MRCGP

AN INTRODUCTION

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The components of the MRCGP

I’ve developed these pages because many trainees and trainers find the RCGP site a bit to overwhelming (and quite frankly, a bit boring).   So, I hope these pages are easier to read, easier to understand, provide you with lots of help tools and make the learning a bit more interesting.  I’ve also weaved in some real experience from both trainees and trainers so that you can learn from the mistakes of others.   And of course, if you have any suggestions, comments or improvements to suggest, please add them via the comments box at the end of this or any other BradfordVTS page.

The first thing to say about the MRCGP is that it consists of three parts.  AND ALL PARTS HAVE EQUAL IMPORTANCE.   The three parts are:

  1. The AKT exam (a multiple choice type paper)
  2. The CSA exam (an OSCE style exam)
  3. Work Place Based Assessment (WPBA)

A lot of trainees think that if they get their AKT and CSA – they will get through GP training without any problem even if their WPBA is a bit rubbish.  TOTALLY WRONG.  WPBA is as important as the rest.   One component of WPBA is the ePortfolio – and for instance, if that is a bit rubbish and you don’t look after it, then you could be given an extension.   Do you want to take that risk

What is each testing?

  • The AKT is basically testing how good your knowledge is – not just clinical, but also medical statistics, evidence based medicine, and organisation stuff too (like understanding how the NHS works, the different forms, the different mental health sections and so on).
  • The CSA is an exam which tests your clinical skills through testing your data gathering skills (=history & examination) and your clinical management skills.   It’s also tests your communication skills with the patient (referred to as you Inter Personal Skills).  A lot of trainees think the CSA is just about communication/interpersonal skills – but that’s wrong.  It’s about both clinical and communication skills.
  • WPBA hast lots of components (like video and case based assessments, supervisor reports, patient and colleague feedback just to name a few) and it tests lots of things.   Basically, in GP training you are tested against 13 Professional Competency areas.  These 13 competencies define exactly what it takes to become a good GP.   Therefore, Professional Competencies are the things which YOU must provide EVIDENCE for to SHOW that you are good at in order to become a GP.   Different components of the WPBA assess different parts of these 13 Professional Competency areas.  In fact, many of them overlap – there are several WPBA components that overlap in what they are testing – and this is important for triangulation purposes.  Triangulation is a technique  that helps validate your performance in a professional competency through cross verification from two or more sources.    I’m sure you’ll agree this is important.   In summary, the WPBA components are TOOLS to help you show that you’re good enough to become a GP.   Can you see why they’re important as the exams?

AKT​

- Applied Knowledge Test
- Machine marked test (at local driving theory test centres)
- held several times a year - click here
- May be appropriate to take before final year, or early in final year

CSA​

- Clinical Skills Assessment
- OSCE type exam held several times a year - click here
- held several times a year (in local driving theory test centres)
- take when in GPST final year. Not too late and not too early.

WPBA

- Work Place Based Assessment
- several components, all recorded via ePortfolio
- as important as AKT/CSA; click here for RCGP section
- if you leave it late, you cannot make up for it later.

4 Key Points

1. RESPONSIBILITY

It is the responsibility of the trainee to ensure that they complete the appropriate assessments and build up a record of their training and evidence of competence AT THE APPROPRIATE TIMES through the e-portfolio. It will be you who tells your trainer/supervisor when you are ready to do a specific type of assessment (not the other way around).    Do not expect your trainee or Educational Supervisor to remind you or check whether you have done the right number of assessments – that is your responsibility.   Qualified GPs have to do all sorts of things in their lives – and they don’t have someone to remind them.  They have to find a system for themselves.  Likewise, you must do the same.

Whilst the process is trainee led, it will be supported by your Educational Supervisor.  There are 6 monthly reviews throughout training at which your progress will be reviewed and actions agreed.  Loads of different things happen in parallel throughout the 3 years.  So plan now to avoid last minute panic

 

2. NEEDS FURTHER DEVELOPMENT (NFD)

Please do not see ‘needs further development’ as a failure. We EXPECT you to have quite a few ‘needs further development’ especially if you are in ST1 or ST2.  If we do see all “competent” or “excellent” grades being given at the S1/S2 stage, as educators, we tend to not regard them highly (and we get more worried than if you had been given NFD) because how can you have no learning needs at such an early stage in your GP training.  If you’re competent or excellent at everything – then surely there’s no point in even doing a GP training scheme.  Do you see where I am coming from?

3. HOSPITAL CONSULTANTS

Some of your hospital colleagues may not be that familiar with what they are doing in the assessments. After all, they’ve been trained up to be the hospital specialist that they are.   Of course, they’re going to be very good at assessing their own specialty trainees who are training up to be what they are.   But the question is, how can they assess a GP trainee against criteria that define what it is to be a good GP – when they have never been a GP?   It’s a good question – and the reality is that often hospital consultants and their GP assessments are not as robust or valid as that done by GP trainers.   

In many regions, they are being trained up though.  Whilst they are being trained up, we would urge you to get a good understanding of how the assessments work and what each domain or competency means so that you are empowered to help your consultant. In this way, we are sure that your hospital colleagues will get the hang of them in no time and it will really help you to get the best out of them. So, please help them to help you.

