Membership of the Royal College of General Practitioners

Membership of the Royal College of General Practitioners (MRCGP) is a postgraduate medical qualification in the United Kingdom (UK) run by the Royal College of General Practitioners (RCGP). On successful completion of the assessment, general practitioners are eligible to use the post-nominal letters MRCGP that indicate Membership of the RCGP (with continued payment of RCGP fees).

The MRCGP exam was first offered to doctors in 1965 and was originally an optional qualification. In 2007 the MRCGP became an integrated training and assessment system to prepare doctors for working in general practice.[1] Doctors are now required to succeed in the MRCGP assessments in order to be issued with a certificate of completion of their specialty training (CCT) in general practice.

MRCGP Postgraduate Qualification since 2007

In 2007 a new system of assessment was introduced, delivered locally in conjunction with deaneries, with the qualification awarded on completion of a three-year specialty training programme.

Immediately after the introduction of the 2007 changes the term "nMRCGP" had helped to differentiate between old and new assessment procedures (with n meaning new). After several years, once all trainees were being assessed using the new methods, the "n" was dropped.

GP Curriculum

The GP Curriculum was first published by the RCGP in 2006.[2] The Postgraduate Medical Education and Training Board (PMETB) approved it to be used for GP Specialty Training, and it was introduced for all programmes starting from 1 August 2007.[3] The curriculum is continually updated.[4]

Having taken over from PMETB as the body responsible for assuring postgraduate medical education, the General Medical Council (GMC) approved the GP curriculum and assessment blue print against the published standards in 2010.[5]

MRCGP assessment

MRCGP assessment comprises three components, each of which tests different competences using validated assessment methods. In combination these assessments cover the spectrum of knowledge, skills, behaviours and attitudes that are outlined in the GP Specialty Training curriculum.[6]

Applied Knowledge Test
  • The Applied Knowledge Test (AKT) is a multiple-choice computer based assessment that tests the knowledge base underpinning general practice in the UK.[7] It covers clinical medicine, critical appraisal/evidence-based clinical practice and health informatics/administrative issues.

Clinical Skills Assessment
  • The Clinical Skills Assessment (CSA) assesses a doctor's ability to integrate and apply clinical, professional, communication and practical skills to general practice.[8] It simulates patient consultations based on scenarios drawn from general practice. Each consultation is marked by a different assessor, and the role of the patient is taken by a trained role-player.

Workplace-Based Assessment
  • The Workplace-Based Assessment (WPBA) uses a number of tools to evaluate a doctor's performance over time, in twelve areas of professional competence.[9] This assessment takes place in the workplace throughout a GP specialty training programme.

History of the MRCGP Qualification

The MRCGP exam was first offered to general practitioners in 1965 and from 1968 it has been a requirement for GPs to hold this in order to join the college.[10] Before 2007 the MRCGP was a credit accumulation exam. Candidates needed to pass four modules within three years, or retake the whole exam.[11]

Controversy

Analysis of the results of the CSA part of the MRCGP examination showed that some groups of doctors were more likely to score lower marks.[12] Consistently high failure rates were seen amongst doctors who had gained their primary medical qualification outside the United Kingdom, who were mostly of South Asian and African origins.[13] The GMC asked Professor Aneez Esmail to carry out an independent review of the MRCGP exam which was published in September 2013.[12][14] In October 2013 legal action taken by the British Association of Physicians of Indian Origin (BAPIO) led to a judicial review being granted to review the fairness of the CSA assessment, although the judge also ruled that the GMC should also be included in the action.[15] At the Judicial Review hearing at the High Court in April 2014, the Clinical Skills Assessment (CSA) was judged to be lawful.[16]

References
  1. McKnight, Agnes (2005). "Changes in Vocational Training for General Practice". Ulster Medical Journal. 75 (1): 3–4. PMC 1891791. PMID 16457398.
  2. Wedderburn, Clare (2 Dec 2006). "The new GP curriculum". Career Focus. BMJ. 333 (7579): s206–s207. doi:10.1136/bmj.333.7579.s206. PMID 21851567.
  3. "RCGP receives official approval for GP training curriculum". GP magazine. 13 October 2006. Retrieved 26 September 2014.
  4. "Training: GP curriculum: overview". Royal College of General Practitioners. Retrieved 27 April 2018.
  5. "Specification for review of the Royal College of General Practitioners (RCGP) Membership of the Royal College of General Practitioners (MRCGP) examination" (PDF). General Medical Council. Retrieved 26 September 2014.
  6. "Training: MRCGP exam overview". Royal College of General Practitioners. Retrieved 27 September 2014.
  7. "Training: MRCGP exam: Applied Knowledge Test (AKT)". Royal College of General Practitioners. Retrieved 27 September 2014.
  8. "Training: MRCGP exam: Clinical Skills Assessment (CSA)". Royal College of General Practitioners. Retrieved 27 September 2014.
  9. "Training: MRCGP Workplace Based Assessment (WPBA)". Royal College of General Practitioners. Retrieved 27 April 2018.
  10. Riley, Ben (January 2008). "The new MRCGP- what's it all about?". InnovAit. 1 (1): 49–52. doi:10.1093/innovait/inm013.
  11. Cross, Peter (15 May 2004). "How to pass the MRCGP". Career Focus. BMJ. 328 (7449): s195. doi:10.1136/bmj.328.7449.s195.
  12. Talwar, Divya (19 October 2013). "GP exam 'unfair to minorities'". BBC News. BBC.
  13. Cooper, Charlie (19 October 2013). "Racial discrimination against black and ethnic minority trainee doctors 'can't be ruled out', warns expert". The Independent. Retrieved 13 March 2015.
  14. Esmail, Aneez; Roberts, Chris (18 September 2013). "Independent Review of the Membership of the Royal College of General Practitioners (MRCGP) examination" (PDF). General Medical Council. Retrieved 14 March 2015.
  15. Soteriou, Marina (18 October 2013). "GMC to face High Court challenge over fairness of CSA test". GP Magazine. Retrieved 17 March 2015.
  16. Siddique, Haroon. "GPs' exams disadvantage ethnic minority students, says high court judge". The Guardian. Guardian Media Group. Retrieved 17 March 2015.
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