For nearly 20 years the RCGP has offered a non-exam based route so that GPs can gain MRCGP.
Since 2007, with the introduction of nMRCGP, it has been compulsory for GPs to sit the CSA and AKT exams and complete a workplace-based assessment to become qualified.
However, there are still over 10,000 GPs who UK did not sit for membership during or after GP training, or who qualified as GPs outside the UK. These GPs can gain MRCGP via the college's Membership by Assessment of Performance (MAP) route.
Assessment criteria reflect appraisal
The latest version of MAP was launched in April 2014. The MAP portfolio contains 13 criteria, for which candidates provide evidence to reflect their skills and learning across the range of general practice activities. The criteria have been developed 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 electronically on easily populated templates.
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.
It is possible to compile evidence for the portfolio from a variety of GP roles; successful candidates include locums, out-of-hours and sessional GPs as well as doctors working in the armed forces and prisons.
From the date their application is accepted, candidates have 12 months to gather the required information for their portfolio. Most of the content needs to be dated within that year, but sections such as multi-source feedback that are required for revalidation may be up to five years old.
Support for candidates
The MAP webpage contains all the supporting materials GPs need. Along with the portfolio templates there is a handbook containing more detailed information.
There are additional guidance notes for each of the criteria as well as a sample portfolio to guide candidates on the types of evidence they are expected to supply. There are also practical tips on how to plan and prepare for the work involved.
The RCGP’s MAP team also provide study days for existing and potential candidates, bringing together small groups to work with experienced MAP assessors to talk through the requirements for each criterion and to receive personalised support. The RCGP faculties often can offer to put candidates in touch with MAP advisers who can deal with individuals who feel they need extra support and advice while completing MAP.
Assessment and feedback
After submission, the portfolio is marked by two trained GP assessors who mark independently, then discuss 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.
When the portfolio has reached a satisfactory standard in all criteria or the candidate has reached the maximum number of re-submissions, it is reviewed by a panel of GPs and a lay assessor.
Most candidates will be recommended for membership at this point. A few may be invited to a face-to-face panel to discuss criteria deemed not to have reached the standard required for MRCGP, so are given a further opportunity to meet the requirements.
Why do MAP?
Previous candidates have described a variety of reasons for doing MAP, including to become a GP trainer or take on another educator role, to become an appraiser, ‘unfinished business’, personal growth and to help improve personal practice.
- Dr Etherington is the RCGP clinical lead for MAP, director of primary care education for Health Education England - North West London and a GP in Harrow, North London