New chief examiner of MRCGP reveals plans to make exam fairer

The new chief examiner of the MRCGP has outlined the work she will lead to address concerns over differential attainment levels.

Dr Pauline Foreman (Photo: Dr Pauline Foreman)
Dr Pauline Foreman (Photo: Dr Pauline Foreman)

Dr Pauline Foreman said a project will start in November with the Academy of Medical Royal Colleges to look in more depth at performance in examinations.

The college is working on how to identify early those trainees who are at greater risk of failure and to intervene to help them.

Dr Foreman said the key to addressing the problem of higher failure rates for black, Asian and minority ethnic (BAME) candidates is working with other organisations, partly because the problem is one of education systems.

‘It is a system problem, not an RCGP problem,’ she said. ‘So I think it is something we have to work together to solve.’

This will involve highlighting the problem and working with other medical colleges and the training community to help influence the development of useful interventions.

Dr Foreman took up her position in April this year, but was closely involved in the legal challenge by the British Association of Physicians of Indian Origin (BAPIO), while shadowing her predecessor Dr Sue Rendall.

Studies of the clinical skills assessment (CSA) have shown significant discrepancies in pass rates between white British, BAME and international graduates. Mr Justice John Mitting ruled the exam was lawful, and the college was neither discriminatory nor in breach of legal duties, but said the CSA did disadvantage minority ethnic candidates.

Dr Foreman said, despite winning, the legal process had harmed the college’s reputation: ‘My key aspiration is to re-establish trust with our key stakeholders.’

She is now seeking to develop the MRCGP and piloting is under way of workplace assessment for the fourth year of training that the college hopes will be approved by the government. Areas being piloted include quality improvement and leadership.

From this month, trainers will also be allowed to sit in on the whole CSA for the first time, in a move designed to make the process more transparent.

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