The Royal College of Anaesthetists Annual Specialty Report … · Kirsty White Head of Quality Regent's Place 350 Euston Road London NW1 3JN 8 th December 2010 Dear Kirsty, The Royal

Kirsty White Head of Quality Regent's Place 350 Euston Road London

NW1 3JN 8th December 2010 Dear Kirsty,

The Royal College of Anaesthetists Annual Specialty Report August 2009 – July 2010

Please find enclosed the ASR for Anaesthesia. This report has been compiled in accordance with the GMC template provided. In addition there are two appendices. Appendix 1 is the FRCA examination data in accordance with the GMC provided template. Appendix 2 is a detailed report on the FRCA examination and comprises data broken down into various areas, which should be used in alongside the main report. As previously discussed the Report has remained generic on purpose. Specific reference to deaneries and hospitals are not made in the report itself in order to enable the report to be shared freely with College representatives and the deaneries. However, the information in the report is derived from information that can be made available to the GMC on request. If you require any further information please do not hesitate to contact me on 020 7092 1558 or [email protected]. Yours sincerely,

R A J Bryant Director of Training & Examinations Copy to: Dr Nightingale - President RCoA Dr van Besouw - Training Vice-President RCoA Dr Thornberry - Medical Secretary RCoA

mailto:[email protected]

www.gmc-uk.org 1

Annex 11 to the Quality framework operational guide

ANNUAL SPECIALTY REPORT TO GMC

Section 1. Details of the college/faculty

Name of college/faculty: The Royal College of Anaesthetists

Specialty: Anaesthesia

Section 2. Contact details

Contact details for the person responsible for submitting this form to the GMC

Name: Mr Richard Bryant

Address: Churchill House, 35 Red Lion Square, London, WC1R 4SG

Job title: Director of Training and Examinations

Telephone number: 020 7092 1558

Mobile number: 07545 586613

E-mail: [email protected]


www.gmc-uk.org 2

Please state the evidence that identified or gave rise to the concern when including concerns in the ASR.

Section 3. Topics and issues to be covered in the ASR

Introduction

Question College Response/Comment

Please provide a summary of college/faculty activity in relation to the specialty during the reporting period (e.g. engagement with deaneries, externality in deanery visits, training programmes for trainers/assessors).

GMC PMETB Merger. RCoA engaged actively in the Patel Review, the consultation on the merger of PMETB into the GMC and attended the workshops. Through this the College was able to demonstrate its eagerness to work closely with all key stakeholders in PMETB.

RCoA Quality Management of Training Committee (QMT). The Quality Assurance Committee restructured in late 2009 to become 2 separate bodies. The Service Accreditation Delivery Board, under the Professional Standards Directorate and the QMT under the Training and Examinations Directorate. This revamped committee has quickly established a more efficient means of analysing QM data and acting on it as required. Internal membership of the Committee has ensured that all aspects of PMET quality management are represented, including the Faculty of Pain Medicine (FPM). The Committee receives and responds appropriately to external reports and is the first College point of contact for any quality issue.

MOUs with Deaneries. Following an initiative from the Northern Deanery the RCoA attempted to establish MOUs with all Deaneries. The Deans were concerned that this approach was fragmented and requested further consideration via COPMeD. As an interim measure the College has produced a declaration of the assistance it will provide to Deans on PMET issues to support QA.

External Advisers RCoA continues to provide external advisers to deaneries for visits and ARCPs. RCoA continues to actively support their representatives, which include Regional Advisers (RAs) and senior consultant anaesthetists; and has encouraged RAs to conduct pastoral visits to hospitals within their regions as part of their normal duties. As this is not a formal visit it does not affect daily routine in hospitals and serves to inform the Deanery and College of any potential concerns and importantly, gives the trainees and consultant staff (including College Tutor) within the hospital a chance to discuss issues about training. This has been very successful and detailed agreed reports have resulted in a clear picture of the delivery of training across the countries.

Visits and QMT Data Capture. The QMT has set up a reporting system and has captured all relevant data from visits in a spreadsheet. This has enabled quick identification of both areas of concern and best practice.

Recruitment. RCoA conducted nationally coordinated recruitment for CT2 and ST3 in 2010 in conjunction with the West Midlands Deanery. This was generally a success, with fill rates being high and trainee satisfaction fairly high. A survey of both trainers and recruiters was conducted and the results are available on request. Lessons identified will be learned in the 2011 recruitment rounds.

