Reasonable adjustments information for all examinations

The Equality Act 2010 requires the RCGP to make reasonable adjustments where a candidate, who is disabled within the meaning of the Equality Act 2010, would be at a substantial disadvantage in comparison to someone who is not disabled. The RCGP is committed to take reasonable steps to overcome that disadvantage.

The Equality Act defines disability as a physical or mental impairment which has a substantial and long-term (usually more than 12 months) adverse effect on someone's ability to carry out day-to-day activities.

Candidates with conditions that fall outside the Equality Act 2010 definition of disability, e.g., conditions that are short-term and/or do not have a substantial adverse effect on the candidate's day-to-day activities, may be eligible to request reasonable adjustments.

Whether an adjustment will be considered reasonable will depend on several factors which will include, but are not limited to:

• the needs of the candidate who has requested the adjustment;
• the effectiveness of the adjustment;
• the cost of the adjustment; and
• the likely impact of the adjustment upon the candidate and other candidates.

An adjustment is not considered reasonable if it:

• involves unreasonable costs to the College;
• involves unreasonable timeframes; or
• affects the security and integrity of the examination.

Any requests for reasonable adjustments have to be agreed before booking an examination (deadlines for submission of requests are at the top of this page).

Each request for reasonable adjustments will be assessed by the examinations team, advised by the MRCGP Disability Advisor as necessary. In complex cases it is possible that the Chief Examiner and an advisory group may also be involved in the decision-making.

Once the request for reasonable adjustments has been processed, candidates will receive an email listing the reasonable adjustments that have been accepted for the relevant examination.

If you wish to provide feedback or make a complaint about the decision made, please follow the steps of the feedback and complaints policy and procedure and email it to exams@rcgp.org.uk.

Confidentiality

Information and evidence about a candidate's disability and requirement for reasonable adjustments will be treated as sensitive personal information in line with the Data Protection Act 2018.

It will be kept confidential within the examinations team and only passed to those who need to know. In some cases, this may include the decision makers (in the case of a complaint) and role players in the case of the SCA examination.

Part of the consideration of your request may need to involve, with your consent, information from your workplace Educational Supervisor or training organisation. In such circumstances, if you do not consent to your Educational Supervisor being contacted, then the RCGP cannot guarantee that all reasonable adjustment requests will be granted.

If you are granted reasonable adjustments, then this will be shared with Pearson VUE (PV) for the purposes of delivering your AKT examination and Professional Role Players (PRP) for the purposes of delivering your SCA examination. You will be asked to indicate your consent for sharing this information on the online application form.

Please make sure to read the reasonable adjustments policy and procedure before requesting reasonable adjustments for your examination.

Each application for reasonable adjustments will be assessed on a case-by-case basis.

It is important to note that the reasonable adjustments listed below are only indicative of the adjustments that may be available. The approval of these adjustments is strictly subject to submission of sufficient supporting evidence. We want to emphasise that this list is intended for candidates who genuinely require these adjustments and are able to provide supporting evidence that allows us to properly consider each case. If approved, we will put the necessary adjustments in place.

The more supporting evidence you provide for your adjustment requests, the easier it is for us to provide the necessary accommodations.

Below is a list of the supporting evidence you need to submit together with your online form:

• Specific Learning Difficulty (SpLD)* – Full Psychology/Neurodiversity assessment report with raw scores, by a chartered or educational psychologist or a specialist teacher assessor with a current practising certificate (PATOSS), performed according to SASC guidelines, conducted post-16 years of age.
  Assessment of Reasonable Adjustments (ARA) or online screening reports are not accepted.
• ADHD and ASD – Assessment by a psychologist or Psychiatrist or a letter from the GP confirming the diagnosis. A GP referral letter and/or a screening test which indicates the above is not sufficient.
• Physical conditions – GP and/or specialist letter.
• Pregnancy at 32 weeks or over** at the time of the examination – MatB1 form, letter from midwife, GP or hospital letter. The document must include your due date.
• Pregnancy under 32 weeks** at the time of the examination, for those experiencing other pregnancy related symptoms – diagnosis letter from the GP or appropriate specialist, it also needs to state due date.
• Breastfeeding** – MatB1 form, birth certificate, letter from midwife, GP or hospital letter.

