Trainee Advisory Group statement in response to RCoA publication of external exams review

The Trainee Advisory Group of the Intensive Care Society welcomes the publication of the independent review of the assessment process of the Royal College of Anaesthetists by Professor John C. McLachlan.

It is good that the serious divisions between the College and the candidates, where trust has broken down on both sides has been addressed frankly and honestly. The recognition of the psychological impact of the exams process on candidates and the far-reaching effects of this is important for the RCoA to acknowledge and address.

We remain concerned that the door is still open for further errors in exam management due to the described underlying examination’s structure not being robust, although a recommendation to restructure the exam delivery set up is welcome. Likewise, regarding strengthening governance and accountability structures across all the college and faculty assessment processes.

It is very pleasing to see a recommendation to have candidate and doctors in training representation at as many stages of the assessment process as possible and we hope that doctors are welcomed into these roles as quickly as is practicable.

We welcome the suggestion of benchmarking by doctors-in-practice at various levels to inform the standard setting for the exams This may address the perceived deviation of particularly the primary FRCA exam content from expected workplace performance.

We are glad that it has been acknowledged there are many more doctors deemed good clinicians who fail these exams that there are poorly performing doctors who pass them.

We are pleased that the drawbacks of the SOE process have been highlighted and the suggested alterations in structure may make the exams fairer. It is also good that Manchester has been suggested as an alternative location for in-person exams.

We hope that the highlighted differential attainment of female candidates in the RCoA exams will become a priority for the college, together with producing more information on the impact of ethnicity and educational background. The recommended appointment of an equality, diversity and inclusion lead is welcome along with suggestions to increase the diversity of the examiner pool.