Origins of the MRCGP Examination syllabus
In devising this syllabus, the College and its Panel of
Examiners have been guided by the General Medical Council’s seminal
document Good Medical Practice (2001). This set out
seven broad headings:
- Good clinical care
- Maintaining good medical practice
- Relationships with patients
- Working with colleagues
- Teaching and training, assessment and
appraisal
- Probity
- Health and the performance of other doctors
The GMC has also, in Duties of a Doctor, set out the
framework of professional responsibilities within which doctors
operate and which should inform assessment processes including the
MRCGP Examination.
Following the publication of Good Medical Practice a
joint working party of the Royal College of General Practitioners
and the General Practitioners’ Committee of the British Medical
Association elaborated these principles within the specific context
of general practice in their Good Medical Practice for General
Practitioners (March 2002). The present syllabus draws
heavily on this latter document. However, an exact one-to-one
mapping of sections from these antecedents onto the MRCGP
Examination syllabus has not been rigidly attempted. For the
purpose of guiding candidates’ preparation, it was found necessary
to expand some areas very considerably (notably clinical knowledge
and skills), and to highlight others (e.g. ‘generalist skills’,
‘risk and resource management’, ‘population, preventive and
societal issues’ and ‘research & evaluation methods’) in order
to afford them their necessary prominence within this
syllabus.
While the MRCGP Examination is (as previously stated)
positioned in the context of British primary care, it also reflects
the broader principles set out in The European Definition of
General Practice / Family Medicine, published by WONCA Europe
in 2002. In particular, this document lists in a
context-independent form eleven central characteristics which
define the discipline of primary care, and clusters them into six
core competencies as follows:
- (1) Primary care management
a) managing primary contact with patients
b) co-ordinating care with other professionals
- (2) Person-centred care
c) adopting a person-centred approach
d) developing the consultation and the doctor/patient
relationship
e) providing longitudinal care
- (3) Specific problem-solving skills
f) using knowledge of the community prevalence of illness
g) managing undifferentiated or serious conditions
appropriately
- (4) Comprehensive approach
h) managing acute and chronic problems simultaneously
i) applying health promotion and disease prevention strategies
- (5) Community orientation
j) reconciling the needs of individuals and communities
- (6) Holistic modelling
k) using bio-psycho-social, cultural and existential
dimensions