Fairness of CSA tests faces judicial review scrutiny

Lawyers acting for the British Association of Physicians of Indian Origin (BAPIO) are pressing for a judicial review into the fairness of the clinical skills assessment (CSA) element of MRCGP exams.

RCGP: judicial review could examine fairness of CSA tests
RCGP: judicial review could examine fairness of CSA tests

BAPIO lawyers argue that the significant difference in pass rates between international medical graduates and UK graduates ‘cannot be explained by a lack of any knowledge, skill or competency’.

They will argue that the variations ‘demonstrate unlawful discrimination under the Equality Act 2010’, and warn that opportunity for bias occurs during face-to-face assessments in which it appears that ‘a physician’s intellectual ability is judged on the basis of how well he/she speaks native English’.

A total of 65.3% of international medical graduates failed their first attempt at the CSA test in 2011/12, compared with just 9.9% of UK graduates, and official data show similar gaps in previous years.

A BAPIO statement pointed out that the international doctors who fail will have passed the GMC PLAB test and undergone supervised training for three years, treating ‘an average of 3,000 patients without any complaints’.

BAPIO president Dr Ramesh Mehta said: ‘Patient safety is paramount. These doctors have had extensive interaction over a period of many years with their trainers and patients without significant concerns. 

‘For them to be judged to be so grossly incompetent in a short exit exam either reflects poorly on years of training, which is unlikely, or it is because the exit exam is flawed. Legal remedy has always been our last resort. We hope that the judicial review will help to expose flaws in the system.’

An RCGP spokesman said the RCGP was continuing to work collaboratively with organisations including BAPIO to address concerns about differential pass rates.

Representatives of the RCGP, COGPED, BAPIO and the British Indian Doctors Association (BIDA) met last month together with BMA observers to discuss the issue.

The RCGP spokesman said: 'We agreed to move forward together to clarify accurate numbers of doctors unable to obtain their certificate of completion of training (CCT) because of CSA failure.

'All parties welcomed an external review of the MRCGP commissioned by the GMC, but despite the productive meeting, BAPIO explained that they will be proceeding with their legal action. All parties agree that they will continue to work collaboratively and another meeting will take place shortly.'

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