21. The RCGP


	The Royal College of General Practitioners THE ROYAL COLLEGE of General Practitioners (RCGP) was established in 1952 to encourage, foster and maintain the highest possible standards in general medical practice. It also aims to raise the status of general practice and to persuade doctors to enter the profession. The College is the only academic organisation in General Practice. It has sought to establish General Practice as a discipline in its own right and to promote the importance of Primary Health Care. Most doctors know about the College because of its membership exam, the MRCGP. Nearly 2000 candidates sit the membership exam each year. Around 18,000 doctors retain their membership and are committed to improving patient care, developing their own skills and developing general practice. Ways in which the College has done this include: providing opportunities for doctors to share ideas and discuss key issues, principally through its local faculties; representing the views of GPs on government and Department of Health committees; maintaining an authoritative voice which effectively speaks for general practitioners; encouraging high calibre people to enter general practice; providing and guiding on continuing education and training; developing new qualifications and methods of assessment; keeping members up to date, through its publications, committees and faculties; developing policy and clinical guidelines for general practice; setting standards of quality and clinical guidelines for patient care; seeking funding for a wide range of projects; awarding fellowships which enable doctors to carry out research; appointing a national research advisor to support GPs involved with research; publishing up to date research and innovations. You don’t have to have passed the membership exam to support the College. You can become an associate member and receive many of the benefits of membership even if you don’t intend to sit the exam. Some colleagues complain that its membership fee is too high and that the College is out of touch. Having sat on the Council of the College for over two years, I am convinced the College is far from out of touch. It is very aware of what general practice in the late 1990s is like and it is very keen to hear the views of others. The doctors who work for the College are GPs who work hard for the benefit of all in general practice - setting standards, promoting quality and supporting research. Such work costs money and this is what the membership fee is for. The fee is tax deductible and being a paid-up member demonstrates your support for the advancement of our discipline. The College is made up of a President, 5 Officers, a Council Executive Committee, a ‘ruling’ Council of officers, faculty and members representatives, and five networks covering Education, Quality, Services, Clinical and Research work. There are thirty-one local faculties and a plethora of special interest groups and committees. The following diagram shows the structure of the College: The College offers members: the British Journal of General Practice - extensively revamped in 1997 and worldwide, the highest ranked journal of primary care. It is the only medical discipline in which a British journal is ranked first in the world. Who says no-one reads it? reduced rates on College publications - including over 50 occasional papers on all aspects of general practice, books, leaflets and policy statements; computer based assessment programme - designed for registrars but a good test for anyone; use of the comprehensive library and information service - including the excellent free College factsheets and summary papers, again on all aspects of general practice; discounted courses; residential accommodation at discounted rates in central London. the opportunity to participate in the development of primary care; support for its members in research and audit via a free research adviser. Members considering research within general practice can discuss their ideas whilst in the planning stages of a project. Obviously some of the College activities will impact on you more directly than others, even if it’s only the BJGP coming through the letter box. But indirectly many of the College’s activities will affect your working lives - for the better. In training for general practice trainers and hospital posts are ‘vetted’ by a Joint Visiting team to assess the suitability of those posts for training. The College, along with some of the specialist Colleges, has produced joint vocational training statements - unique guidance on the content of SHO posts. To stay in touch with the College’s activities, support your local faculty, read the members’ news sections in the BJGP, especially the subjects that Council has considered and visit the College’s web site. The College is only as strong as its members’ support. The College has a whole host of different groups. Some of these are: The Audit Programme; Maternity Care Task Group; HIV/AIDS Working Party; Vocational Training Working Party; Inner City Task Group; Adolescents Working Party; Rural Practice Task Group; Commissioning of Care Task Group; Joint Computing Group (with GMSC); Prescribing Task Group; International Committee; Medical Ethics Committee; Patients’ Liaison Group. The College has recently