PLG. Membership of the PLG comprises 9 lay members and 7 medical members, one of whom is a Vice President of the RCoA. The Lay Chairman of the PLG is requested to sit on College Council. Lay members participate in all key college committees and working parties which concern training: Quality Management of Training, Training, Examinations and Equivalence. They have been directly involved on the production of the e-portfolio for anaesthesia trainees. The PLG was represented at all stages of the development of the new curriculum this year and the resultant examination review. In addition, both the Faculty of Pain Medicine and the newly formed Faculty of Intensive Care Medicine have lay members on their respective Boards and this will extend into representation on their respective training committees when

www.gmc-uk.org 3

formed.

Please provide an update on the feedback provided by PMETB/GMC on last year’s ASR. Please note any actions taken.

The feedback from the last ASR submission was welcome and provided clear guidance from the GMC on the requirements for this year’s report. The recommendations have been incorporated into this report. The report includes areas from Core Training and ACCS (Anaesthesia).

The recommendation to provide specific details on areas of concern specific to deaneries and LEPs has been discussed with the GMC. Whilst there will be no specific references in this report, as this report is distributed to all Deaneries and College Representatives, the author has discussed with the Head of Quality a suitable work around.

What initiatives and plans has the college identified for the following year?

Support to RAs. A programme of visits to regions has been set up for 2010-11 to visit RAs and discuss key concerns that effect them locally, these visits will be supported by members of Council including the College Officers and Senior Management Team. The College continues to support clinicians actively involved in all aspects of training and will continue to seek reassurances that they will be appropriately supported by Trusts.

Visits to STCs. The Director of Training and Examinations and the Training Manager will over the early part of the academic year 2010-11 visit school and deanery STCs to discuss training delivery and in particular the implementation of the 2010 Curriculum. This will identify areas of concern trainers might have in the delivery of training within the new Curriculum, particularly in terms of assessments.

Curriculum implementation. The College consulted extensively before finalising the implementation plan for the 2010 curriculum. All CT 1 trainees started on the new curriculum in August 2010 and the remainder of the CT2 to ST5 trainee cohort will transfer on a School of Anaesthesia basis , transfer will be completed by August 2011. Due to the changes at the higher and advanced levels in the curriculum, trainees in ST6 and 7 will remain on the 2007 curriculum to CCT. So far, the feedback on the clinical aspects of the curriculum has been very positive.

MTI. RCoA will fully implement MTI for 2010-11 and will work closely with the AoMRC and Trusts to ensure suitable training and posts are provided which will allow a doctor to utilise their training experience upon return to their home country.

Workforce Planning. Workforce planning is a key factor in PMET delivery and quality. With the creation of CfWI the RCoA is now actively engaged in collection and analysis of workforce data. A clear and distinct workforce strategy is being developed by the College to ensure that the specialty is appropriately supported and correctly configured to meet the future requirements of the NHS in England and the devolved nations.

Recruitment. RCoA continues to improve the national recruitment process for anaesthesia. Recruitment to CT1 anaesthesia and ACCS will be coordinated nationally for the first time in 2011 with the 2nd iteration of CT2 and ST3. Further work will continue over the next 3-5 years to streamline and further improve recruitment to anaesthesia to meet the needs of the workforce plan.

Simulation. Further work will be conducted on the use of simulation to support training. A working group is being set up to identify and to take advantage of existing best practice in the use of simulation for trainers and trainees.

Continued Engagement with COPMeD and Deaneries. RCoA will continue to engage with COPMeD and Deaneries on improving the communication between them and striving for quality improvement.

Broad Based Training. It is clear that trainees are eager to gain a broad spectrum on experience during the early part of their career. RCoA will

www.gmc-uk.org 4

further investigate options to provide broad based training at core level.

Review of FRCA Examinations. RCoA will conduct a thorough review of the FRCA. This will include investigation into the content, position and delivery of both the Primary and Final FRCA within the current curriculum.

FFPMRCA Examination. The FPM project to introduce a Fellowship entry examination will be entering its final stages during 2011, with the first examination expected in 2012. The examination is NOT an exit examination, but will allow the Faculty to monitor standards in Pain Medicine from amongst its future Fellows.

International Programmes. RCoA though the Bernard Johnson Adviser (International Programmes) (BJA(IP)) will look to further investigate support to developing countries over the next year.

RAF Critical Care Air Support Team (CCAST) Training. The College is working with the Defence Medical Services to resolve a problem with training continuity for RAF trainees who have a service obligation to support the Critical Care Air Support Team. This work is ongoing and is expected to be resolved in early 2011.

