Unfair GP exam?

The BBC Asian network today reveals that doctors from the ethnic minorities are four times more likely than their white (presumably British) counterparts to fail the clinical GP exam. This has been researched after ethnic minority doctors branded the exam as unfair. The Royal College of GPs has issued a robust defence and the debate lumbers on.

The exams referred to are mock situations in which candidates are required to demonstrate proficiency in all aspects of GP care. Thus, clinical reasoning, communication, patient management and a whole host of other criteria are being assessed. Professor Aneez Esmail is leading the argument which points to unfair bias against ethnic minority doctors in the UK.

While I can see the basis of his argument, I think he is missing a fundamental point. All medical students have to pass their exams to progress in their training irrespective of ethnicity. That is beyond doubt. What is missing in this argument though is the views of the estimated 60 million Britons who access GP care. The views of Professor Esmail and the Royal College are all well and good but it has to be the views of the patients which carry the most weight. As I write, I see no findings as to what patients think. That is probably because they aren't involved in the process of assessment. This I feel is a big mistake.

Given that patients come form all walks of life and all sorts of cultures, this would surely be a much better basis for assessment. Clinical knowledge and reasoning has to be professionally assessed and nobody would argue with that. But that is to assess the would be GP from just one side of the fence. Given the existing levels of distrust between the public and the doctors in the wake of so many prominent healthcare scandals, it would seem a trifle naive to continue this assessment process without some form of patient involvement.

To demonstrate my point, I'm pretty sure that I would struggle with an assessment in Spain or Italy or Germany because my proficiency in those languages is poor. My medical knowledge is not being disputed. It is my ability to convey it and implement it in another language and culture which underpins this whole debate.