Examinations statement

The Royal College of Anaesthetists remains committed to continuing to deliver examinations during these challenging times. This statement is an update of our progress to support the large number of our members who require examination places this academic year.

We are proud of how well our staff and clinical examiners have worked together to keep our examinations running on behalf of our anaesthetic, intensive care and pain medicine trainees.

This has been a particularly challenging academic year for our members, examiners and College staff alike. While our staff and examiners have worked and collaborated remotely, they have also sourced, learned and launched new methods of examination delivery. The College acknowledges and continues to meet the challenge of addressing the high demand for examination places following the unfortunate, yet necessary cancellation of exams in 2020.

Since August 2020, when we restarted our full diet of examinations, we have examined the following number of candidates:

 

 

In addition, the College also delivers the FICM examinations, with another 287 candidates examined thus far.

The College sees these numbers as a considerable achievement so far, but we are aware that we still have much more to do. Many other Medical Royal Colleges have had to postpone exams scheduled for the first quarter of 2021 but we now have systems in place that have allowed us to continue uninterrupted.

Agreeing these changes, training staff, and implementing the new exams has taken considerable time, planning and communication with national organisations and supervisor and trainee networks. We thank everyone involved for their support and understanding.

Demand

We understand and appreciate that the cancellation of examinations in 2020 was a huge disappointment to many members who had dedicated significant study time and had very clear career and training plans that aligned to these examinations. The backlog of candidates after the cancellations in 2020 meant that it was simply impossible to meet the additional demand whilst upholding the standards and credibility of our examinations. We are continuing to do our utmost to support those members in need of the examinations.

Delivering examinations online has reduced the number of candidates we are able to accommodate in sittings of the clinical examination component (SOE/OSCE). This is unfortunate but necessary, as the process of managing connection issues, and aligning candidates and examiners at each round is complex and takes more time than the traditional method of walking from one station to another. We have mitigated this, to some extent, by examining for two weeks instead of one in the Primary and adding an extra week for the Final.

However, examiners and their time are not an inexhaustible commodity, they also face the work pressures inherent in this pandemic. We have added to the existing pool of examiners, from those recently retired, and continue to look at ways to increase the numbers whilst maintaining the high examiner standards that we uphold. We also continue to explore alternative solutions to increase our candidate throughput.

Our work on monitoring demand and pass rates is closely coordinated through the Education, Training and Examinations Board and the Training Committee.

Prioritisation

As you will all be aware, following the restart of our full diet of examinations in 2020 and the issues noted above, we had been required to update and implement a longstanding policy in section 4 of the Primary and Final Examinations Regulations on prioritisation of examination placements. This section has been within the regulations for more than 12 years, but we never had to implement this policy until this point, as we had been able to accommodate all applicants in face-to-face clinical exams by working long days and weekends – the pandemic means that these measures are no longer sufficient despite examining over longer periods and introducing extra exam sittings.

The prioritisation policy is in place to support those candidates in most need of an examination place due to their stage of training and proximity to a critical progression point. We have also taken steps to discuss the prioritisation with Heads of School and encourage anyone who feels they have exceptional circumstances, as outlined in the exam regulations, to gain the support of their Head of School.

The College sought GMC and independent advice to develop our current prioritisation process. We have done all we can to ensure the process is as fair as possible to candidates, while acknowledging that there may be circumstances for specific candidates that need to be considered.

Therefore, we recognise that there may be candidates who fall outside of the category of exceptional cases, currently included within prioritisation regulations who, nevertheless, require access to the examination. We have updated the examination regulations to offer any candidate the opportunity to inform the College that they have a particular circumstance that may mean that they require an examination place. This must have the support of their Regional Adviser or, if the Regional Advisor cannot be contacted directly by a trainee, via a College Tutor or other supervisor responsible for the management of an individual’s training.

Supporting entry to Specialty Training posts

The decision to prioritise candidates was based on the requirement to maximise progression of trainees through the HEE recognised training programme. Failure to support this would lead to a number of serious consequences both for individual members and also for the wider anaesthesia workforce.

We have taken the step of allowing anyone in possession of the Primary FRCA MCQ to apply for ST3 posts and there are no marks attributed to the exam in the recruitment process. We have also moved back the requirements for completion of both exams as part of the derogation process. In effect this means that progression to Higher Specialty Training posts is not in any way adversely affected.

Further guidance for applicants

We are aware that some candidates have withdrawn from examinations that they have been registered for. We fully recognise that circumstances are largely outside of the control of candidates, particularly at the present time, with the possibility of being redeployed to support the COVID-19 response or even becoming unwell themselves. However, examination places are extremely valuable and so we ask that, as far as possible, all applicants ensure that they are genuinely able to sit the examination ahead of applying. Unfortunately, it is not possible for us to invite replacement candidates at short notice.

The impact of COVID on postgraduate medical exams has been profound and there will be an ongoing requirement for prioritisation across many specialties. We remain positive that we will catch up with the additional demand by the end of this calendar year, but there is a number of factors outside of our control, in particular the availability of our incredibly dedicated group of examiners who have so far managed to provide continuity and additional time for examining under the most difficult of circumstances.

Dr Mark Forrest
Chair, RCoA Examinations Committee

Dr Chris Carey
Chair, RCoA Education, Training and Examinations Board