27 September 2013

RCGP Response to the Independent Review of the Clinical Skills Assessment of the MRCGP Examination

RCGP responds to Independent Review of MRCGP exam saying there is no evidence of racial discrimination and all International Medical Graduates are assessed equally to graduates from the UK.

The RCGP welcomes this independent report and its key findings which show there is no evidence of subjective bias due to racial discrimination and that IMGs are assessed in exactly the same way as those from the UK.

It also finds that lack of preparedness of International Medical Graduates may be an explanation for the differences in pass rate, but that the method of assessment is not. The CSA examination and marking are based on internationally recognised methods.

The RCGP is committed to equality and diversity and has always strongly refuted allegations of discrimination in the MRCGP, subjective or otherwise. All of our assessment procedures are designed with fairness in mind but also to ensure safe care for patients, and we are always looking to enhance and improve our processes.

UK medical graduates have more exposure and training in general practice, both through medical school training and the foundation programme, than most International Medical Graduates whose home countries might not have health systems as dominated by primary care as the NHS is in the UK.

In noting the recommendations, we recognise many of the issues raised - particularly around the diversity of MRCGP examiners and role players, the mix of cases used in CSA exams and candidate feedback - and have been working hard to address these for some time.

For the past three years we have proactively approached doctors with primary medical qualifications obtained outside the UK and those from Deaneries currently under-represented on the panel of examiners to apply for examiner roles.

The ethnic mix of those role-players trained for the CSA is now broadly similar to the ethnic composition of the population of the United Kingdom and the RCGP is also reviewing the ways in which it can improve the feedback provided to candidates. We have already consulted with experts in this area, conducted an online survey amongst GP trainees, and are arranging a focus group with International Medical Graduates who have recently sat the examination.

Next week, a paper will be published in the British Journal of General Practice which looks at candidate and examiner gender and ethnicity in the MRCGP and finds no bias.

The College has co-operated fully with the GMC and Professor Esmail throughout the independent review and notes that the findings reflect similar disparities in other medical specialties.

Read the GMC statement on Professor Esmail's report

Further Information

RCGP Press office - 020 3188 7574/7575/7576
Out of hours: 0203 188 7659


The Royal College of General Practitioners is a network of more than 44,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.