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GPs who perform poorly in exams more likely to be sanctioned, finds study

GPs who perform poorly in postgraduate exams are up to 12 times more likely to face professional sanctions during their medical career, new research suggests.

The study by UCL and the University of Cambridge found the correlation between low exam scores and professional sanctions applied equally to GPs and doctors in other specialties.

Researchers assessed the exam results of UK-registered doctors in knowledge-based exams and clinical assessments set by the RCGP and the Royal Colleges of Physicians.

It found that doctors sanctioned by the Medical Practitioners Tribunal Service (MPTS), which runs hearings about whether doctors are fit to practice, had scored far lower on both the knowledge and clinical skills assessments.

Each additional increment in knowledge or skill contributed to a reduced likelihood of later sanctions. Doctors in the lowest 2.5% of exam performance were about 12 times more likely to have sanctions than those in the top 2.5%, the research found.

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According to Dr Katherine Woolf, a co-author of the study at UCL Medical School, it was the first study of its kind.

She said: ‘The findings demonstrate that postgraduate examinations measure important high-level knowledge, skills, and attitudes, which underpin doctors’ real world behaviour. The findings contradict the frequent assertion that postgraduate medical examinations are unrelated to doctors’ clinical practice.’

Professor Chris McManus, one of the lead authors at UCL, said there were no real differences between how GPs and other doctors performed in the study. For both groups the clinical assessment proved a slightly better predictor of future sanction than the knowledge test.

He said: ‘For GPs, the talking to patients of the simulated surgery seems to be a better predictor than the knowledge test.’

The study cited previous research stating that GPs are among the most likely doctors to be sanctioned whereas other doctors are among the least likely. However Professor McManus said that why this might be the case was still not widely understood.

The study did not distinguish between different types of sanctions. Nor did it take into account changes to the GMC’s fitness-to-practise procedures that occurred over the study period.