MRCGP exam changes unveiled

20 July 2010

A NUMBER of changes will be made to the MRCGP exam from September.

The Royal College of General Practitioners unveiled its plans to revamp the Clinical Skills Assessment (CSA) and Applied Knowledge Test (AKT) components following a “rigorous review” of the exam process. The College said the changes would make the exam more relevant to “everyday working life”.

The move means candidates applying for membership of the College will be graded on more cases in the CSA. The CSA pass mark will be set using the borderline group method – where each case will have its own pass mark – rather than the current system which requires passing eight out of 12 cases.

RCGP examiners will also now mark all the cases on the circuit, so candidates will be evaluated on 13 cases instead of the current 12. The cases will continue to be marked using the current three domains but candidates will receive the total score for all 13 cases instead of individual marks for each case. The pass mark will be set by the combined judgements of examiners for that day.

The RCGP said the borderline group method of marking was an “established and robust” method that will allow them to deal with the variability in difficulty of cases.

Feedback statements have also been changed as part of the review, and take into account comments from Associates in Training and CSA examiners. Candidates will then be given more information and advice on how to improve performance as well as additional feedback on any performance areas identified as deficient.

The latest format of the computer-based AKT will pilot new questions, including free text answers where the candidate types in the answer rather than selecting from a list of options. They will be able to use short video or sound clips and so-called Hot Spots, where the candidate clicks on a graphic to indicate the site of a clinical sign.

The changes have been made in line with suggestions from the Postgraduate Medical Education and Training Board, which is now part of the General Medical Council.

Dr Sue Rendel, RCGP chief examiner said: “The proposed changes will serve to make both the AKT and CSA more relevant to the day to day working lives of our candidates and will ultimately improve the care that the next generation of general practitioners deliver to their patients.

“Candidates should not notice any difference in their experience of the exam or the way in which they prepare for it.”

RGCP chair Professor Steve Field added: “Having been an examiner for many years, I know how much work goes into developing the exam. I look forward to seeing these changes manifest in improving patient care.”