How are the competences assessed?

 

 

Remember, most GP trainees will not be able to show evidence of competence at the beginning of their training but will gradually build up evidence as training progresses. Therefore, it is OKAY to mark trainees down as "needs further development" or "insufficient evidence (to make a judgement)" if you feel it is appropriate. We've even told them to expect it and not to be too disheartened on our induction course. We would expect there to quite a few "needs further development" for ST1s and ST2s: competency develops with time; they can't be 'perfect' right from the start: otherwise there would be no need for a GP training programme.

 

 

Progress through each of the competence areas can be recorded as one of the following:

 

(I) Insufficient evidence

From the available evidence, the doctor’s performance cannot be placed on a higher point of this developmental scale.

(N) Needs further development

Rigid adherence to taught rules or plans. Superficial grasp of unconnected facts. Unable to apply knowledge. Little situational perception or discretionary judgement.

(C) Competent

Accesses and applies coherent and appropriate chunks of knowledge. Able to see actions in terms of longer-term goals. Demonstrates conscious and deliberate planning with increased level of efficiency. Copes with crowdedness and is able to prioritise.

(E) Excellent

Intuitive and holistic grasp of situations. No longer relies on rules or maxims. Identifies underlying principles and patterns to define and solve problems. Relates recalled information to the goals of the present situation and is aware of the conditions for application of that knowledge.

 

 

 

 

To Re-emphasise: Don't Feel the Need to Mark GP Trainees as Excellent

 

We're seeing quite a few trainees at the beginning of thier scheme (ST1/ST2 stage) being awarded "Excellent" grades when they really ought not to be. I repeat: the level of achievement of these competencies is being assessed against what is required of a fully fledged GP: NOT at the level expected relative to where they are in training. It is important you understand this.

 

 

So it's okay to mark trainees as "insufficient evidence" for example if there was no opportunity in that case to demonstrate that particular competency; it's also okay to mark trainees as "needing further development" where there was an opportunity to discuss a particular area but a need for further work identified.

 

Rather than viewing the MRCGP as an exam, one should view it as a portfolio where trainees are not necessarily judged on individual components but their "training picture" as a whole. Having said that, there is a minimum number of required assessments which should be adhered to.