FRCA Internal Examination Review

We are committed to improving the calibre of our examinations, ensuring that they are delivered in line with best practice in assessment for each medical specialty. As part of that commitment, we undertake regular internal reviews of the FRCA examination, the most recent of which we published on 11 January 2023.  

We are grateful to all members of the Examination Review Group, and also to our lead examiners, for their time and expertise in contributing to the review.  

In conducting the review, we recognise that the FRCA is a high stakes assessment that has a significant impact on candidates’ personal and professional lives. Through the inclusion of an anaesthetist in training representative on the Examination Review Group, we have sought to ensure the experiences of candidates were central to the review process.

The review makes a series of recommendations, which we will implement over the coming months and years. In implementing these recommendations, we will:

• Invest additional resources in our examinations function to implement the recommendations of the review and strengthen our capacity to deliver exams. We have established an Examinations Development and Assurance Group to lead the development, quality and alignment of exam processes across the FRCA and Faculty exams.
• Give candidates and doctors in training a greater role in our assessment processes, including more representation on College committees engaged in assessment. These representatives will also play a central role in supporting communication with candidates.
• Review the purpose of our assessments in accordance with the changes made in the curriculum and the changing nature of clinical practice in our specialties. We will consult with members and stakeholders to define this.

• Implement a unified approach to the use of, and training in, standard setting across all our assessments.
• Undertake research to inform our assessment design process. This will include three validity studies (concurrent, predictive and construct) to compare performance in the workplace as estimated by trainers and supervisors with performance in RCoA assessments. We will also undertake further research to investigate the impact of gender, ethnicity and educational background on exam performance.

Alongside our internal review process, we recognise the value of independent assurance and insights into the development and delivery of our assessment processes. To that end, we have also commissioned an external review of the FRCA, FFICM and FFPMRCA exams. The independent review was conducted by Professor John McLachlan and commenced in January 2022.

The scope of the independent review is to consider all aspects of the College’s exams, with particular focus on issues arising from the delivery of the September 2021 FRCA Final Written Exam and the October 2021 FFICM Objective Structured Clinical Examination (OSCE).

While the two reviews differ in their scope and timeframe, the recommendations from both have informed our proposed programme of development for our examinations. Having held publication of the internal review to allow us to draw comparison with the independent review, we are publishing it now to avoid delay. We will publish Professor McLachlan’s report in February 2023, following consultation with our faculties and examiners.