4. THE RCGP WEBSITE

The RCGP website is your essential resource for all the latest information and guidance. It is being continually updated, therefore if it says anything different from what’s on this website: believe the college!    www.rcgp.org.uk

4 Quick Starting Tips

Understand the Professional Competencies

The candidate demonstrates sound performance in the domain both in principle and in detail, operating clearly above the level for safe independent clinical practice. Performance is fluent although not necessarily sophisticated. Positive behavioural indicators of performance are consistently and proficiently met and on balance any negative behaviours observed are not thought to be of concern.

Understand the Professional Competencies

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Understand the theory behind Reflection

The candidate's performance shows ability but overall is below the level for safe independent clinical practice. The positive behavioural indicators are not demonstrated to a consistently adequate standard and negative behaviours may be of concern.

Do a QIA project in ST1

The candidate has a sound grasp of the principle of the domain more so than the detail, operating at or just above the level for safe independent clinical practice. Positive behavioural indicators are consistently met, although performance may not be fluent. On balance any negative behaviours observed are not thought to be of concern.

Do your Out of Hours (OOH) sessions on time

The candidate performs well below the level for safe independent clinical practice. The range and depth of the positive indicators are poorly demonstrated and performance may be inconsistent. Negative behaviours may be of concern.

Remember you're a GP trainee

The candidate has a sound grasp of the principle of the domain more so than the detail, operating at or just above the level for safe independent clinical practice. Positive behavioural indicators are consistently met, although performance may not be fluent. On balance any negative behaviours observed are not thought to be of concern.

Remember your ePortfolio

The candidate performs well below the level for safe independent clinical practice. The range and depth of the positive indicators are poorly demonstrated and performance may be inconsistent. Negative behaviours may be of concern.

Read a consultation book in ST1

The candidate has a sound grasp of the principle of the domain more so than the detail, operating at or just above the level for safe independent clinical practice. Positive behavioural indicators are consistently met, although performance may not be fluent. On balance any negative behaviours observed are not thought to be of concern.

Read other sections on this website

The candidate performs well below the level for safe independent clinical practice. The range and depth of the positive indicators are poorly demonstrated and performance may be inconsistent. Negative behaviours may be of concern.

Don't miss your scheme's induction

The candidate has a sound grasp of the principle of the domain more so than the detail, operating at or just above the level for safe independent clinical practice. Positive behavioural indicators are consistently met, although performance may not be fluent. On balance any negative behaviours observed are not thought to be of concern.

Plan which courses and when

The candidate performs well below the level for safe independent clinical practice. The range and depth of the positive indicators are poorly demonstrated and performance may be inconsistent. Negative behaviours may be of concern.

Please leave a comment below if you have any words of wisdom to help others or if you have any questions you wish to ask…

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[toggle title_open=” THE GP CURRICULUM ” title_closed=” THE GP CURRICULUM ” hide=”yes” border=”yes” style=”default” excerpt_length=”0″ read_more_text=”Read More” read_less_text=”Read Less” include_excerpt_html=”no”]

The curriculum covers the knowledge and skills that all GP trainees need to learn in order to deliver the highest quality standards of patient care.  Familiarise yourself with the GP curiculum; it’s a big document but the more you look at it, the more familiar it will become. All components of MRCGP are mapped to the competencies defined in the curriculum.

[highlight]RULES, REGULATIONS AND REQUIREMENTS CHANGE OFTEN. PLEASE VISIT AND RE-VISIT THE RCGP WEBSITE FREQUENTLY BECAUSE IF YOU DON’T ONLY YOU LOSE OUT![/highlight]

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[toggle title_open=”HOW CAN I PREPARE FOR THE MRCGP” title_closed=”HOW CAN I PREPARE FOR THE MRCGP” hide=”yes” border=”yes” style=”default” 

Here are some quick bits of information you should know right now:

  • Some clarity on what some of the Curriculum Statement headings mean:
    • Teaching, Mentoring and Clinical Supervision means the teaching the trainee has has been involved with and/or delivered, NOT the educational experiences which they have received.
    • Management in General Practice means organisational management, NOT the clinical management of patients.
  • DOPS
    • There’s no point recording previous experience which hasn’t been directly observed. It’s essential to get the ePortfolio entries for the compulsory DOPS put in by whoever observed the procedure. If this isn’t done, the ARCP panel will bounce your ePortfolio when it’s submitted for CCT at the end of ST3.   Also, the procedure has to be on a patient and not, for example, in a skills lab on a dummy.
  • COTS
    • Try and get your GP trainer to do some COTS via directly observing you in real time in a joint surgery consultation (as well as the usually method of doing it via video recordings).   This will help you prepare for CSA and will help you get a bit more comfortable with consulting when someone is watching.   Also, it means that a range of normal consultations are observed by the trainer, not just the good ones which trainees tend to select for COTs
  • OOH (Out of Hour work)
    • The educational reason for doing OOH is for trainees to acquire the relevant competencies in case they wish to participate in Out of Hours once they qualify.  Simply recording the number of sessions worked doesn’t provide evidence of this. Trainees must record a brief list of paitents seen (and what was done) and [highlight]reflect [/highlight] on one or two of the interesting ones which they think will help them provide evidence for curriculum coverage as well as some of the professional competencies.
 

 

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