GP Clinical Exam: How Is It Bias Against Minority?!

[hawker1986]

As I am going to be sitting this exam in the next 6 months I whole-heartedly agree with peoples sentiments on here, the article is ridiculous.

As someone has said they should differentiate with british born and educated minority groups and doctors who have been educated else where. I imagine if they broke down the numbers that way then the difference would almost certainly be due to people from abroad doing worse due to their communication skills, which is key to being a good doctor as everyone has said.

Hawker

 

[shadow_boxer]

I know that I'll be in the minority here but from first had experience I do agree with the article. There is, unfortunately, huge bias in this examination process against foreign graduates. This exam is all about communication skills and not the quality of medical care given. The RCGP examination's focus is in my opinion completely wrong. I have met a few people who are international medical graduates and have done the exam and have failed purely based upon language skills. Yes, I do agree that obviously you must be able to understand your GP/doctor but the length this examination goes to in assessing language and communication is quite frankly a joke. There are 13 ten minute stations and largely medical knowledge is not being assessed. You essentially need to make sure you are safe (which for the majority of doctors is pretty straight forward stuff that even a newly graduated medical student can do without difficulty). The rest is an English test. A big issue that a lot of the graduates from abroad seem to have is that, they are assessed when taking the GP training entry exam for both language and communication and the vast majority are passed (obviously they subsequently enter the training) so then only to be failed on essentially the same examination 24-36 months later. Lets be honest, the vast majority of foreign graduates can speak English to good level but this examination severely penalises them for incorrect grammar, use of verbs etc, and largely disregarding the medical side.

As has been asked above, "native" ethnic, English speaking graduates tend to do okay, it's mainly an issue and concern for foreign graduates.

 

[No1newts]

Some people want equality of outcome not opportunity, and are happy and willing to dumb down to achieve it.

+1

Equality drive is skewed by this, great post.

 

[Malevolence]

I'd like to know how my GP managed to pass this. Not only is she completely useless as a GP, but you can't understand a word she says.

 

[Orionaut]

I know that I'll be in the minority here but from first had experience I do agree with the article. There is, unfortunately, huge bias in this examination process against foreign graduates. This exam is all about communication skills and not the quality of medical care given. The RCGP examination's focus is in my opinion completely wrong. I have met a few people who are international medical graduates and have done the exam and have failed purely based upon language skills. Yes, I do agree that obviously you must be able to understand your GP/doctor but the length this examination goes to in assessing language and communication is quite frankly a joke. There are 13 ten minute stations and largely medical knowledge is not being assessed. You essentially need to make sure you are safe (which for the majority of doctors is pretty straight forward stuff that even a newly graduated medical student can do without difficulty). The rest is an English test. A big issue that a lot of the graduates from abroad seem to have is that, they are assessed when taking the GP training entry exam for both language and communication and the vast majority are passed (obviously they subsequently enter the training) so then only to be failed on essentially the same examination 24-36 months later. Lets be honest, the vast majority of foreign graduates can speak English to good level but this examination severely penalises them for incorrect grammar, use of verbs etc, and largely disregarding the medical side.

As has been asked above, "native" ethnic, English speaking graduates tend to do okay, it's mainly an issue and concern for foreign graduates.

Of course they are concentrating on Lingustic ability. Unless the qualifications are outright fraudulant, Anybody with medical qualifications should have the technical knowledge to pass the test (And those that dont are probably fairly obvious and are weeded out early on)

It is not enough to have good English! One needs to speak and understand it like a native!

English is a language full of hidden meaning carried on such subtleties as delays, hesitation and inflexion.

Understanding that patients do not always give honest answers and having the ability to work out what people are not saying and when to press them harder is an essential skill for Doctors and Consultants (And, in particular, GP's! being the first line contact)

I have come across many, highly educated and very well "English" spoken foreigners who nevertheless never manage to master this! Being misunderstood by an asian taxi driver is annoying. Being misunderstood by a Doctor can be (and often is) fatal!

 

[muon]

I think people do not understand that graduates these days do not speak in broken English. This and tests like this should prevent what happened with older migrants who perhaps weren't fluent in English. But there is a threshold.

I wouldn't expect to be told I can't communicate properly in English. However, if I fail on subtle rules of grammar which can be often be disregarded in speech then I would question the purpose of this test.

The people aren't the much older generation of migrants who had little training or testing in English.

 

[Destination]

The other tests are all geared towards knowledge.
The last thing to be assessed is clinical ability in regards communication.
If they don't assess it, you could have a deaf mute GP.
Perfectly capable of medicine, incapable of a GPs role.

 

[muon]

The other tests are all geared towards knowledge.
The last thing to be assessed is clinical ability in regards communication.
If they don't assess it, you could have a deaf mute GP.
Perfectly capable of medicine, incapable of a GPs role.

What if we started implementing very high standards across all public professions. What do you think would happen? What if we did it for nurses?

