The MRCGP is the
licensing exam for general practitioners and has been
designed to test whether doctors in training are
performing well enough to practice independently i.e.
without being continually supervised.
How do the
assessors know what to test?
There are two parts to this:
1. Firstly and most importantly, the knowledge skills
and attitudes that GPs require are laid out in the RCGP
curriculum. The curriculum can look overwhelming, but it
isn't if we remember that the curriculum itself is
described in the core curriculum statement Being a
General Practitioner. The core statement has 9 principal
areas as shown in the table below. The first 6 are
called ‘domains’ and the last 3 are called
‘essential features’. The other curriculum statements
are interpretations of the core statement, illustrating
how the competencies in the core statement manifest
themselves in different contexts.
2. For the MRCGP, the nine areas of the core curriculum
statement have been translated into 12 competency areas
which we call the competence framework. The relationship
between this framework and the curriculum is as follows:
Why translate the
curriculum?
The core curriculum was written in order to explain the
essence of being a GP. It contains many ideas, but was
not designed to specify the behaviours that doctors must
have in order to pass the licensing exam. This is why a
translation was needed. The competence framework doesn't
represent the entirety of the curriculum and to
understand each of the 12 assessment areas properly, you
need to read about the area of the curriculum to which
it is related, as shown in the table.
|
The
Curriculum: |
Related MRCGP competency areas: |
|
Primary care management |
Clinical management
Working with colleagues and
in teams
Primary care administration
and IM&T |
|
Person-centred care
|
Communication & consulting
skills |
|
Specific problem-solving
skills |
Data gathering and
interpretation
Making a diagnosis/making
decisions |
|
A comprehensive approach
|
Managing medical complexity |
|
Community orientation
|
Community orientation |
|
A holistic approach |
Practising holistically |
|
Contextual features |
Community orientation |
|
Attitudinal features |
Maintaining an ethical
approach to practiceFitness to practise |
|
Scientific features |
Maintaining performance, learning and teaching |
By having behaviours
that are specified, trainees know what they are expected
to do for the MRCGP and assessors to know what to look
for.
Where are the 12 assessment areas tested in the MRCGP?
All 12 assessment areas
are tested continually through workplace-based
assessment. Most of them are also tested in the other
two examination components. For example, clinical
decision-making and interpersonal skills and attitudes
are tested in CSA and the knowledge base of general
practice and how it is applied this tested through the
AKT.
How
can ‘Becoming a GP’ help me?
As we can see, the exam
is based on a series of specified competencies developed
from the GP curriculum. ‘Becoming a GP’ describes each
of these behaviours in detail, putting them into the
context of a GPs working life with advice on how these
behaviours can be achieved. It also describes various
stages in the development of the competencies.
In this way, the book
helps trainees right from the start of training to
understand exactly what is being tested in the GP
licensing exam, the standard of performance that they
must reach in order to pass the nMRCGP and the
milestones on the way to success.
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