Workplace Based Assessments Working Party. RCoA has set up a WBA working party to provide clear guidance on WBA within the training programme to all trainers as well as provide advice and recommendations on changes to WBAs.

Key issues

Question College Response/Comment GMC Standards for Training Domains

Did the college/faculty identify any key issues in relation to training nationally for the specialty? (For example challenges on the horizon).

Overseas Doctors Training Scheme (ODTS). ODTS has been widely misunderstood and was being used to employ doctors on short term contracts to cover service shortfalls. As a result the ODTS was suspended in June 2010 and after a period of evaluation the College has decided to fully embrace MTI as the means of providing quality training opportunities to doctors from overseas.

e-LA. The removal of funding support to ELfH has severely affected assistance provided to trainees, particularly in preparing for the FRCA. E-LA is an essential resource that is well used by trainees. Continual development is required.

Lead Employers. The current structure of employment contracts for doctors in training has complicated and compromised the ability of training programmes to move trainees around hospitals within a programme and makes seamless training delivery more difficult. A move to a system of a lead employer within a programme will assist with the issues of rotation. Complexities of repeatedly changing employer is time consuming and makes the training programmes generally inflexible. Discussions on this issue are ongoing.

Funding. The change of Government and the enhanced focus on efficiency savings and stringent cuts has already begun to affect training. SHAs and Deaneries are looking to reduce costs and this is resulting in a reduction of support to trainers and in some cases a reduction in training numbers (see below).

Domains 2,3,4,6,7,8 Domains 5,6,7,8 Domain 2,6,7 Domains 1,2,5,6,7,8

www.gmc-uk.org 5

Workforce Planning. There has been an increasing occurrence of SHAs arbitrarily cutting ST3 numbers, South Central are cutting ST3 numbers by 25% in Oxford and 20% in Wessex for 2011. Although the justification for this is given in reference to the CfWI report it is clear that this is not robust data. RCoA is concerned that the cutting of NTNs is a national issue and should not be conducted at a local level.

Reconfiguration. Reconfiguration will affect all aspects of training delivery as well as service. SHAs are looking to make significant savings by service reconfiguration and training provision is not high on their priority list. There is considerable danger that training will be adversely affected as Trusts reconfigure services.

LTFT Training. There has been an Increase in female recruitment (50% to CT1– 100% for CT 1 in Northern Ireland for August 2010 intake) to the specialty which has resulted in a need to incorporate more slot shares into training rotations and has long term implications for workforce planning. The unknown is how many will want to train on a LTFT basis, perhaps from an earlier stage in the training programme and then how many will wish to work LTFT as a consultant?

Remedial CT2. There is an inconsistency of interpretation on the extension to core training allowed in the Gold Guide. Some Deaneries continue not to extend CT2 contracts if a trainee fails to achieve the BLTC mostly due to examination failure, whereas others automatically grant a full 12 months extension and title this CT2 Remedial. This has an immediate impact on recruitment to ST3 and available vacancies.

Domains 1,4,6,7 Domains 1,5,8 Domains 2,3,4,5,6,7,8 Domains 1,2,4,6,7,8,9

Did the college/faculty identify any concerns in relation to training nationally for the specialty?

Initial Assessment of Competence (IAC). Feedback from trainers has indicated there is some confusion on the level of supervision required for various procedures after a trainee has achieved their IAC. This is of particular concerns with ACCS trainees in EM and AM. The IAC does not allow a trainee to be unsupervised but allows them to be included on the on-call rota where sufficient supervision at the right level is provided. A Training Programme Update was released clarifying the rules pertaining to the IAC and trainers have been informed of the requirements.

Obstetric Competencies/Initial Assessment of Obstetric Competence (IAOC). Evidence suggests that the IAOC is, in some cases not being conducted. This is a key competence at CT2 and non compliance is a concern regarding clinical skills at core level. RAs and CTs are addressing this and the College has mandated that completion of the IAOC is formally reported.

Protected Training Time. Protected training time continues to be an ongoing challenge. Although WTR has impacted upon training time there are other factors which create a challenging environment in which to ensure the delivery of a high quality teaching programme. The College has made it clear that for each unit of training, trainees must be programmed for a minimum of 20 direct training sessions to enable them to achieve the core clinical learning outcomes specified in the curriculum.

