GMC published its much awaited report ‘Independent Review of Membership of the Royal College of General Practitioners (MRCGP) examination’ by Prof A Esmail and Prof C Roberts on 26th September 2013.
BAPIO PRESS RELEASE
BAPIOs’ response to publication of ‘Independent Review of Membership of the Royal College of General Practitioners (MRCGP) examination’ by Prof A Esmail and Prof C Roberts:
BAPIO welcomes and is relieved by the findings in Professor Esmail and Roberts’ paper which clearly quantify and demonstrate that doctors who qualified from UK medical schools belonging to Black and Minority Ethnic (BME) background are failed in substantially higher numbers by the MRCGP examination compared with UK doctors who are white. For international medical graduates the differences are even higher. It is clear from this paper that there isn’t any statistical explanation for this very disparate pass rate which BAPIO has long argued is because of inherent subjective bias in the CSA, which is flawed in its design.
Esmail and Roberts could not have put it more clearly; they say ‘We cannot exclude subjective bias owing to racial discrimination in the marking of the clinical skills assessment as a reason for these differential outcomes’. This is consistent with the long stated position of BAPIO that the RCGP did not take the necessary steps to eliminate subjective bias while formulating the CSA.
They also say ‘cultural factors cannot explain differences between white candidates and black and minority ethnic candidates who have trained in the UK, and who would have had similar training experiences and language proficiency’. Dr Ramesh Mehta, BAPIO President said “It is damning that in this day and age the sole reason that UK educated and trained doctors are four times as likely to fail this exam seems to be solely on basis of their skin colour. A fifteen times worse result imposed on International Medical Graduates who have passed every assessment set to them, be it language or clinical, before reaching the MRCGP CSA by using culture and a variety of usual well-rehearsed excuses and platitudes should not wash any more”.
It will not be wise to ignore Esmails’ and Roberts’ concerns when they say ‘We cannot ascertain if the standardised patients (played by actors) behave differently in front of candidates from non-white ethnic groups. Nor can we confidently exclude bias from the examiners in the way that they assess non-white candidates’. It is very difficult to have confidence in an examination under these circumstances.
Professor Rajan Madhok, Chairman of BAPIO said “This bias has been highlighted by BAPIO repeatedly over the last two years and now this independent report has confirmed the extent of the discrimination in the examination. Sadly, it took the Judicial Review to force the authorities to undertake this review. We hope that the General Medical Council will soon publish the full report, and more importantly take appropriate action”. To continue to suggest that ‘candidate factors’ account for the high failure rate of BME doctors in MRCGP examination is a denial of the reality which is that there is racial (whether direct or indirect) bias. Sadly, this head in the sand approach has led us to this stage where hundreds of careers have already been ruined at huge costs to the NHS and patients.
Dr Satheesh Mathew, BAPIO Vice President said “There has been a systematic failure by both, the regulator: the GMC who failed to set proper policies and procedures to ensure fairness; and the RCGP who whilst staring at the problem, the College claims to be one of the most advanced in monitoring ethnicity in its exams, failed to take action”.
BAPIO calls upon the GMC to act decisively on the contents of this publication. We call upon the RCGP to review their stand on this issue and reframe the MRCGP examination in a manner that will be equitable to everyone, and also take steps to support those who have already suffered due to this gross negligence by the College.