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Notice of amendments to the MRCP(UK) Regulations and Information for Candidates 2011 in respect of changes to the Part 2 Clinical Examination (PACES) To have effect from the 2011/3 diet onwards Changes are being made to the way in which the pass mark is set for the MRCP(UK) Part 2 Clinical Examination (PACES) that come into effect at the 2011/3 diet. As a result several changes have been made to the 2011 Regulations and Information for Candidates so that they remain accurate and up-to-date. To minimise any confusion, where a section of the 2011 Regulations has been amended or revised, that section is included in full below, using the same numbering as the text in the 2011 Regulations that it replaces. Candidates for the MRCP(UK) Part 2 Clinical Examination (PACES) should be aware that the revisions to the Regulations detailed below supersede the corresponding text in the 2011 Regulations. No other sections of the Regulations are affected by these changes. These changes will be incorporated into the 2012 Regulations. -------------------- 12. MRCP(UK) Part 2 Clinical Examination (PACES) 12.1 Format – this section remains unchanged 12.2 Attending the MRCP(UK) Part 2 Clinical Examination (PACES) Changes to method of assessment section only Changes have been highlighted for ease of reference. Method of assessment 16 marksheets in total are completed by the examiners: • one by each examiner at Stations 2 and 4 (total 4); • two by each examiner at Stations 1, 3 and 5 (total 12). Candidates are awarded marks for between four and seven separate clinical skills at each patient encounter, allowing a minimum of eight and a maximum of 16 judgments to be made on each candidate’s performance in each skill over the course of the examination. A description of each of the seven clinical skills, and at which stations they are assessed, is available on the MRCP(UK) website: www.mrcpuk.org. The onus is on the candidate to demonstrate each of the skills noted on the marksheet for each encounter. All marks are recorded on a three-point grading system and are detailed on the MRCP(UK) Part 2 Clinical Examination (PACES) marksheet. The grades are: Updated September 2011 • unsatisfactory • borderline • satisfactory These grades are converted to numeric values 0–2 (unsatisfactory=0, borderline=1, satisfactory=2). Grade descriptors are provided on the marksheets and are further refined in the examiner calibration process that takes place before each candidate is seen. These numerical values are totalled to give the candidate’s score for each skill, and a total score. To pass the MRCP(UK) Clinical Examination (PACES), candidates will be required to attain a minimum standard in each of the seven skills assessed AND also attain a minimum total score across the whole assessment. For the year from October 2011 – September 2012 the Clinical Examining Board determined that the standards required will be as follows: Skill A B C D E F G Minimum score total Physical Examination Identifying Physical Signs Clinical Communication Differential Diagnosis Clinical Judgement Managing Patient Concerns Maintaining Patient Welfare All encounters and skills Pass mark 14 14 10 16 18 10 28 130 12.3 After the MRCP(UK) Part 2 Clinical Examination (PACES) Results of MRCP(UK) Part 2 Clinical Examination - replaced by the following text. Changes have been highlighted for ease of reference. Results of MRCP(UK) Part 2 Clinical Examination The MRCP(UK) Clinical Examining Board has overall responsibility for policy and procedures relating to, and the organisation of, the MRCP(UK) Part 2 Clinical Examination (PACES). The MRCP(UK) Clinical Examining Board will consider reports from Examiners (and others as necessary) on the delivery of the MRCP(UK) Part 2 Clinical Examination (PACES) at centres within and outside the UK to ensure that the examination has been conducted appropriately and in accordance with the procedures of the Royal Colleges of Physicians. The MRCP(UK) Clinical Examining Board is responsible for setting the pass marks on an annual basis. Results for UK candidates will be released to the MRCP(UK) website approximately two weeks after the examination date. For overseas candidates, results will be released approximately three weeks after the examination date. A letter confirming results will follow. Updated September 2011 The MRCP(UK) Clinical Examining Board reviews the whole Examination three times a year, considering statistical analyses of all candidates’ performance, together with the comments of the examiners. In the light of these analyses and opinions, the MRCP(UK) Clinical Examining Board may: • alter the pass marks for forthcoming examinations • make modifications to the structure and format of the MRCP(UK) Part 2 Clinical Examination (PACES) that it deems desirable to ensure the validity of the Examination. Candidates can access their examination results via the Results area of the MRCP(UK) website by entering their