established a group called the Careers Support Forum which will be looking at the career difficulties faced from finishing training through to entering the (pre- retirement) home straight! For further information about the College call the Membership Department on 0171 581 3232 or visit the College’s web site: This has a mass of information about the College, including information on Associate Membership, a rural doctors’ and a registrars’ discussion forum, and contact details for all the local faculties. Some of the many achievements and initiatives: Establishing the Commissioning of Care Working Group; Publishing a major report on clinical guidelines which has set a national standard for the whole of medicine and made a significant contribution to effective health care; Securing funding from the DoH for a major six year programme on clinical audit and guidelines; Securing funding to raise the standard of palliative care through the activities of a group of GP facilitators funded by the Cancer Relief Macmillan Fund; Funding a National Convenor for Joint Hospital Visiting; Campaigning for the use of generic medicines rather than branded drugs and advising the House of Commons Health Producing pioneering research notably in oral contraception, HRT, termination of pregnancy, cardiovascular disease and asthma; Setting up an extensive programme of educational and research training fellowships producing publications on: rural medicine; maternity care; commissioning; re-certification; clinical audit; HIV/AIDS; national back pain guidelines. MRCGP - the exam The Membership Exam of the Royal College of General Practitioners is the sole route to full membership of the College. It is a mark of excellence within our profession. Approximately 2,000 candidates sit the exam each year. The exam is wide-ranging and testing. It is said to have been subjected to more educational analysis than any other College’s postgraduate medical exam. The examiners are committed to making it more user-friendly and they genuinely welcome and listen to feedback. The exam is based upon the job description of the general practitioner and the content of general practice as defined in The Future General Practitioner - Learning and Teaching (RCGP-1972). It is orientated towards general practice within Britain and within the NHS. The MRCGP is a rapidly evolving exam. Candidates are advised to get a copy of the most recent handbook from the Examination Department of the RCGP or from the College website. There isn’t a set curriculum but the Candidate’s Handbook gives good guidance on the areas that the exam tests and the ways it does it. Broadly, the exam assesses knowledge, skills and attitudes in all areas of general practice. From May 1998 the exam is becoming fully modular making it easier to take but not easier to pass. There will be four modules. Papers 1 and 2 will be available on the same day. Paper 1 - a three-hour written paper derived from the former Modified Essay Questions and ‘current literature’ elements of the former Critical Reading Questions Paper 2 - a three-hour machine marked paper consisting of Multiple Choice Questions and elements of the former Critical Reading Questions Consulting Skills - an assessment of 15 videotaped consultations or (in exceptional circumstances) a simulated surgery (this has been shortened from the previous four-hour tape) Oral Examination - two 20 minute orals (shorter than previous 30 minute orals and now concentrating on professional qualities not clinical cases) Also required is a copy of your full registration with the GMC and certificates of competence in: basic cardio-pulmonary resuscitation (required at application) child health surveillance (required when you apply to take the consulting skills module). All four modules have to be passed to pass overall but modules can be taken in any order and each will be available twice a year. If you fail any one module, you only have to resit that module (for £150) and not the whole exam. Any one module can be sat up to three times. A one-off fee of £500 can be paid for the whole exam or you can pay £150 module by module. You must gain passes in all modules within three years. Contrary to popular belief, the College does not make a huge profit from the exam. The fee is set to ensure the College breaks even and absorbs the running and development costs. Advice to prospective candidates: buy a copy of the Candidate’s Handbook and Video and Oral Pack (£10, refunded on application). read The MRCGP Examination - A Guide for Candidates and Teachers Richard Moore 3rd Edition. The author is an experienced examiner and this is an excellent guide on how to prepare for and get through the exam. The second edition was written before the modules were introduced but a new edition is in preparation. consider a revision course - details in the Candidate’s Handbook of possible courses. see the GP press for articles on the process of the exam and the subject areas to cover. study in a group - it makes it much easier and less painful. Further details from the Exam Department at the RCGP or from their web site. Update from the NASGP Webmaster May 1999 The format of the MRCGP examination changes regularly, as does the cost of taking the exam. For the latest details visit the RCGP's MRCGP Examination web page.