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

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. :(

Is being "white" a prerequisite to being able to speak English properly?

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.

Pretty much what is the concern here, minority doesn't = immigrant.
 
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.

Agreed. Having spoken to somebody involved in this investigation, recent figures actually have shown that ethnic minorities born and educated in the UK are actually between three and four times less likely to pass the exam compared to white trainees, which is incredibly concerning in my opinion given they've had the same education and time in this country etc. The GMC have recognised this problem and are encouraging this issue to be pursued.
 
This 100%.

It's the same with all the "equality" forms you have to fill in when applying for jobs or university or whatever. It doesn't matter whether the person is white / black / straight / gay / male / female / disabled / muslim - just take the best person for the job. If it then turns out that all the people you hired were disabled black lesbian women then who cares, you hired them because they were the best candidate not because of what categories they were!

Too true, why ask before interviewing if the idea is to not have your decision affected by the answer?

Aside from the gay/straight thing, most of those "classifications" are easily identified when you meet the people anyway.
 
Too true, why ask before interviewing if the idea is to not have your decision affected by the answer?

Aside from the gay/straight thing, most of those "classifications" are easily identified when you meet the people anyway.

It's to get an idea of who your company/university is appealing to enough that they submit an application. If you have a very low numbers of a certain group then you can look at whether you need to target them better or if there's a different reason. Getting statistics whenever possible is a good thing, it isn't done to give preference.

They are also all optional.


I find it amusing that you rant about language skills.
 
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Saw this on Breakfast. Looks like the ultra-liberals are annoyed that GPs are expected to be able to speak English clearly, they think the British public are racist because they don't like it when they can't understand their doctor.

I'm hard of hearing (and can't sign due to poor vision too), so clearly spoken English is vital for me. Indian call centres are a no-no for me too for the same reason. Subtitles on TV as well for anything that's fastly spoken like comedy.
 
Read this to understand the exam system better
http://www.rcgp.org.uk/gp-training-and-exams/mrcgp-exam-overview.aspx

It should be noted that there is a higher failure rates for UK-born ethnic minority and international candidates taking the exam.


My wife is originally form india but was born and grew up in the UK. She was educated in a top private school, got 5 A's at A levels a first in medical school. She has excelled all the way though her GP training to the point where there are a number of practices trying to employ her as soon as she is done with her exams.

It costs close to £1800 to take the exam each time (her take home pay is £2.6k pcm) she had to take the exam 3 times before she passed. Its probably the most stressful experience she has ever been through. She has never in her life failed an exam, her supervise and program director could not understand why she failed. On her 3rd attempt she passed but this time she got the highest score ever recored in her deanery.

A couple of months later the royal collage gave her a refund of her exam fee with no explanation why. She has called the royal collage a few times to find out why she got a refund but no one will tell her.

I do agree many of the foreign graduates have poor language skills, however they should to be allowed to get to the final year of GP training before they find out that they can never be a GP. Thats 3 (soon to be 4) years of training down the drain and a few hundred thousand pounds lost for the government.

I and never quick to call racial bias but there is something wrong with the system. Gay students have also been known to struggle with this exam.

RCGP figures for 2010-11indicate that the failure rate for IMGs taking the CSA component of the MRCGP is at 63.2%, compared with 9.4% of UK graduates.

Quite often its the actors they employ that may have an issue with the non white GP's and make it difficult for the doctor.

Also read this
http://www.pulsetoday.co.uk/your-pr...ion-of-research/20004479.article#.UmMwSBbx1WY

Lots of feedback here
http://drunacoales.blogspot.co.uk/2013/03/bapio-and-bpdf-leaders-say-no-to-biased.html
 
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Where are all the white GPs at?

Immigrant doctors have constituted nearly half of NHS medics since the 1960's and it's a widely held believe that the NHS wouldn't have survived without them.

More recently, it's simply because more students from ethnic minorities get into medical school. I don't know if it's because becoming a doctor is still considered to be the ultimate job in ethnic minorities, or just because they work harder, but about half of my year in medical school are 'non-white'.

Regarding the original topic, I'd have to say that I could definitely see how the GP clinical exams could be biased. I'm not sure how they could reform the exam to eliminate the bias though.
 
Originally Posted by TruthSeeker
Where are all the white GPs at?


This is changing. 15+ years ago you could come out of medical school with a MBBS qualification and become a GP and no more training was required.

