British Association of Physicians of Indian Origin British International Doctors Association Royal College of General Practioners. Way Forward Finding Solution to CSA Issues. Meeting at RCGP 10 December 2012. Way Forward Finding Solution to CSA Issues. Issue:
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British Association of Physicians of Indian Origin
British International Doctors Association
Royal College of General Practioners
Meeting at RCGP
10 December 2012
Significant Failure rate at CSA for IMGs
Objectives of the Meeting:
Audit of the perception of GP trainees regarding CSA Exam Oct 2012
British Association of Physicians of Indian Origin
Over last 2 year steadily increasing number of GP Trainees have been contacting BAPIO regarding Concerns about CSA
CSA Results 2010 - 11
Male = 106
Female = 52
Did not state = 2
114 (58.5%) 1 attempt
45 (23.1%) 2 attempts
12 (6.2%) took 4+ attempts
7 (5%) trainees had to leave GP training due to failure in the AKT
153 (95.6%)Trainees in the survey had attempted CSA
Factors that contributed to the CSA failures
‘No real support but lip service.’
‘It is a vague programme, with individuals left to work out the system’.
‘Poor induction programme, poor effort by the deanery to support the weak candidates- almost washing their hands off the candidates- as these IMG's were recruited through MMC- a big mistake. There is no structured educational programme’
‘I have always been told that I am very good , good videos and good when doing role-plays with actors but failed repeatedly. My trainer and supervisor said I have good communication skill but not that is needed for CSA! The bias of the examiners and actors did not help.’
'Have good references from 20 hospital Consultants, several GP trainers, 40 excellent MSF,100 PSQ- have been working for NHS for seven years, have seen at least three thousand patients in GP Surgeries, passed AKT with good marks-cannot pass my CSA , about to be kicked out of the programme. If I am not fit to practice why did my trainers not raise concerns, why are the RCGP actors taking centre stage ? Are they more genius than my Trainers, Consultants, Patients and colleagues?' The RCGP actors are deciding who is worthy to be a NHS GP!
‘The GPVTS course did not prepare us for the biased exam. We were given 2 days of practice with the rest of the VTS group and I did not find any difference between the British qualified doctors and the international medical graduates.’
Some responses (randomly chosen)
‘This CSA and what they have done to my career has left me with financial trouble. I am in the process of selling the house too as we can't keep up with the mortgage and the credit taken’
‘In the words of our trainer and the assistant dean "We train you to be a good GP and not pass the exam". Then how it is that after training to be good GP we can not pass the CSA exam? After going through the rigorous process of selection and then rigorous training and being stamped - unattainable. Is it justice???’
‘Actors bias-Very evident throughout the consultation(My experience from 3 CSA attempts and from many colleague mentioned the same). I work in a surgery with 92 % White middle class population. My trainer is happy with my consultation as he had seen many videos on my consultation many times before the exam”
“My real patients are much different from CSA actors in communicating and information giving and making a rapport during the consultation and I never had any dysfunctional consultation’
‘I felt actors were very vague and holding information unnecessarily”
“RCGP asking for real empathy and emotions in an artificial environment and we have to assume certain things and act. I am a person good at these skills in real environment and I feel inside they are not real patients. I am not an actor!!!’
‘No comparison with real surgery patients in terms of responding to our questions.(Verbal and non verbal communications)”
“Time pressure, Uncertainty, Awareness of IMG failure rates, Huge sum of examination fee make us very tensed during the exam and impairing our real possible emotional outpouring impossible’
‘Why I am depressed.
I have no faith in this exam and I am not sure about my last
and fourth attempt. My trainer and myself do not
understand the real problem as feed back is general and
wont give you anything to improve.
I have no money as I have spent already 7000 pounds in total
towards exam and preparation courses without any hope.
My 3 exam score sheets not giving any consistent picture.
I have felt actors bias throughout and found it difficult from
real patient in my usual day to day surgery’
‘No exam focus at all. VTS schemes need to take the CSA exam very seriously and as a part of their job. No specialty grade jobs in GP. Unlike other hospital specialties general practice has a dead end for significant number of IMGs. It ruins those doctors lives. I sincerely mean it!!!’