The MRCGP is comprised of three independently assessed components: workplace-based assessment, an applied knowledge test (AKT) and a clinical skills assessment (CSA). During the CSA the candidate is assessed undertaking 13 clinical scenarios (cases); until September 2010 all 13 cases were marked but only 12 cases were counted towards the candidate’s overall score. The 13th case was used to pilot new cases and did not contribute to the candidate’s overall mark.
From its introduction in September 2007 until September 2010 the passing standard for the CSA was based on a ‘number of cases to pass’ (N2P) methodology. It was impossible to fine tune this to make allowances for daily variability in the difficulty of the mix of cases and to allow compensation between performance on different cases. The standard setting methodology was therefore revised from September 2010. This increases confidence levels to ensure that the RCGP passes only doctors who are competent and safe for independent practice in the interests of patient safety, which is our overriding duty.
More detailed information about the CSA marking change can be found in the appendices, including:
- The reasons behind the CSA marking change (appendix 1);
- The way in which the new borderline-group marking methodology works (appendix 3);
- How and why the RCGP chose the SEM for each diet of the CSA (appendix 6);
- The relationship between the three components of the MRCGP, and why it is important to pass all three (appendices 7 (a) and (b)).