Quality management of GP training

Our role in quality managing GP training involves working in close partnership with the postgraduate deaneries and the GMC.

Quality managing the GP curriculum and assessments

All postgraduate medical education curricula and assessment systems must be mapped to the specialty’s curriculum and approved by the GMC before they can be implemented.

The GP curriculum and MRCGP were approved by PMETB (the previous regulator) in 2007. The three components of the MRCGP test different competences using validated assessment methods. The utility, validity, reliability, feasibility, cost effectiveness, opportunities for feedback. Impact on learning of each assessment method, and impact of the assessment system as a whole, comply with standards defined by the GMC. This is also true of the best assessment and educational practice, in terms of quality assurance and standard setting.

Applied Knowledge Test (AKT)

The AKT is quality assured through comprehensive item-writing and training, question-banking and selection processes, and robust standard setting and linear equating processes.

Recorded Consultation Assessment (RCA)

The validity of the RCA resides in its assessment of real-life consultations, within a range of mandated criteria. Candidates are assessed on 13 consultations of twelve minutes each. Examiners are comprehensively trained, and each case is marked by 2 examiners. Examiners are quality assured through continual monitoring. Robust standard setting is achieved through borderline regression.

The RCGP are currently redeveloping a new clinical skills assessment to replace the RCA which was developed in response to the Covid-19 pandemic in 2020.

Workplace Based Assessment (WPBA)

Deaneries are responsible for the management of the quality of WPBA locally. RCGP has overall responsibility for ensuring quality through the design and development of the WPBA tools. We are responsible for delivering suitable mechanisms for recording WPBA in the Trainee Portfolio.

External scrutiny

The Gold Guide states that Royal Colleges have a role in quality managing deanery Annual Reviews of Competence Progression (ARCP) panels. This helps ensure that deaneries make consistent decisions about trainees’ progress.

External Advisors

Detailed external scrutiny is provided by the RCGP’s team of External Advisors on the ARCP process and decision-making. An External Advisor visits each deanery every two years to observe that deanery’s ARCP panel process. External Advisors also remotely quality manage a sample of Trainee Portfolios every year. Feedback is provided to deaneries following this exercise in the Annual Report on the Quality Management Sessions.

External Advisors are also involved in ARCP appeal panels at a deanery’s request.

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