There is a level of English commensurate with a role. What the people disputing the tests are saying is that it isn't.

 

[Rofflay]

Good if they fail a test then they deserve it by not learning the required cultural or English skills.Everything these days is minorities this or minorities that.Half of todays doctors and GP's are useless.Everything i go to my GP i get 5 minutes at most and sent home with a box of pills.It does not matter if you are sad or in pain or just need something simple cured.It is here take these pills and sod off.


Labour and the ultra left wacko birds tend to flip a lid and print lots of news articles when anything that impedes thier inflow of immigrants gets slowed down or hassled.It is a scam to rig the electorate as its well known most migrants join or vote for Labour.

So Labour encourage extreme mass immigration to change the voting landscape of the UK.In a sense it is a sneeky legal method of electorial fraud.

 

[Orionaut]

What if we started implementing very high standards across all public professions. What do you think would happen? What if we did it for nurses?

There is a level of English commensurate with a role. What the people disputing the tests are saying is that it isn't.

It would be a good start! Perhaps we could make it a legal requirement for call centres too!

 

[Deus Ex]

Of course they are concentrating on Lingustic ability. Unless the qualifications are outright fraudulant, Anybody with medical qualifications should have the technical knowledge to pass the test (And those that dont are probably fairly obvious and are weeded out early on)

Medicine is a career of lifelong learning. Trust me that you want a consultant overseeing your care often, rather than a junior doctor. Your idea that medical school graduates are immediately competent is grossly wrong.

There is still racism in medicine, along with some class bias and it needs stamping out.

 

[dirtychinchilla]

I've personally had problems with GPs not speaking very good English. I couldn't care less where they came from or what colour their skin is etc, it's just difficult to accurately communicate something to someone who doesn't actually understand what you're saying!

So, I'd imagine this could cause some difficulties in passing an exam. Having said that, that's an insane ratio.

 

[shadow_boxer]

I think people do not understand that graduates these days do not speak in broken English. This and tests like this should prevent what happened with older migrants who perhaps weren't fluent in English. But there is a threshold.

I wouldn't expect to be told I can't communicate properly in English. However, if I fail on subtle rules of grammar which can be often be disregarded in speech then I would question the purpose of this test.

The people aren't the much older generation of migrants who had little training or testing in English.

Absolutely, this is the problem. That is exactly what they are testing. Also one of the other major issues is that they've essentailly already passed a communication test that allows them to enter GP training and work as a fully qualified doctor often very very little supervision as an independent practitioner. This is my concren. The vast majority of supervisors won't bother teaching these skills let alone assessing them on a one to one basis. I'm all for having a well spoken doctor/colleague but why the difference in standards in assessing communication skills at the start of training and the end. Training is geared towards the medical aspect and not their English skills.

 

[SexyGreyFox]

they should add writing in plain understandable English too

Absolutely this but for all Clinical staff.

 

[heeeed]

The vast majority of supervisors won't bother teaching these skills let alone assessing them on a one to one basis. I'm all for having a well spoken doctor/colleague but why the difference in standards in assessing communication skills at the start of training and the end. Training is geared towards the medical aspect and not their English skills.

In actual fact the communication skills and consultation models that are being tested in the CSA are massively part of GP training and very much should be refined from the starting point of training. Picking up clues and asking certain questions to make sure all aspects of a consultation are covered in 10 mins isn't always easy. I'm quite certain there is cultural bias on those who trained from undergraduate level in UK having an advantage as a lot of undergraduate training starts with the communication skills in a similar model to GP consultations in this country . Is this racism? Personally I don't think it is racism, and making sure the profession has very clear standards expected of communication I think is important and I support the RCGP in this.

 

[kitch9]

Seriously who cares about this stuff? If a wannabe gp can't pass a UK exam to practice then quite frankly they should do something else.

Whoever they are.

 

[Art]

Seriously who cares about this stuff? If a wannabe gp can't pass a UK exam to practice then quite frankly they should do something else.

Whoever they are.

The argument they're making is that even British born candidates who have passed all of the same exams are far more likely to be failed by an observing examiner.

He said all British doctors, whether white or from ethnic minorities, had "gone through medical school and passed all that and so we're not talking about people who aren't as good as - they're exactly the same".

What they're worried about is the observing examiner unconciously awarding minority candidates worse marks for the same performance in the same way you can get gender bias in CV selection.

 

[antijoke]

Of course you should be told you can't communicate properly if you can't!!

You're not getting a recipe wrong that will taste bad, you're giving out medical advice..

It's not racist, it's just how it is.

 

[SexyGreyFox]

Actually when this was on the News this morning I thought it was white people kicking off about minorities becoming GPs over them. Anybody who lives in Stoke will tell you that a white GP is as rare as rocking horse poo.

 

[TruthSeeker]

Where are all the white GPs at? I had an x ray on my knee and couldn't understand a word the girl was saying I think she was Indian or Pakistani. It was very embarrassing.