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How to pass the Royal College of GPs actor CSA exam as an ethnic minority or black GP trainee
I think I did everything I could to pass this exam. I feel the exam lacks objectivity and depends on role players and actors. Why don't they use some real patients?? The actors mistake ruined my life/ my career.
On November 8, 2013, the British Medical Association donated £25,000 towards BAPIO's High Court Judicial Review of the CSA exam and asks GP trainees to click the email link on their website http://bma.org.uk/news-views-analysis/news/2013/november/call-for-royal-college-exam-experiences to share their CSA experiences for the impact statement for Judicial Review and hosts the link to BAPIO's paypal donation page.
On November 13, 2013 a male IMG who just sat his 3rd CSA writes me, 'I feel my life will end if I fail the CSA...My wife is trying to console me in vain.'
Many BMEs/IMGs have told me they have resigned membership of the RCGP once they have passed their CSA and gained their CCT or CEGPR or their FRACGP in Australia. It may be worthwhile for the College to implement changes to the exam like videotaping of stations for a fair appeals process, 2 examiners per station to reduce observer bias and testing of all actors and examiners for unconscious bias, ie unconscious racial preferences and selecting those with no preference for race. Continued membership to the RCGP is optional and not mandatory to work in the NHS as a GP once you have your CCT or CEGPR.
UPDATE November 2014: One of the Indian male GPs in a photo in this blog article has now packed and is taking his young family to Australia, leaving behind the 'socialist' NHS for freedom to practice medicine.
In April 2014, one white posh High Court Judge deemed the CSA a fair exam and stated he did not believe in unconscious bias. This means the exam continues without testing of actors or examiners for unconscious bias and male BMEs/ IMGs still write me that they keep failing CSA by 1-2 marks. Now even after passing AKT and CSA, one educational supervisor may decide not to sign off a GP trainee at the end of training! My advice at this stage would be to consider legal representation if this is an employment matter or simply go into private practice without MRCGP or a CCT. CCT is mandatory to work as a NHS GP but not as a private doctor. Some doctors go straight into private practice with an MBBS after completing their foundation years.
Please consider carefully whether as an IMG or BME, you wish to embark on GP training as you are sitting an exam which fails 15x more IMGs than white British, which does not record stations for fair appeals, has a marking system in which one extreme hawk may score you 0-1 marks out of 9 which may skew your overall marks to a fail, and examiners may not be scrutunised in a formal college appeal.
If released your options are:
The GP specialist application advises:
'You are eligible to apply for a CEGPR if you have completed a period of at least six months specific training in general practice.
An application for a CEGPR is both time consuming and costly so we encourage applicants to read all the published guidance first, and to consider very carefully whether they have some prospect of success before deciding to pursue this route. Please be advised to read the Specialty Specific Guidance. Page 5, paragraph 7 deals specifically in relation to your situation.
We also suggest to applicants who have trained in the UK that they should not simply provide evidence of their training programme and the failed assessment. It is important to show that they have improved their performance and rectified the deficiencies, keeping in mind the requirement to demonstrate that they have achieved the standard of the CCT and the general practice curriculum. This might be through further learning and validated, objective assessment since release from training but there are no prescribed ways of doing this. Some doctors have considered applying for training outside the UK and returning to apply for a CEGPR, others focus on evidence of learning in current clinical work. Again, there are difficulties with the latter as the doctor is no longer working in general practice.
I hope this advice is of some help in deciding whether to make an application.
GP Specialist Applications Team
30 Euston Square
Tel: 020 3188 7656'
Or you can just go straight into private practice like Dr Chiara Hunt with MBBS (the RCGP cofounder's granddaughter) or Dr Leah Totton MBBS, as you do not need MRCGP or GP CCT (certificate of completion of training) outside of the NHS. You may wish to join the Independent Doctors Federation for annual appraisals and revalidation.