High Court judge rules CSA is lawful and fair

The RCGP and GMC are not in breach of equality laws after a High Court ruling found British minority ethnic (BME) and international candidates were not discriminated against on account of their race or ethnicity in MRCGP assessments.

High Court: judicial review ruled on fairness of CSA test
High Court: judicial review ruled on fairness of CSA test

The British Association of Physicians of Indian Origin (BAPIO), which took the RCGP and GMC to court for racial discrimination, failed to convince judge Mr Justice Mitting that international and BME candidates were subject to bias and at a disadvantage compared with their white UK peers.

The CSA is an essential step in becoming a fully-qualified GP in the UK, and involves trainees having to treat actor patients while under observation. Reports last year revealed significant discrepancies in the CSA pass rates of white British, BME and international graduates, which sparked allegations that the RCGP, which conducts the exam, was being racially discriminatory against BME and international candidates.

The judicial review began on Tuesday at the Royal Courts of Justice in London and lasted for three days.

In the hearing, BAPIO claimed that the requirements for membership of the RCGP, particularly the passing of the CSA, were unlawfully racially discriminatory.

It also argued that the RCGP was in breach of its Public Sector Equality Duty by ‘failing and continuing to fail to undertake an Equality Impact Assessment of the requirements for membership of the RCGP’.

They said that both of these claims meant that the RCGP was failing to meet the lawful requirements set out by the Equality Act 2010.

The GMC, which BAPIO said was accountable for ensuring a fair process, also stood accused of failing to comply with its Public Sector Equality Duty under the Equality Act.

BAPIO launched the case against the RCGP and GMC in February 2013, claiming that aspects of the GP assessment process – in particular the clinical skills assessment (CSA) – were racially discriminatory.

The action came in response to reports last year which revealed that international candidates were 16 times more likely fail this test than white UK candidates, and BME candidates were four times more likely to fail compared to their white contemporaries.

Following the judgement against BAPIO, RCGP chair Dr Maureen Baker said: ‘We welcome the verdict of the Court that the Clinical Skills Assessment (CSA), run by the RCGP, is lawful and fair.

'Patients have a right to expect safe care and it is our responsibility to ensure that all doctors who qualify as GPs meet the highest standards to ensure this safe care. That is the purpose of this exam, and the other requirements to become a practising GP.

‘We hope that today's judgment means we can now draw a line under the events of the past year and concentrate on delivering a robust and fair exam for future generations of GPs and for the benefit of our patients.’

Niall Dickson, CEO of the GMC, said: ‘Mr Justice Mitting’s judgment is an important decision for medical education and regulation. He has recognised that we take seriously our responsibility to operate procedures that are fair and free from discrimination. At the same time, stringent checks for doctors, and high standards of medical education, are vital for the safety and quality of medical care in the UK.

‘We do understand that there are serious and complex issues at play here.  International medical graduates have made a huge contribution to healthcare in this country and we will continue to do whatever we can to support these doctors who provide so much frontline care in the UK. We will work to make sure that diversity and high standards go hand in hand.’

Dr Ramesh Mehta, BAPIO president expressed disappointment in the decision. He said: 'We are naturally extremely disappointed in today's decision and still believe that the Clinical Skills Assessment racially discriminates against both international medical graduates and UK graduates with ethnic minority backgrounds.'

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in