New RCGP exam to be taken virtually in GP trainee’s own practice

A new exam is to replace the recorded consultation assessment which has allowed GP trainees to qualify during the Covid pandemic.

In July 2020, the RCGP rolled out the RCA as the third component of the MRCGP in place of the clinical skills assessment (CSA) to enable trainees to complete their training programmes and enter general practice, given the restrictions and disruption caused by the pandemic.

While the CSA had required all trainees to be assessed in person at the RCGP in London, currently candidates have to submit recordings of 13 consultations, which cover a number of mandatory criteria, with marks are given in three domains – data gathering, clinical management and interpersonal skills.

Now the RCGP said that from November the assessment will be replaced by a new GP exam, which will see trainees take the examination virtually in their own practice with actors playing the role of patients.

The new exam, which will need to be approved by the GMC, would see GP trainees use standardised cases.

Dr Margaret Ikpoh, Vice Chair for Professional Development for the Royal College of GPs, told Pulse that the new exam is being developed in consultation with trainees, trainers, examiners and patients, as well as using feedback from both the RCA and the CSA.

She said: ‘A new exam has been in development for a number of months to replace the Recorded Consultation Assessment as one of three forms of assessment trainees need to complete in order to attain MRCGP and practise independently as a GP in the UK, and our plan is for it to be in place before the end of the year.

‘The Recorded Consultation Assessment was rapidly introduced in 2020 towards the start of the Covid pandemic in order to allow trainees to attain their CCT and join the workforce as fully qualified GPs. It was never the intention that the RCA would be a permanent part of MRCGP assessment.

‘The new exam is being developed in consultation with a range of key stakeholders, including trainees, trainers, examiners and patients, and has taken on feedback from both the RCA and its predecessor, the Clinical Skills Assessment. The new exam is likely to retain elements of both exams.

‘The purpose of the MRCGP assessment is to ensure patient safety, and that trainees have the clinical and communication skills necessary to practise independently as a GP in the U.K. These, and other factors such as continual efforts to address differential attainment and the ability for GPs to take exams wherever they live in the U.K., have been key in the development of the new exam.

‘More details will follow in due course and trainees will be informed of any changes to their exam at least six months in advance of implementation in order to give them sufficient time to prepare.’

In the past, the RCGP faced a judicial review brought by international doctors seeking to declare the exam unlawful, but consistently denied that the exam was in any way discriminatory or biased. Meanwhile, more than 600 practices are now offering patients access to their GP records through the NHS App, according to the director for digital transformation at NHS England.