MRCGP: Membership by assessment of performance

Dr Clare Etherington explains the alternative pathway to attaining membership of the RCGP

Newly qualified GPs currently attain membership of the RCGP through written and clinical examinations and workplace-based assessment during their training.

About 20,000 GPs in the UK did not sit for membership during or after GP training, or qualified as GPs outside the UK. Membership by Assessment of Performance (MAP) was created in 2000 as the path to MRCGP for these GPs.

This became iMAP for a few years and was relaunched as MAP in April 2014. It is the only route to MRCGP for GPs who are not in training. The RCGP has now welcomed more than 1,000 new members who have successfully completed MAP.

Portfolio of evidence

Over a period of one year, candidates complete a portfolio of 13 criteria with pieces of evidence to reflect their skills and learning across the scope of their practice.

The criteria have been refined to parallel the types of evidence needed for appraisal and revalidation. This means work for MAP contributes most of the appraisal evidence that year, rather than being extra activity. The portfolio is submitted on easily populated templates.

The RCGP provides a variety of online resources, including a candidate handbook, detailed instructions for each criterion and a sample portfolio. It also runs MAP workshops around the country and has a network of locally based support contacts who can be accessed through local RCGP faculties.  

Work for the portfolio includes completion of, and reflection on,  learning from Personal Education Planning or Essential Knowledge Updates (RCGP internet-based learning programmes designed for GPs’ continuing professional development), quality improvement programmes, use of an ethical model to think about a clinical situation and reflection on a series of acute cases and referrals.

The guidance is broad to ensure both practice-based and widely varied ‘portfolio’ roles can easily be used to produce the evidence.

Submissions from any doctor appraised as a GP, including salaried doctors, locums, military practitioners, prison-based doctors, independent GPs and GPSIs, are all welcome.

Assessment and feedback

After submission, the portfolio is marked by two trained GP assessors who mark independently, then discuss it to produce a unified grade and feedback for each criterion.

Constructive written feedback with suggestions for improvement is given for all criteria receiving a ‘borderline’ or ‘unsatisfactory’ grade and the candidate is given two further opportunities to submit these.

The portfolio is then reviewed by a panel of GPs and a lay assessor, and most candidates will be recommended for membership at this point. A few are invited to a face-to-face panel to discuss criteria the panel deem inadequate for a ‘satisfactory’ grade.

Feedback has been exceptionally positive, with candidates highlighting the relevance of the assessment to their day-to-day work and the lasting difference it has made to their practice (see box).

What recent candidates say about MAP

It gave me the opportunity to reflect in detail on what I had started to take for granted, having worked in medicine for over 20 years. As a consequence, I upped my game in all areas and felt a sense of great pride having successfully completed it

Helped to increase confidence in clinical abilities. Made me come out of my comfort zone. Gave me enough confidence to apply for a new job – and I got it

Preparing the portfolio was helpful for me in structuring my work as a sessional GP, as I have little or no support from practices. It was extremely useful in helping me as a GP appraiser. I feel more confident and able to support other sessional GPs as appraisees, who find themselves in a similar position, as they prepare for revalidation

Source: RCGP survey

Successful candidates state that the top three reasons motivating them to undertake MAP are to become a GP trainer, personal development and career progression.

Current fees from April 2015 are £400 at application and £800 on submission of the portfolio. The small percentage of applicants who are called for a face-to-face assessment are asked to pay a further £250.

Doctors who would like to consider applying for MAP can find comprehensive information on the RCGP website (see Resources). If there are further questions, the staff at the MAP office are usually able to help by email.

The MAP team would strongly recommend obtaining advice from local RCGP faculty offices, from peers who have gained membership via MAP, or by attending a MAP study day. Further details of these can be found on the RCGP website.

  • Dr Etherington is the RCGP clinical lead for MAP and a GP in Harrow, north London


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