment (CSA) exam widened in 2011/2012, coming shortly after the GMC commissioned an independent review into MRCGP exam failures.

Proposing the motion, GPC member Dr Chris Williams said: ‘General practice can be proud of the cultural diversity it embraces. But something is wrong, something is broken in how we train our international medical graduates.’

Dr Williams said getting onto a GP training programme involves a rigorous selection process, with those offered a place identified as having the necessary qualities to succeed. Yet too often these people are released after three or more years learning the craft, with no option but to leave general practice for good, he said.

‘We should be concerned if there’s a group that has particularly low pass rates. For several years now, it’s been clear that successive cohorts of international medical graduates have had less success in navigating the assessments they are required to undergo.’

Dr Asim Safdar, from Bedfordshire, said the MRCGP clinical skills assessment has a pass rate of 91% for UK graduates and only 36% for non-UK graduates and an investigation into the discrepancy was ‘long overdue’.

He said: ‘We need these trainees to come through, properly qualified, to help ease the burden of overworked NHS GPs.’

Dr Saqib Anwar, from Leicestershire and Rutland, told delegates that non-white international medical graduates have a ‘shockingly’ 25% higher failure rate than their white counterparts and highlighted that black and ethnic minority UK graduates fare worse than White UK graduates.

Dr Anwar acknowledged that the RCGP, the GMC and Academy of Medical Royal Colleges are all looking into the problem, but said not enough has been done.

‘We need good doctors from diverse backgrounds to deliver high-quality patient-centred care to our diverse patient population,’ he said.

‘It is imperative that the BMA contributes to moving this “slow moving tanker” for the benefit of everyone,’ he said.

Speaking against the motion, Dr Andrew Purbrick from Dorset said there is a need to look at the reasons for the disparity in pass rates and the possibility of providing more support for international graduates, but cautioned against challenging the validity of the exam process itself on this basis alone.

However, Dr Krishna Kasaraneni, chair of the GPC GP trainees subcommittee, countered that it is clear that many GPs are concerned the problems do raise questions about the validity of the exam.

He said: ‘It’s time to get a move on and get this sorted once for all.  The BMA will take this to the GMC and the RCGP and we will see it through.’