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Features: Assessing the assessments

25 May 2009

How GMC doctor assessments are kept up to date and hear from a doctor who has gone back to the classroom.

To help us make fair decisions about a doctor’s fitness to practise, the GMC needs to be able to assess formally a doctor’s skill and competence. So how do we make sure those assessments are fit for purpose? That’s where you come in. GMCtoday looks at how the assessments are kept up to date and hears from one doctor who has gone back to the classroom to help us in ‘assessing our assessments’.

The GMC has been running a system of assessments for more than a decade. These provide an overview of a doctor’s performance, including their knowledge and skill, which help to inform decisions on that doctor’s fitness to practise.

Good practice and medical knowledge change over time and we have to ensure that we ourselves stay in touch with developments. We must be confident our methods of assessment are appropriate and as fair as possible. One of the ways we do this is to invite working doctors to help us out by taking the tests themselves. We’ve held over 50 of such ‘volunteer’ days in the past few years. They have added a huge amount of value.

The programme of creating, developing and reviewing the questions and scenarios used in the tests is complex and rigorous.

It is also essential that it is robust – and we are particularly grateful to members of the Medical Royal Colleges who are very generous with their time and expertise in helping us with this work.

The actual Tests of Competence are maintained, developed and assembled under a contract with University College London (UCL). We have also signed intellectual property agreements with the Royal Colleges of Surgeons, Physicians, Anaesthetists, Emergency Medicine, Ophthalmologists and Psychiatrists. We continue to talk to other colleges with an eye to future development work.

A volunteer’s view

Bath-based General Practitioner, Dr Anna Cumisky, shares her experiences of volunteering.

When a year or so ago I first saw the advert in GMCtoday looking for volunteers to attend the GMC building in London and spend a day doing practical tests and a written paper, my first instinct was to smile and wonder who would voluntarily put themselves through such an ordeal. Me, it would turn out!

Now a regular assessor for these pilot events, they are something I enjoy and look forward to and have encouraged colleagues to attend. I view them as a day out of regular practice, a useful opportunity for self-assessment and a valuable insight into the activities and procedures of the GMC.

As a GP colleague pointed out after her day as a volunteer: ‘It is extremely useful to see what goes on, on the other side of the fence. Although I hope I will never be requested to attend the GMC personally for assessment, it is useful to know the form this takes and see that the GMC are committed to investigating each case carefully to see how someone can be potentially helped, not simply “struck off”'. Certainly, from a personal point of view, curiosity and slight fear of the GMC were the main reasons for my initial attendance.

For their time and efforts, the GMC offers doctors a reasonable financial remuneration and covers costs. All grades from consultants to FY2 take part and this is taken into account at marking. A variety of days are run to cover most specialties and the requirement is usually four months’ experience of the specialty within the last year.

From kick-off at the rather leisurely start time of 9.30am to departure sometime around 4pm, the day is extremely well organised and volunteers are carefully looked after at the GMC's Clinical Assessment Centre.

Good food is on offer throughout the day and travel costs are reimbursed by the GMC. The remuneration for the day (at the time of writing, £350) seemed to be one of the major selling points when asking colleagues the honest reasons for their attendance.

‘Only a little less than a day locuming and a pleasant change from the norm,’ said one, whilst another felt the day was fairly remunerated given ‘the sheer brainpower involved’. Others expressed their delight to be paid for what they believed was excellent examination revision rather than shelling out on expensive private courses.

The day also provides a good opportunity to network with colleagues of differing grades from all over the country and, outside the exam room, there is a pleasant informal atmosphere.

That said, I should say that my very first impression when I arrived for an emergency medicine pilot day was one of fear. On entering a room of older doctors, I immediately recognised two as local A&E consultants and one as a senior OSCE tutor and ex-A&E consultant from my medical school days. My fears were thankfully short lived when a group of younger colleagues arrived.

For those at a stage when exams are looming, the day provides an excellent source of revision. I found the OSCE circuit provided excellent practice for the GP CSA exam.

Similarly, the written paper is a gruelling two hours, good practice for the demands of the AKT exam or similar level specialty exams. The days are also helpful with appraisal and when composing a personal development plan. They have the added bonus of providing useful CPD points.

A colleague commented that the questions and stations were ‘entirely fair without any tricks’ and applauded ‘the high standard of the actors involved’. Certainly it is my view from being both an assessor and a volunteer that the questions were pitched very fairly and the results achieved were as anticipated.

Results are sent to each candidate a short time after the pilot day. The feedback is thorough and can be a useful confidence boost when exams are looming and also help direct further revision.

I would highly recommend the day to anyone and would encourage all to get involved and become familiar with the GMC for the right reasons....

The very blackest scenario is that, on the day, a volunteer will act in a manner that concerns the GMC enough to need further investigation. In reality this is an extremely rare occurrence. My attitude is that if the GMC thought my actions as a doctor were so questionable that I am unsafe, I would certainly rather know about it and address the problem sooner rather than later.