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Exit examination: a survey of UK psychiatrists' views

  • Nicholas S. Hughes (a1), Angela Haselgrove (a2), Matthew S. Tovey (a3), Waqqas A. Khokhar (a4), Muj Husain (a5) and Victoria C. Osman-Hicks (a6)...
Abstract
Aims and method

The Royal College of Psychiatrists is considering how best to introduce a post-MRCPsych-examination assessment (‘exit examination’) in anticipation of external pressures to ensure patient safety through the use of such assessments. The Psychiatric Trainees' Committee conducted an online survey to gather the views of psychiatrists regarding the possible format and content of this examination in the hope that this information can be used to design a satisfactory assessment.

Results

Of the 2082 individuals who started the survey, 1735 completed all sections (83.3%). Participants included consultants and trainees from a range of subspecialties. There was general agreement that the content and structure of the exit examination should include assessment of clinical and communication skills.

Clinical implications

UK psychiatrists believe that an exit assessment should focus on clinical and communication skills. It should assess both generic and subspecialty-specific competencies and incorporate a mixture of assessment techniques.

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Copyright
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to Nicholas Hughes (nickhughes1@nhs.net)
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Declaration of interest

None.

Footnotes
References
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Exit examination: a survey of UK psychiatrists' views

  • Nicholas S. Hughes (a1), Angela Haselgrove (a2), Matthew S. Tovey (a3), Waqqas A. Khokhar (a4), Muj Husain (a5) and Victoria C. Osman-Hicks (a6)...
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eLetters

Exit examination: a survey of UK psychiatrists' views

Gordon R W Davies, Psychiatrist, University of Wollongong
22 October 2015

As an early member of the Association of Psychiatrists in Training which was founded to support the changes involved in the new College structure and was very active from 1968 to 1972, I would like to comment on the paper by Hughes and colleagues (1) as well as the issues raised by Shields (2).

Measuring trainees’ competence before considering them competent to practise in an unsupervised and leadership role is eminently reasonable. However, it should be understood that such an examination should essentially be a measure of the training programme, rather than the individual competence of the trainee. This is not to say that the competence of the trainee is not important, but that the exit examination should not function as a selection criterion. It is simply not fair to allow a trainee who does not have the potential competence to successfully work as a consultant – and this would seem to particularly involve clinical and communication skills – to devote fruitless years to training. For various reasons, candidates considered suitable initially may at a later stage demonstrate problems that preclude a successful transition to a consultant career. Nevertheless, the main selection point should be early enough to allow those regarded as less suitable to pursue alternative areas of medicine for which they may be better fitted.

Thus, while the final examinations should be rigorous, they should focus on more specific areas of knowledge and the expected pass rate of properly trained candidates should be very high. I would also note that the reliability quoted by Burn& Bowie (3) simply represents a correlation between test items and apart from making the assumption that the results represent interval rather than ordinal data says nothing about validity.

References

1. Hughes NS, Haselgrove A, Tovey MS, Khokhar WA, Husain M, Osman-Hicks VC.Exit examination: a survey of UK psychiatrists’ views. BJPsych Bull2015; 39: 254–9.

2. Shields GS. Raising the standard: it’s time to review the MRCPsych examinations. BJPsych Bull 2015;39: 262.

3. Burn W, Bowie P. Raising the standard: it’s time to review the MRCPsych examinations. The Royal College of Psychiatrists’ response. BJPsych Bull 2015;39: 262–3.

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