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GP trainees locked out of MRCGP exam could get ‘sixth’ attempt

Exclusive The RCGP is considering adding a further sixth attempt at its end of training Clinical Skills Assessment for doctors who have been locked out of general practice by being unable to complete the final exam.

The RCGP told Pulse it was considering the changes in conjunction with education bosses’ plans for a ‘Targeted GP Training’ (TGPT) programme to support doctors unable to pass the CSA or changing specialty.

Black and minority ethnic doctor representatives said requiring trainees to pay ‘almost £2,000’ for another retake did nothing to address fundamental issues with the exam which mean non-white doctors are much less likely to pass.

But the BMA’s GP trainee committee was more hopeful, saying that the individual education support package in the programme could be the difference, rather than ‘doing the same thing over and over again.’

Tthe RCGP only allows four attempts but in August 2016 began allowing a fifth ‘in exceptional circumstances’.

Dr Ramesh Mehta, chair of the British Association of Physicians of Indian Origin (BAPIO), said that College representatives were receptive to the idea of allowing failed CSA candidates toretake the exam after been locked out of training in a meeting last week. 

He told Pulse: ‘They said that there is a possibility that the number of attempts, which is four at the moment [with a fifth in exceptional circumstances], is going to go up to six.’

However, he said that the RCGP continued to insist that BAPIO’s proposed changes to its exam, such as providing video feedback to unsuccessful applicants or using two examiners to correct for bias, were ‘too expensive’.

Dr Mehta added: ‘The amount of money they charge for these exams is nearly £2,000 and these poor trainees pay every attempt. But they [the RCGP] are saying their exam is making a loss.’

RCGP chair Professor Helen Stokes-Lampard said changes to the exam are ‘unlikely to be implemented’ before it has heard back independent review of the MRCGP’s first ten years – as revealed by Pulse.

The College meets regularly met BAPIO and others to ensure ‘all elements of the assessment remain fair to all candidates’ and she added: ‘During our last meeting with BAPIO, the possibility of further attempts at the Applied Knowledge Test or Clinical Skills Assessment was discussed in the context of potential Targeted GP Training proposals being considered by HEE – but until these are published we are not in a position to make any decisions or comments.’

GPC education, training and workforce lead Dr Krishna Kasaraneni told Pulse that ‘simply adding more and more attempts isn’t going to serve a purpose’.

‘I’ve spoken against it before, because what’s the point of doing the same thing again and again without extra support or added focussed training.

’But this scenario is looking at people who have been unsuccessful in the past and have used up all their attempts but putting them through the targeted training programme and giving them a chance to get through the assessment.’

The TGPT programme is working to identify how many GPs could benefit having failed before, but Pulse revealed last year that RCGP records showed around 400 doctors had hit the maximum attempt threshold.

The talks between BAPIO and the RCGP follows a High Court challenge by the association three years ago which ruled the College’s exam was lawful but that action was needed to address the gap.

But last week Pulse revealed that the College’s own figures show it is the widest ever recorded in the MRCGP qualification’s ten-year history.