MRCGP has come with a whole new load of acronyms, assessments and deadlines, which you have to master.
There are three formative and summative elements (click to download):
- Workplace-Based Assessment (WPBA) CBDs/COTs/MiniCEX etc and MSF, PSQs and CEPs
- Applied Knowledge Test (AKT) & Clinical Skills Assessment (CSA)
Each of these is independent and tests different skills but together they cover the curriculum for specialty training in general practice. Evidence for the workplace-based assessment is collected in the e-portfolio of each GP Trainee.
The Applied Knowledge Test (AKT) is a summative assessment of the knowledge base. The test takes the form of a three-hour multiple-choice test of 200 items.
Approximately 80% of question items will be on clinical medicine, 10% on critical appraisal and evidence based clinical practice and 10% on health informatics and administrative issues. Questions focus mainly on higher order problem solving rather than just the simple recall of basic facts.
The Clinical Skills Assessment (CSA) is ‘an assessment of a doctor’s ability to integrate and apply clinical, professional, communication and practical skills appropriate for general practice’. Each candidate is allocated a consulting room and has 13 consultations, each of 10 minutes. All thirteen cases are assessed. Patients are played by role-players who have been trained and calibrated to perform their role in a consistent manner. Candidates’ performance in three domains (Data gathering, Clinical management and Interpersonal skills) in every consultation is graded Clear Pass (3pts), Marginal Pass (2pts), Marginal Fail (1pt) or Clear Fail (0pt) by assessors who observe the consultations.
Workplace based assessment (WPBA) is defined as the evaluation of a doctor’s progress over time in their performance in those areas of professional practice best tested in the workplace. It is a process through which evidence of competence in independent practice is gathered in a structured and systematic framework. Evidence is collected over all three years of training. The evidence is recorded in a web-based portfolio (the e-Portfolio) and used to inform six monthly reviews and, at the end of training, to make a holistic, qualitative judgement about the readiness of the GPStR for independent practice.
The Workplace Based Assessment (WPBA) component of the MRCGP exam is designed to test GP trainees’ competence in 13 key areas derived from the core RCGP curriculum statement ‘Being a GP’.
Competence means having the abilities, knowledge and skills necessary for professional practise. Our framework for WPBA is made up of 13 competences:
- Communication and consultation skills – communication with patients, and the use of recognised consultation techniques
- Practising holistically – operating in physical, psychological, socioeconomic and cultural dimensions, taking into account feelings as well as thoughts
- Data gathering and interpretation – for clinical judgement, choice of physical examination and investigations and their interpretation
- Making a diagnosis and making decisions – a conscious, structured approach to decision making
- Clinical management – recognition and management of common medical conditions in primary care
- Managing medical complexity and promoting health – aspects of care beyond managing straightforward problems, including management of co-morbidity, uncertainty, risk and focusing on health rather than just illness
- Organisation, management and leadership - an understanding of the use of computer systems to augment the GP consultation and primary care at individual and systems levels, the management of change, and the development of organisational and clinical leadership skills
- Working with colleagues and in teams – working effectively with other professionals to ensure good patient care, including sharing information with colleagues
- Community orientation – management of the health and social care of the practice population and local community
- Maintaining performance, learning and teaching – maintaining performance and effective CPD for oneself and others
- Maintaining an ethical approach to practice – practising ethically, with integrity and a respect for diversity
- Fitness to practise – the doctor's awareness of when his/her own performance, conduct or health, or that of others, might put patients at risk, and taking action to protect patients
- Clinical examination and procedural skills – competent physical examination of the patient with accurate interpretation of physical signs and the safe practice of procedural skills