Many doctors moved here in the 60's and 70's from india and passed the equivalent of the PLAB however they where not able to get jobs as consultants (of they where just junior doctors) so most became GP's.

Now to become a GP you have to do 2 years of foundation training, follows by 4 years (from 2014) VTS training, because its such a hard life working in the hospital many UK graduates now want to go into GP training so you will find the new GP's are better trained and many more of them are UK trained.
 
Immigrant doctors have constituted nearly half of NHS medics since the 1960's and it's a widely held believe that the NHS wouldn't have survived without them.

A couple of weeks ago I took 32 young Doctors for Manual Handling training and I'd say about 1/4 were white.
The NHS would be dead in the water without immigrants (obviously all of them could have been born here).
 
If anyone fails the test it just shows they are not good enough..simples really.
I think the exams should be way hard because it's people lives you dealing with not a car mot.

I agree that if a doctor is not good enough they should not be practicing but the point is that it does look like doctors that are capable are struggling to pass because of the way they look, sexual orientation or race.
 
I agree that if a doctor is not good enough they should not be practicing but the point is that it does look like doctors that are capable are struggling to pass because of the way they look, sexual orientation or race.


Sorry that's a load of old bullocks where I live. The top surgeons at my hospitals are women!
My (chief) surgeon is a lady from Cornwall who took over from a rubbish surgeon from Pakistan, I think he was a veterinarian!

My GP is a Women and the women GPs out number the men at my clinic 4 women 2 guys.

I think it's "I can't pass a test so I will play the race card"
 
I have never seen a white British doctor in my life. I didn't think there was such a thing.

Do i care? No. As long as they pass their exams and know what the hell they are doing im happy.
 
I agree that if a doctor is not good enough they should not be practicing but the point is that it does look like doctors that are capable are struggling to pass because of the way they look, sexual orientation or race.

That isn't how I've read anything in this thread at all. More focus is put into grammar and language in general than you could suggest should be, and people are failing because of that. There is no reason sexual orientation, race or the way they look would change the words on a paper.

What it sounds like is ethic minorities have worse general English grammar including those born in the UK.

Someone said this should not happen because they have access to the same education, to that I say, complete tosh.

I am not racist, or a bigot in any way, I grew up in London, many many of my friends at three different schools(middle/high/college) and then after that at uni were asian or black and many many asian kids who grew up here are first or second generation born here of immigrants. Their families often speak other languages at home, just because you are born in England doesn't make English your first language, many kids are taught their parents or grandparents language as children and learn English as a secondary language but are far far less exposed to English than your average white English kid until you start to reach school.

Many parents who immigrated have passable but not brilliant grammar, many speak somewhat broken English, the same way many languages order their words differently and so speak English the wrong way around so to speak and these things often get passed on as it becomes natural to learn to talk a certain way.

Why would grammar be such a big deal, who gets sued if someone puts a couple of words the wrong way around and a different medication or condition is essentially described, if someone uses the wrong word and a patient dies. If that incorrect grammar ends up on a form and results in a death, who gets the blame, who gets sued and how many millions does it cost in compensation.

Why did so many imported doctors in the past 50 years pass yet aren't passing today.... the culture of suing would explain why exams are becoming stricter and harsher on grammar.


Either way this, in the third link you put out


was a case of testing to find a result you wanted.

FIrst running the test to make them associate specific words with left and right, then reversing the test, but ignoring that they had just done the reverse. It's a completely ridiculous test to start with and proves nothing, if you take the same test over and over, say an IQ test and you saw the same numbers and generally the same question you might jump to the answer as you've seen it before but miss that the question had reversed the numbers so the answer was actually different.

That's before you get to the other video of actors with a script picking on the guy in a turban and calling it unconscious bias, not it's not, it's a bunch of actors being paid to show actual bias on purpose.

Then you get into this "four fold" worse for minorities but maybe I'm being blind, they rarely say what this four fold number is. They don't say anywhere there are 4 times as many white as non white people passing. Later on the bbc article says foreign trainee's are 14 times MORE LIKELY TO FAIL.

This could mean that white uk trainee's are passing at 99.9% and foreign trainee's are passing at 98.6%.

What it's saying to me is most likely for every 1 white uk born person failing 4 non whites are failing and 14 foreign trainee's, but if that is 10 white people, 40 non white and 140 foreign out of the 5000 tested, it's not a sign of anything.

