RCGP exam not discriminatory, court rules

THE RCGP membership exam does not unlawfully discriminate against ethnic minority candidates, a High Court judge has ruled.

The British Association of Physicians of Indian Origin (BAPIO) had launched a legal challenge against the Royal College of General Practitioners and the General Medical Council over big differences in pass rates amongst doctors taking the exam’s clinical skills assessment component.

Mr Justice Mitting said the CSA was a “proportional” way of determining who can practise as a GP despite the disparity in success rates between white UK graduates and non-white graduates who qualified in the UK and abroad.

But despite ruling in the RCGP’s favour, he said BAPIO had won “if not a legal victory, then a moral success” and said the College must now take action.

Concluding the three-day judicial review at the Royal Courts of Justice in London, the judge cleared the RCGP of unlawful racial discrimination and of breaching its public sector equality duty. He also rejected a claim that the GMC, which did not face accusations of unlawful discrimination in the legal action, had breached its equality duty.

The judge noted that a number of reviews have been carried out by the RCGP showing “unavoidable unconscious bias” due to the nature of the assessment. Some of the differences in pass rates, he said, could be attributed to education and cultural differences.

He warned: “The college needs to act to eliminate discrimination and has identified some of the means by which that need might be addressed and fulfilled.

“If it does not act, and its failure to act is the subject of a further challenge in the future, it may well be that it will be held to have breached its duty.”

RCGP chair Dr Maureen Baker said she hoped the verdict “means we can draw a line under the events of the past year”. She accepted that the College had to take further action and said work was already underway to support the small number of trainees who fail the CSA.

She said: “We are already developing further web-based learning resources and publications to help trainees and their trainers prepare for the exam and are reviewing how to improve the quality of feedback that candidates receive from the exam so that they can target any areas of underperformance with their trainer.

“We are also committed to acting on recommendations made in recent reviews to ensure the MRCGP minimises any possible risks of unfairness and we are very keen to work with the GP training community to develop effective training strategies for those who might struggle with the exam.”

BAPIO said it was considering an appeal. President Ramesh Mehta said: “We are naturally extremely disappointed in the decision and still believe that the clinical skills assessment racially discriminates against both international medical graduates and UK graduates with ethnic minority backgrounds.”