RCGP to investigate plunging pass rates

By Gareth Iacobucci

Exclusive: Pass rates for the RCGP's new licensing exam have crashed dramatically this year, with the college blaming an unusually low quality of candidates.

The pass rate for the new version of the MRCGP clinical skills assessment has plummetted from 81% last year to just 46%, fuelling concerns that the quality of new candidates is falling because of a drop in the number of aspiring GPs.

The RCGP is also being forced to investigate whether the ‘unusually low' scores are a product of the changes it has made to this year's CSA, with pass marks now set using the ‘borderline-group method'.

The changes mean that candidates now receive a total numerical score for 13 cases instead of receiving individual marks for each case, with the pass mark set by the combined judgements of examiners for that day. This is a departure from the old system where candidates only needed to pass eight cases out of 12.

The fall in pass rates will further reduce the number of young GPs entering the jobs market, exacerbating the problems many practices are experiencing in filling new positions.

The RCGP said lower marks had been expected in the September cohort because of the high proportion of people retaking and the large number taking the exam for the first time, but that it would investigate the reasons for the surprisingly sharp fall.

Dr Michael Bewick, chair of the RCGP assessment committee, said: ‘The overall pass rate is just under 46%. That is unusually low, and we are looking at why.'

Dr Bewick said the college was satisfied with the revised method of testing and said

it had a duty to fail those who didn't match the standards set by the GMC: ‘We think it's to do with the cohort rather than the assessment. At the end of January, when the next two cohorts have gone through, we'll get a clearer picture. We have to make sure for public safety that people don't get through who shouldn't.'

One GP registrar who failed this year's CSA told Pulse: ‘The new assessment is entirely different from the previous one. How is this fair when my colleagues went through the previous version, not this looking-for-perfection assessment?'

Dr Una Coales, a GP trainer in Stockwell, south London, said: ‘My concern is that we may be setting the bar too high.'

But news of the drop in pass rates came as the GMC reported ‘significant concerns' over aspects of medical training following a major survey of medical trainees and trainers.

Trainees responding to the survey raised concerns over limited time for training, with some worried they were being asked to take on tasks beyond their competence.

Dr Tanya Johnston, a GP in County Durham and director of the Northumbria vocational training programme, said the standard of candidates she was seeing was ‘variable'.

‘I do wonder whether the foundation years have prepared them for independent practice,' she said.

* Please note: this story was amended on 13 October to clarify the exam marking process - for full details please see the RCGP website.

Are you about to sit the CSA? Click here to read a new multi-part series offering practical advice on how to pass the exam from GP training programme director Dr Nigel Giam.