Examination regulations specific to those sitting MRCGP examinations during periods of Targeted GP Training

Targeted GP Trainees and exams during COVID-19

Targeted GP Trainees (TGPT) now have the opportunity to sit both the Applied Knowledge Test (AKT) and the Recorded Consultation Assessment (RCA)/Clinical Skills Assessment (CSA).

Conversations with educational supervisors, about how ready you are to sit your exam, are now even more important given the COVID-19-related disruption to your training.

Exam currency guidance for AKT:

All trainees (which includes TGPT, LTFT and those on maternity leave) who were in ST2 or ST3 between 18 March 2020 and 3 August 2021 and whose training may therefore have been affected by the pandemic will have the currency of their AKT assessment extended from 7 years to 7 years and 6 months. 

Exam currency guidance for CSA:

All trainees (which includes TGPT, LTFT and those on maternity leave) who were in ST3 between 18 March 2020 and 3 August 2021 and whose training may therefore have been affected by the pandemic will have the currency of their CSA assessment extended from 7 years to 7 years and 6 months. 

The Targeted GP Training (TGPT) Scheme enables specified cohorts of doctors to re-enter GP Specialty Training and to make up to two further attempts at either the MRCGP Applied Knowledge Test (AKT) or Clinical Skills Assessment (CSA) where failure to pass either of these examinations has resulted in a previous ARCP Outcome 4 decision. 

The scheme, which becomes operational in February 2019, applies to Health Education England (HEE) and NHS Education for Scotland (NES). The standards set for TGPT candidates are the same as those exam standards for all other candidates sitting AKT or CSA in a standard training programme. Full details of the scheme and its entry criteria are available from the following websites:

Guidance on the recommended educational support for doctors in TGPT, the mandatory workplace-based assessments (WPBA), and the additional mandatory requirements regarding "Readiness to sit" either AKT or CSA are also available on our website.

MRCGP examination regulations

TGPT doctors should be familiar with the most current version of the MRCGP Examination Regulations which are accessible from the RCGP website, and which apply to all candidates sitting these examinations.

The regulations apply principally to those undertaking GP Specialty Training, so those sections concerned with eligibility for examinations will not, of course, be relevant to those undertaking Targeted GP Training.

Eligibility to sit examinations that were not previously passed during GP Specialty Training 

Doctors on the TGPT scheme will be eligible to apply to sit the Applied Knowledge Test (AKT) or Clinical Skills Assessment (CSA) following receipt of a favourable Annual Review of Competence Progression (ARCP), after 12 months of whole-time-equivalent targeted training.

This review will include confirmation from the trainee's first 12-month ARCP panel that there is sufficient evidence to confirm both engagement and progression, and that the minimum WPBA requirements for a trainee in their ST3 year of training have been met for each year that they are on the scheme. Full details of these requirements are available from Health Education England's website.

The evidence available in the trainees' ePortfolio considered at this ARCP should also include a positive recommendation in the Education Supervisor's report that the trainee is appropriately prepared for the examination.

Trainees on the TGPT scheme will need to be assessed as to their readiness to sit the exam not previously passed (CSA or AKT), and their readiness to sit any exam whose currency has elapsed due to time. Where readiness to sit has already been established for a trainee on the TGPT scheme, a further conversation with the Education Supervisor and/or their support Training Programme Director (TPD) is strongly recommended before making any applications to take either of the exams.

Examination passes which expire during Targeted GP Training 

The currency of all MRCGP AKT and CSA passes is seven years in line with the GMC's expectations about the currency of national professional examinations. Doctors who find that an AKT or CSA pass obtained during GP Specialty training has become invalid whilst they are undertaking TGPT, will be required to re-sit this examination. All doctors must have valid exam passes in both CSA and AKT, as well as satisfactory workplace-based assessments, at the time they are awarded a Certificate of Completion of Training (CCT).

Trainees on the TGPT scheme should also be assessed by their educational supervisor or training programme director for their readiness to sit examinations whose currency has elapsed, typically at the first interim Educational Supervisor Report (ESR) which will occur no earlier than 6 months (whole time equivalent) into the TGPT scheme. This decision on readiness to sit should be confirmed in the Interim Review documentation and should be reviewed through the ARCP process (see the section above on eligibility to sit examinations that were not passed during GP Specialty Training).

Number of attempts permitted for trainees on the TGPT scheme

A maximum of two attempts will be permitted for each of the exams, regardless of the number of attempts for either CSA or AKT made by the trainee previously when in GP training. No attempts are permitted for trainees out of programme.

The standards set and pass marks for attempts at either the CSA or AKT by TGPT candidates will be the same as for all other candidates sitting these examinations.

Less than Full-Time (LTFT) Trainees

The TGPT scheme length is 18 months whole-time equivalent. For LTFT trainees, all the requirements for the workplace-based assessments and the readiness-to-sit discussions advice should be considered pro-rata, with the sole exception of ARCPs which can be held no less frequently than annually.

Exceptional fifth attempts

The RCGP's policy on exceptional fifth attempts at the AKT and CSA examinations is not applicable to those on the TGPT scheme.

Mitigating circumstances

The RCGP has a clear policy for considering mitigating circumstances [PDF] which is applicable to all attempts at both the AKT and CSA. Mitigating circumstances must be reported to the RCGP Examinations Office or an invigilator as soon as the circumstances arise, or as soon as possible thereafter, and no later than 48 hours after the examination has been sat.

The RCGP would normally expect a candidate who believed that their performance was likely to be affected by mitigating circumstances arising before an assessment - for example illness - to withdraw from that sitting and re-sit at a later date. All candidates who present themselves for the AKT or CSA sign a declaration as part of the registration process on arrival at the examination centre through which they confirm that they are fit to sit the examination.

A request for consideration of mitigating circumstances should not be considered as a default route for obtaining additional attempts at examinations.

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