RCGP should use CSA test videos to rule out discrimination, says BMA

The RCGP should film GP trainee assessments to ensure they do not discriminate against international medical graduates (IMGs), the BMA has said.

Dr Krishna Kasaraneni: reason for low IMG pass rate must be clarified
Dr Krishna Kasaraneni: reason for low IMG pass rate must be clarified

GPC GP trainee subcommittee chairman Dr Krishna Kasaraneni has written to the RCGP to express concerns about the way the Clinical Skills Assessment (CSA) - which tests GP trainees’ ability to communicate effectively - is being carried out.

Dr Kasaraneni expressed concern that although CSA results published on the RCGP website showed that IMGs had a lower pass rate than other graduates, a reason for the low pass rate was not clear.

He said that there was a view among GPC GP trainee subcommittee members ‘that there is something intrinsic to the operation of the CSA that means it discriminates unfairly against IMGs’.

The letter says: 'While we have been provided with no evidence to substantiate these claims, there was some support for these suggestions among members of the subcommittee. The prevalence of the perception highlights the importance of attaining some insight into the real reasons for the pattern in results.'

The subcommittee advised the RCGP to ‘make use of video recording technology to assist with the investigation into this issue’.

Dr Kasaraneni said that by having access to video footage of their assessments, trainees would not only have evidence of any potential discrimination, but they would also have a good source of feedback.

‘Right now the problem we have is people don’t get appropriate feedback. With the video they can look at it and work out where their weaknesses are,’ he said.

Dr Kasaraneni’s letter also asked the RCGP to share with the subcommittee any work it was doing to assess the ‘relatively poor outcomes for IMGs’ who take the CSA exam.

The letter follows meetings late last year between RCGP leaders and the British Association of Physicians of Indian Origin (BAPIO) and the British International Doctors Association (BIDA), after the groups expressed concern about the fairness of CSA tests for IMGs.

RCGP chair Dr Clare Gerada and RCGP associates in training committee chair Dr Ben Brown wrote to GP trainees to reassure them that the college was looking at accusations of unfairness ‘very seriously’.

The RCGP has produced a set of FAQs for trainees on the CSA.

In response to the BMA letter, an RCGP spokeswoman said: 'We are very grateful that the BMA GP trainee subcommittee has shared its concerns with us directly. We are now considering the points made and will be responding shortly.’

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