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Big AIT Questions

Big AIT Questions. Question and answer session with the college . Members of the panel. Dr Claire Gerada Chair RCGP Dr Helen-Stokes Lampard Honorary Treasurer RCGP Dr Sue Rendel Chief Examiner RCGP Dr Ben Brown Chair, AIT Committee

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Big AIT Questions

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  1. Big AIT Questions Question and answer session with the college

  2. Members of the panel • Dr Claire Gerada Chair RCGP • Dr Helen-Stokes Lampard Honorary Treasurer RCGP • Dr Sue Rendel Chief Examiner RCGP • Dr Ben Brown Chair, AIT Committee • Dr Krishna Kasaraneni Chair, GP Trainee’s Sub-committee, BMA

  3. Questions Asked: • What will the format of the 4 year programme be? • How will they make sure that the 4th year is not a coasting year? • What is your advice for trainees who will soon be qualifying? • Does the college think the curriculum needs more emphasis on leadership and business skills in view of the changes with commissioning?

  4. Questions asked 5)Is the CSA a fair examination?

  5. Is the CSA a fair exam? • 65.3% of non-UK graduates fail the CSA compared with 9.9% of UK graduates • White UK graduates have a failure rate of 5.8% and black UK graduates, a failure rate of 24.4% • 97% of candidates eventually pass the CSA • Professor AneezEsmail – one of the UK’s leading experts on racism in the NHSwas asked by the GMC to investigate claims of racial bias in the MRCGP’s clinical skills assessment • His independent review was published 26th September 2013

  6. Colleges views on the CSA • Professor Gerada: ‘We have unbelievable faith in the IMGs, my father was one of them. But we cannot expect to have an exam where just because you’re sitting it you de facto pass it” • Dr Helen Stokes-Lampard, ‘We have to look at it from the patients’ point of view – call it the “Daily Mail” test. They want doctors who have passed exams, they want doctors who have been given the qualifications for doing the time in training, they want them to have proven they are of a standard to be good at the most difficult job in medicine, which is being a good generalist” “The differential pass rate is something we all regret – it’s not ideal and we will try to address what we can. But the reality is we’ve got to defend our patients – I’m not getting a plane with a pilot who isn’t qualified to fly that plane”

  7. Views of other panel members: • Dr Krishna Kasaraneni: “one curriculum is not enough and the whole process has to be looked at, not just the end measure but constraints on funding would make this difficult to achieve.”

  8. GMC’s views on the report: • Niall Dickson, Chief Executive of the General Medical Council, said: “The report found that while there are significant differences in pass rates between different groups of doctors, the way they are assessed in the CSA is not the cause of those differences” “In particular it found that the pass rates for doctors sitting the computer marked applied knowledge test mirrored their performance in the CSA exam”

  9. BMJ paper conclusions: • Subjective bias due to racial discrimination in the CSA may be a cause of failure for UK trained candidates and international medical graduates. • The difference between British black and minority ethnic candidates and British white candidates in the pass rates of the CSA, despite controlling for prior attainment, suggests that subjective bias could also be a factor. • Changes to the CSA could improve the perception of the examination as being biased against black and minority ethnic candidates.

  10. The College’s explanation • The college states it takes equality and diversity issues "extremely seriously". • It strongly refutes any allegations that the exam is discriminatory in any way • The lack of preparedness of IMGs may be an explanation for the differences in pass rate • UK medical graduates have more exposure and training in general practice, during medical school training and the foundation programme, than most IMGs

  11. What the RCGP is doing about the CSA • They have audited all actors and examiners to see whether they are biased towards particular candidates • Individual deaneries should be identifying candidates who may struggle and giving them additional help and support • The ethnic mix of the role-players trained for the CSA is now broadly similar to the ethnic composition of the population of the UK • The way in which feedback is provided to candidates is being reviewed by the RCGP • The RCGP has already consulted with experts in this area, conducted an online survey amongst GP trainees, and are arranging a focus group with IMGs who have recently sat the examination. • But ultimately the CSA examination is not being changed • Dr Claire Gerada: “Don’t worry, 97% of candidates eventually pass”

  12. So is the CSA a fair or flawed examination?

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