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BMA calls for review of postgraduate GP training to address alleged racial bias

The whole of postgraduate GP education should be reviewed for international medical graduates, with training tailored to ‘individual needs’, the chair of the BMA GP trainees subcommittee has said.

Dr Krishna Kasaraneni said one curriculum was not enough and that ‘the whole process has to be looked at, not just the end measure’, but said he acknowledged constraints on funding would make this difficult to achieve.

Dr Kasaraneni was speaking at a session on training at the RCGP annual conference in Harrogate last week. It comes after a row erupted over a review of the MRCGP exam by academic Professor Aneez Esmail, who refuted RCGP and GMC claims his report had exonerated the exam of any racial bias.

RCGP chair Professor Clare Gerada said in her final annual conference address that she was sorry that the allegations of bias were causing distress, but that the college completely rejected the claims.

She said: ‘I am very sorry these allegations are causing so much distress. But as an organisation that takes equality and diversity very seriously, the College refutes the claims – totally. And last week I was pleased to see the College was vindicated by an official GMC report that found “the method of assessment is not a reason for the differential outcomes”.’

Speaking later at the session on training, Professor Gerada added: ‘We have unbelievable faith in the IMGs, my father was one of them. But we cannot expect to have an exam where just because you’re sitting it you de facto pass it.’

But the Dr Kasaraneni insisted questions over the differential pass rates for international and UK medical graduates from non-white groupsneeded to be answered. He said: ‘If someone is failing at the end of three years, the whole process has to be looked at not just the end measure. The problem isn’t simply about where somebody’s trained and then they’ve come here. IMGs don’t just land at Heathrow and come in and take the CSA.’

He added: ‘Professor Esmail [in his report] published last week specifically said the problems IMGs face compared with UK graduates are very, very different. Language plays a role – but there’s also issues regarding primary care in that person’s country of origin.’

But Dr Helen Stokes-Lampard, RCGP honorary treasurer, defended the College’s position. She said: ‘We have to look at it from the patients’ point of view – call it the “Daily Mail” test. They want doctors who have passed exams, they want doctors who have been given the qualifications for doing the time in training, they want them to have proven they are of a standard to be good at the most difficult job in medicine, which is being a good generalist.

‘The differential pass rate is something we all regret – it’s not ideal and we will try to address what we can. But the reality is we’ve got to defend our patients – I’m not getting a plane with a pilot who isn’t qualified to fly that plane.’