RCP Code Number. Candidates will not be identified by name, and are therefore advised to take careful note of their RCP Code Number when they receive their admission documents. Candidates may opt out of this facility when making their application and they must also re-confirm this on each occasion they apply for the Examination. Results cannot be collected from the Royal Colleges of Physicians or given over the telephone or by fax or email. In addition, candidates registered with MyMRCP(UK) can access their total mark, scores by skill and encounter through this site. Pass result Candidates who have not passed MRCP(UK) Part 2 Written Examination Candidates passing the MRCP(UK) PACES Examination must pass MRCP(UK) Part 2 Written Examination before they can be elected to Membership of the Royal Colleges of Physicians of the United Kingdom. Candidates can apply for MRCP(UK) Part 2 Written during the application periods for that Examination and do not need to wait until their result for MRCP(UK) PACES is confirmed. Candidates who have already passed MRCP(UK) Part 2 Written Examination Candidates passing the MRCP(UK) PACES Examination, who have already passed MRCP(UK) Part 2 Written Examination within the same seven-year period of eligibility can proceed to be elected to Membership of the Royal Colleges of Physicians of the United Kingdom (see section 13 for further details). Fail result The MRCP(UK) Part 2 Clinical Examination (PACES) may be failed in the following ways: • a candidate does not achieve the pass mark on one or more skills, or the overall minimum total score; In addition, any candidate who receives the following will have his/her overall performance reviewed by those appointed by the Clinical Examining Board to act on their behalf, and may fail the examination irrespective of total test score: • a mark of 28 or less on the skill ‘maintaining patient welfare’; • three or more recommendations for counselling from different examiners. Updated September 2011 If a candidate fails the MRCP(UK) Part 2 Clinical Examination (PACES) at their first or second attempt they may be deemed by the MRCP(UK) Clinical Examining Board to require more clinical experience before re-attempting PACES, or be recommended for counselling from a nominated Fellow or Member of one of the Royal Colleges. Candidates may request counselling themselves through their College of Entry. Candidates who fail badly may be recommended to defer reentry for one or more Examinations. The Royal Colleges of Physicians may require evidence of further training before candidates who fail badly are permitted to reenter the Examination. A candidate may be recommended for counselling from a nominated Fellow or Member of one of the Royal Colleges. Candidates may request counselling themselves through their College of Entry. Candidates may apply for the MRCP(UK) Part 2 Clinical Examination (PACES) in the next application period once they have received confirmation of their result via the MRCP(UK) website. Poor performance in the MRCP(UK) Part 2 Clinical Examination (PACES) All doctors practising in the UK, including examiners and the Officers of the Royal Colleges of Physicians, are governed by the principles outlined by the UK General Medical Council in the publication Good Medical Practice. The Royal Colleges of Physicians acknowledge that some good doctors may perform badly and aberrantly under examination conditions. However, where there are genuine concerns that a doctor’s fitness to practise is called into question by facts coming to light during the course of the MRCP(UK) Part 2 Clinical Examination (PACES), the Royal Colleges of Physicians are duty bound to inform those to whom the candidate is contractually or professionally responsible. In exceptional circumstances, where no such person can be identified, this information may have to be communicated directly to the UK General Medical Council or similar professional body. The candidate concerned will be informed by letter when their poor performance in the MRCP(UK) Part 2 Clinical Examination (PACES) warrants referral to a sponsor, employer, or professional body, as outlined above. Reporting may take place as a result of consistently poor performance in repeated Clinical Examinations, or in exceptional circumstances, as a result of poor performance in a single examination. Before the candidate may re-enter any part of the MRCP(UK) Diploma (or any examination run under the auspices of any of the three Royal Colleges of Physicians of the UK) written evidence must be received from the sponsor, employer or professional body confirming that remedial action has been taken. It will be for the Chairman of the MRCP(UK) Clinical Examining Board to confirm whether the evidence presented is satisfactory to warrant re-entry to the MRCP(UK) Clinical Examination. The Chairman of the MRCP(UK) Clinical Examining Board will also be available to consider any representations that the candidate wishes to submit. Updated September 2011