You can also supplement the above information, where appropriate, with the following information:

• Diagnostic reports/letters from assessors/specialists/GP
• Occupational Health reports/letters
• Access to work reports/letters
• Supervisor/workplace supporting letter
• Professional Support or GP Registrar Development and Wellbeing Service report/letter
• Evidence of neurodiversity coaching or support

*Approved assessors for Specific Learning Difficulty (SpLD) include:

• Specialist teachers who hold a practising certificate in assessing specific learning difficulties from their relevant professional body, such as Dyslexia Action or PATOSS. You can find out whether a proposed assessor has the appropriate qualification by checking the SASC (SpLD Assessment Standards Committee) website.
• A practising chartered or educational psychologist who is registered with the Healthcare Professionals Council. You can check whether a proposed assessor is registered by checking the HCPC register.

** Please note that reasonable adjustments put in place for pregnancy and breastfeeding are temporary adjustments and only valid for the examination you intend to book in. If you require adjustments for a different sitting, you will need to apply for reasonable adjustments by completing the online form and submitting the supporting evidence within the relevant deadline.

For certain complex reasonable adjustment applications, we may ask you to contact your Educational Supervisor for a supporting letter. This should highlight your condition and its impact on day-to-day clinical activities within the work environment. In particular we would like your supervisor to answer the following questions:

• are you aware of the application made by your candidate for reasonable adjustments?
• do you support your candidate's requested reasonable adjustments?
• what is the diagnosis or condition your candidate has?
• do you think this diagnosis or condition has an impact on your candidate day-to-day working in practice?
• if yes, can you detail what impact you or the team have observed. It would be helpful to know the impact on the following:
  • communication with patients and colleagues
  • use of IT equipment in practice for consultations, referrals, prescribing and reading hospital letters, time management and organisation, engagement with trainee portfolio
• is there anything else you would like us to know which might help us come to a fair decision?

Disability assessment funding

Fees for professional assessments are the candidate's responsibility.

Please note that the Examinations Team are unable to advise on Deanery funding.

To process your reasonable adjustments in time for the examination, we recommend that you complete your online form and submit supporting evidence while in ST1 or as soon as you have a new diagnosis. The online form and supporting evidence (when available) must be submitted as soon as possible and no later than 15 working days before the booking window.

Once your permanent reasonable adjustments have been approved for an examination, they will continue to be applied to subsequent sittings of that examination. You do not need to request them again but should notify us if your circumstances change.

Please note that reasonable adjustments are not transferable between examinations, so you need to request them for the AKT and SCA separately, by completing and submitting each of the examination online forms and emailing us the relevant supporting evidence.

If you are waiting for an assessment, report or supporting evidence, you must ensure that it is submitted before the deadline (15 working days before the booking window) for the examination diet you wish to sit. Unfortunately, exceptions cannot be considered.

Here are the different steps from when you submit your reasonable adjustment request to the examination day:

Step 1: Complete the reasonable adjustment online form with all relevant information and email your supporting evidence to exams.accoms@rcgp.org.uk as soon as possible and before the deadline (see deadline dates on the reasonable adjustments page). The deadline for submission of the online form and supporting evidence is 15 working days before the booking window of the examination you intend to sit in.

Step 2: The reasonable adjustment request alongside the supporting evidence you have provided will be assessed on a case-by-case basis by the examinations team, advised by the MRCGP Disability Advisor as necessary. In complex cases it is possible that the Chief Examiner and an advisory group may also be involved in the decision-making.

Step 3a: If your reasonable adjustment is not complex, we will send you a confirmation of your approved reasonable adjustments within 10 working days of receiving your online form and supporting evidence.

Step 3b: If the reasonable adjustments you have requested are complex, we may require more time to process your request, and we will let you know of this within 10 working days. Complex reasonable adjustments may take up to 28 working days to be processed from the date we receive your online form and supporting evidence.

In some cases, we may require further information and/or supporting evidence from you.

Step 4: Reserve and apply for your examination.

Step 5: Your reasonable adjustment for the examination diet you have booked will be sent to the external stakeholder who delivers your examination - a week after the booking window closes.

