General practice is in an unprecedented state of change following the government's recent White Paper. Never before has it been more important for all GPs to be members of the RCGP and to be seen as a cohesive professional group that can rise to the enormous challenges ahead.
There is an easy way for GPs who are practising at a good standard to become members - membership by assessment of performance (MAP).
MAP has a long history in UK general practice of more than 10 years. It has changed and progressed from the assessment of a GP in their practice to what we have now - iMAP2. Although the practice assessment visit has gone, the essential ingredient of MAP is retained - assessment of the GP's performance.
Portfolio of evidence
At the heart of MAP is the portfolio of evidence, which the candidate submits and which is a reflection of all aspects of their practice. The evidence required takes the form of criteria. Each criterion reflects an aspect of good medical practice. There are, therefore, criteria on prescribing, audit and significant events among others.
The portfolio represents an extensive array of evidence of the candidate's work in their practice. It is intended to mirror a GP's performance. The portfolio also demonstrates a commitment to continuing professional development.
Candidates often ask how much work is involved in undertaking iMAP and of course there is a need to apply oneself to the process. However, what is required for iMAP is a clear statement of that which the average competent doctor does daily.
Planning is important so that those criteria that are time sensitive, for example audit (criterion 3), emergencies (criterion 6) and learning (criterion 8), can be completed in time to meet the deadline for submission.
It is useful to work to a timetable with a set number of days being devoted to each criterion.
Many candidates report that the most cumbersome part of the process is writing up the work. Here, one may enlist the help of a friendly secretary or typist to do the bulk of it, with the fine-tuning being done by the candidate. This will speed things up.
In the case of audit, involve the practice, so that what you set out to do has the engagement of your colleagues. This is more likely to happen if it is a topic that is relevant and important to the practice as a whole.
Changes to criteria
iMAP2 has changed somewhat from iMAP (or what should really be called iMAP1). In iMAP2 there are 15 criteria compared with 19 in iMAP. Descriptions of a management plan and of equipment in the surgery are no longer required.
Maintaining good medical practice is now a single criterion instead of two as in iMAP. To satisfy this criterion one needs to undertake the RCGP 'essential knowledge challenge' or the new 'personal educational programme' from RCGP Scotland. Both of these are recognised educational tools for all GPs. They should also satisfy the needs of appraisal.
There is a single criterion on referrals which now requires the candidate to submit 15 referral letters. This is a useful exercise and many candidates claim the quality of their letters has improved as a result of this criterion.
In other words, the entire process of iMAP2 is now more straightforward and relevant.
It helps to attend a course on writing the iMAP2 criteria and subsequently one on preparation for the orals. The first course would take you through the various steps of writing the portfolio and provide useful hints on pacing yourself. It is also helpful to work with colleagues who are doing iMAP2, so that you can share ideas and keep up momentum.
Once submitted to the RCGP, the portfolio is marked by two assessors. The assessors mark each criterion as 'good', 'satisfactory', 'borderline' or 'fail'. If a criterion is marked 'good' or 'satisfactory' it means that this criterion is acceptable for the orals.
Candidates need to pass each one of the 15 criteria to be invited to the orals, but should not be disappointed if one or more criteria are marked 'borderline' or 'fail'. Comments will be included suggesting what needs to be done to pass the criterion. Follow these suggestions and resubmit with the suggested improvements.
Once your work has been accepted you will be called to an oral assessment of your work. We consider this a lively discussion between colleagues and not a medical school viva.
Why become an MRCGP?
MRCGP is the recognised postgraduate qualification in UK general practice and it is increasingly used in other parts of the world. By pursuing and completing iMAP2 you will know that your work is of an acceptable standard.
You will be part of the college, have the opportunity to participate in its various activities and help to shape the way general practice develops in the UK. Above all, you will have the approval of your peers.
The deadline for iMAP2 is 31 December 2011.
- Dr Graham is a GP in Croydon, south London, and Dr Menon is a GP in Essex.