Saturday, 15 June 2013

BMA Annual LMC Conference votes in support of motion on CSA exam concerns

What Would You Do? Bike Theft (White Guy, Black Guy, Pretty Girl)
Youtube video of a social experiment in racial profiling
On May 23-24, 2013, the British Medical Association convened its annual Local Medical Committee conference in London. Motion 41 on concerns regarding the MRCGP GP licensing exam called the CSA (Clinical Skills Assessment) was presented to a conference of up to 400 National GP LMC delegates from all over the UK and passed in all its parts.
Motion 41 played back at 6:11:17 on the BMA webcast recorded on Thursday May 23, 2013.

What is it that UK and IMG ethnic GP trainees ask of the Royal College of GPs?

Simply, that the 13 CSA exam stations (with one actor playing a patient and one examiner marking) are videotaped and such tapes be made available as evidence for a fair appeal if 'unconscious foreigner bias' or 'racial profiling' adversely affected their marks. The exam is conducted with 12/13 white British actors and 12/13 white British examiners, all strangers who meet and make judgements about Black doctors, Indian doctors, Chinese doctors and White British doctors in 10 minute intervals.

The CSA has the highest pass rate for white British female doctors and the highest failure rate for Black, Chinese and Indian male doctors, yet all have completed the 3-year UK GP specialty training programme with good patient satisfaction surveys and regular reviews with their respective GP trainers. Interestingly there is a 20% total discrepancy between male and female pass rates and a 10% discrepancy between white UK male and white UK female pass rates, with the latter female pass rate being higher. There is also a discrepancy between white, black, Indian and chinese UK doctor pass rates with a double chance of failing as an Indian UK graduate and a triple chance of failing as a black UK graduate when compared to that of a white UK graduate.
The A-level exam for drama, music and dance allow audio and video recording to be submitted as evidence for exam appeals.
All these ethnic doctors (612 ethnic doctors failed CSA in 2011-12 and 300 mostly Indian male doctors were expelled after failing the CSA actor exam), ask for videotaping of each exam station for review by an impartial board of appeal before their career in general practice is ended abruptly, before it has even begun. The NHS relies heavily on ethnic minorities who have become the backbone of the NHS as doctors, nurses and healthcare assistants, and now more than ever GP partners need urgent relief and reinforcements from newly qualified graduate GPs of all races and sex.

BMA Annual LMC Conference Motion 41.

41 THE GPC: That the GPC seeks the views of conference on the following motion from the GP trainees GP subcommittee:
That conference is concerned that the MRCGP examination pass rates for international medical graduates (IMGs) are consistently lower than UK graduates and the discrepancy is getting worse, and:
(i) is worried that this raises concerns about the validity of the MRCGP exam
(ii) calls for a GMC, RCGP and BMA investigation into the reasons for the disparity, which is robust and establishes definitively at which part(s) of the training or examination process any problem lies
(iii) calls on the RCGP to set up a career guidance service for trainees who had to leave GP training as a result of being unsuccessful in obtaining the MRCGP
(iv) demands the feedback from the MRCGP exams to be improved immediately.
41a MID MERSEY: That conference believes that the new clinical skills assessment (CSA) figures which reveal widening gaps in first time pass rates between international medical graduates (IMGs) and UK graduates requires an in depth investigation.
41b BEDFORDSHIRE: That conference calls on the GPC to ensure that training practices that have non-UK undergraduate trained vocational trainees are given adequate training and support to ensure that their trainees have equal opportunity when they take their CSA exams.
41c GRAMPIAN: That conference recognises the problems faced by international medical graduates in relation to the CSA exams and urges the RCGP to take steps to ensure that a fairer system of assessment is put in place.
41d COUNTY DURHAM AND DARLINGTON: That conference expresses concern at the disparity of pass rates in nMRCGP examinations on the basis of ethnicity and that it calls for the Royal College of General Practitioners and the deaneries to review the process (including recruitment) and to explore possible reasons and find solutions.
32 LMC Conference 2013: General practice in our hands... Agenda
41e THE GPC: That the GPC seeks the views of conference on the following motion from the GP trainees GP subcommittee:
That conference is concerned that the MRCGP examination pass rates show significant differences between different ethnic groups in trainees even after correcting for country of primary medical qualification, and ask the RCGP and COGPED to:
(i) provide a detailed explanation as to why this is the case
(ii) immediately review the selection, training and assessment processes to ensure that trainees are not discriminated against because of their ethnic origin.
41f THE GPC: That the GPC seeks the views of conference on the following motion from the GP trainees GP subcommittee:
That conference welcomes the GMC review into the MRCGP certification process and calls for:
(i) complete transparency of the process
(ii) comprehensive analysis and swift conclusion by the GMC in consultation with the BMA GP trainees subcommittee.
41g CLEVELAND: That conference is disappointed that the funding for undergraduate education in general practice is still uncertain,
under the new LETB process, and feels that we should redouble our efforts to:
(i) maintain funding at least at current real term levels
(ii) ring fence funding for use in general practice
(iii) increase funding to reflect increased teaching in general practice where it can be introduced.