Step 6: The external stakeholder who delivers your examination will apply your approved adjustments to the system.

For the AKT, extra examination time, separate room and reader reasonable adjustments only:
When Pearson VUE have processed the request, they will send you a new booking email confirming your extra time/separate room/Reader adjustments. You may also receive an automated email ahead of this, cancelling your original booking where necessary.

For the SCA you will receive an email confirming which adjustments will be in place for the examination you have booked, three weeks before the examination date.

Step 7: Examination day - your approved adjustments will be delivered in your examination.

Candidates who are unable to meet deadlines for the submission of requests see deadline dates on the reasonable adjustments page) can choose to sit at a later date or book and take the examination without adjustments. If you choose to sit the examination without an adjustment when you have a known diagnosis, please be aware that this sitting will be valid and cannot be voided in the future, as you will be choosing to sit without your recommended reasonable adjustment.

If you have received a reasonable adjustments confirmation email from us on or after the 1st August 2023, then these adjustments will continue to be applied to all subsequent sittings of the exam for which it was approved until the end of your training. There is no need to apply for it again, but you should inform us if there are any changes to your circumstances. 

Reasonable adjustments approved on or before 31 July 2023 will not be automatically applied. Candidates must submit a reasonable adjustment request form, ensuring that the form is submitted before the deadlines. 

Please note that reasonable adjustments are not transferable between examinations, so you must apply for reasonable adjustments for the AKT and SCA separately. 

Once approved, the reasonable adjustments will apply to all subsequent sittings of the AKT or SCA.

It is your responsibility to notify the RCGP of changes to these requirements.

SCA only - you are required to confirm at the point of booking your examination that you have received approval of your reasonable adjustments prior to your booking and that you confirm that your requirements have not changed since receiving the approval.

Requests to change reasonable adjustments will be considered through the process for new requests as above, inclusive of all timelines.

We recommend, if you are unsuccessful in an examination and feel that your performance may have been impaired by an underlying disability, that you seek further medical advice. Where after an unsuccessful attempt you receive a diagnosis of a disability of which you were previously unaware, you may be entitled to reasonable adjustments for any future attempts if submission deadlines are met and the reasonable adjustments are approved. RCGP may void any previous attempts which you took while having that disability without the appropriate reasonable adjustments. Please check our void examination attempts following diagnosis of disability section for more information.

GP Registrars can request reasonable adjustments as per the reasonable adjustments policy (PDF file, 587 KB). GP Registrars are required to complete an online form and submit any relevant supporting evidence which may include a Psychology assessment report for Neurodiversity, or a GP/Hospital specialist report detailing any medical condition. See the section about supporting evidence needed.

Candidate requests for reasonable adjustments will be assessed on a case-by-case basis.

The MRCGP Disability Advisor is a practising GP and MRCGP examiner with experience in supporting GP Registrars needing reasonable adjustments at their workplace.

For certain requests, the examinations team, on the advice of the Disability Advisor, may ask the GP Registrar to seek further supporting evidence or clarification from the educational supervisor or the local training scheme.

This information should highlight the condition and its impact on day-to-day clinical activities within the work environment. We would like the Educational Supervisor to answer the following questions:

• are you aware of the application made by your candidate for reasonable adjustments?
• do you support your candidate's requested reasonable adjustments?
• what is the diagnosis or condition your candidate has?
• do you think this diagnosis or condition has an impact on your candidate's day-to-day working in practice?
• if yes, can you detail what impact you or the team have observed. It would be helpful to know the impact on the following:
  • communication with patients and colleagues
  • use of IT equipment in practice for consultations, referrals, prescribing and reading hospital letters, time management and organisation, engagement with trainee portfolio
• is there anything else you would like us to know which might help us come to a fair decision?

GP Registrars can supplement the above information, where appropriate, with a letter from their training programme. This could be a letter from the TPD or the Occupational Health and Professional support unit.

Examples of commonly requested reasonable adjustments can be found in the following sections of the website:

• Reasonable adjustments available - AKT
• Reasonable adjustments available - SCA
• Reasonable adjustments webpage