Surely if 20% of white people were failing and 80% of non white were failing.... they'd be saying that everywhere.

What it suggests is a very small amount of people are failing and it's being suggested that grammar plays a large part in that, considering many ethnic minorities ARE passing, and that only a few aren't, that they are much more likely to come from families where English isn't used much at home and simply that their English grammar is worse?


It all comes across as an agenda, when racism isn't a problem, create unconscious racism/bias, which is tested for in a completely unfair, pointed and intentionally misleading way.... yay for equality.
 
Sorry that's a load of old bullocks where I live. The top surgeons at my hospitals are women!
My (chief) surgeon is a lady from Cornwall who took over from a rubbish surgeon from Pakistan, I think he was a veterinarian!

My GP is a Women and the women GPs out number the men at my clinic 4 women 2 guys.

I think it's "I can't pass a test so I will play the race card"

You have not understood my post, I am not saying women struggle to pass, I may say GAY men have problems passing.

A veterinarian from pakistan would never be allowed to operate on humans and generally they will not recognise a pakistani post graduate surgical qualification in the uk so your post is really BS.

I agree many of the IMG's are playing the race card and they have failed because they have poor communication skills (they often have good medical knowledge). However there have been many ethnic doctors who are exceptional doctors, born and educated in the uk but have had more issues with this exam compared to their white peers.

The Royal collage is known for being rightwing and this has been going on for years. The doctors that have communications issues should be pushed out or helped in the first year of VTS training and not be allowed to waste a 5 to 6 years and come out with thing.

My wife is prime example, there is no way someone can go into a clinical skills assessment exam (you cant really study for this exam) and fail but then take the exam again 6 or 7 weeks later and get the higher score ever achieved in her deanery. She claims she has done nothing different between the 2 exams.

She has a file full of thank you letters and cards from patients r and many of them are very upset that she is leaving the surgery in a few weeks (end of her training).
 


You do understand how this exam works right?

You sit in a room, and you see 13 actors one at a time who pretend to be patients and there is a examiner watching you do your consultation.

Each case is marked by a different examiner. The examiner marks each case on three domains or areas - data gathering, clinical management and interpersonal skills. This creates an overall numerical mark for the
case. Each domain carries the same number of marks. The marks for each case are added to create a final mark. Each of the 13 cases contributes equally to the overall score.

Example


One British Asian writes, 'I am a devout Muslim and have had a beard since my life transforming pilgrimage to Mecca 10 years ago. For 10 years I had a neatly kept beard that in my opinion was an important part of my faith. It was suggested to me that I shave it off as that it could be working against me, especially with biased examiners. At first I couldn't believe what I was hearing but after 2 CSA fails I felt I had to as there really wasn't anything else I could change. I reluctantly shaved off my beard for the first time in 10 years and passed the CSA with an excellent mark on the 3rd attempt. I can honestly say, hand on heart that I don't think I did anything differently in the 3rd exam than in the 1st or 2nd.

How many of you will honestly say you would not have some bias against a muslim with a full beard? Or the examiner may not have a bias but the actor can make life very difficult for you.
 
Why would grammar be such a big deal, who gets sued if someone puts a couple of words the wrong way around and a different medication or condition is essentially described, if someone uses the wrong word and a patient dies. If that incorrect grammar ends up on a form and results in a death, who gets the blame, who gets sued and how many millions does it cost in compensation.

This is my expertise.
None that I know of in the last 10 years at my Trust.

HOWEVER, if grammar and stuff is going to be tested they really need to judge all Doctors handwriting. This is no lie, one morning I came in and saw 4 colleagues around a computer screen trying to decipher what a Clinician had wrote so we just sent it back and asked him to translate (it was also a white Clinician). On a weekly basis me and my colleague will point at something in Hospital Notes saying 'WTF is that?'.
 
Whenever I make an appointment over the phone, I ask to see an English doctor. I've never been questioned about this or made to feel that I shouldn't be.

Quite simply, I don't feel that language barriers should be in place between the doctor and patient. The patient should be able to explain their needs without having to repeat themselves, just because the doctor isn't fluent in English.
 
How many of you will honestly say you would not have some bias against a muslim with a full beard? Or the examiner may not have a bias but the actor can make life very difficult for you.

its not his religion it his beard that may be the problem.

Western people don't trust people with beards :p
 
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