Levels of Competence. There continue to be incidents where trainees are asked to perform tasks that are beyond their self-perceived or actual levels of competence. These issues have been raised with specific deaneries following feedback from both pastoral and triggered deanery visits. Where required deaneries have directly addressed the

Domains 1,2,3,6,7,9 Domains 1,2,3,6,7,9 Domains 5,6,7,8 Domains 1,2,6,9

www.gmc-uk.org 6

issues. RCoA actively monitors Trusts where these concerns have been identified in accordance with agreed deanery protocols.

Deferment of Units of Training. There has been a slight increase in the request to defer units of training from the intermediate phase of training to higher. The RCoA is keen to champion the principles of spiral learning and is working with Schools of Anaesthesia to ensure that the curriculum is deliverable.

Service vs Training. There is continued evidence of hospitals providing less effective training opportunities. Deaneries are faced with increasing pressure to reduce costs and adhere to SHA cost cutting policy. This is evident in a number of hospitals currently causing concern.

Domains 2,5,6,7,8,9 Domains 1,2,6,7,9

Did the college/faculty identify any areas of notable practice in relation to training nationally for the specialty?

Defence Medical Services Training. PMETB approved for training a period of deployment to field hospitals for anaesthetic trainees in the Armed Forces in 2009. The training opportunities afforded in the Role 3 hospital at CAMP BASTION, Afghanistan is exceptionally high, with a substantial caseload including trauma, ICU and massive blood transfusion cases. Data is deemed too politically sensitive to include in this report. The PMETB approved training has only been available for those trainees in fulltime service with the UK Armed Forces. The College will seek in the coming year approval from the GMC to extend the approval to those doctors in training who are members of the reserves and who are deployed to CAMP BASTION.

Pain Training Advisory Group Training Days. The FPM has been supportive of the move from local PTAGs, notably in London, to run regular training days. These aim to provide education to Advanced Pain Trainees and also to give these doctors, who are often the only one of their kind within a Trust, a useful discussion forum.

LTFT. In recognition of the predicted increase in demand for training on a less than full time basis, RCoA has run an all day meeting (30 Nov 10) aimed at current LTFT trainees, prospective LTFT trainees and trainers with responsibility for LTFT. The meeting “Making Part-Time Work” included talks from Professor Sir John Temple and Dr Anita Holdcroft as well as presentation of the 1st national anaesthetic LTFT trainee survey. This looked at quality of training, opinions on flexible working and implications of the WTD.

Domains 2,5,6,7,8,9 Domains 2,5,6,7 Domains 2,3,5,6,7

Did the college/faculty identify any key issues with specific deaneries and/or local education providers if not identified above (e.g. notable practice or concerns? In case of any concerns was the Dean notified and if so,

Mid Staffs. The enquiry into Mids Staffordshire identified a gap in the continuity of reporting of concerns as a result of the creation of PMETB. This issue has been resolved by the introduction of a Reporting of Concerns mechanism and the ASR process.

Patient Safety. There were a number of deanery visits attended over the year at which College external advisers raised concerns specifically on patient safety issues. In these cases the College engaged with the deanery involved to ensure appropriate action was taken. These issues are continually monitored and the RCoA reserves the right to escalate their concerns via the GMC or CQC should the actions of the deanery be deemed inadequate. In every case, the deanery actions have been in accordance with the formal reporting process and the RCoA has been informed of progress. The means of communicating concerns on service issues affecting patient safety and not necessarily linked to training has been raised with COPMeD.

Domains 1,7 Domains 1,9

www.gmc-uk.org 7

how was the deanery notified?)

Support to Deanery Visits. In every case where the College nominated an external adviser or assisted on a visits and where RAs conducted informal, pastoral visits, the Dean was sent a copy of the report and was kept informed of College activities related to any identified areas of concern.

Capture of Quality Intelligence. RCoA closely monitors and captures all information on visits, including ARCP outcome reports. This is recorded in a data spreadsheet and is used by the Quality Management of Training Committee (QMT) to capture areas of concern and areas of good practice and to identify the actions required by the College. This spreadsheet forms part of the evidence base for this report.

Domains 7,8 Domains 2,7,8,9

Assessments and Examinations


How has the college/faculty developed the workplace based assessments?

Workplace Based Assessments. RCoA has conducted considerable work in improving the WBA forms and these have now been implemented across all schools. The College continues to provide support and advice to trainers seeking clarification on WBA via the training department and use of the CTs discussion forum on the secure areas of the RCoA website.

Domains 2,5,6,9

How did the college/faculty support training of assessors/ examiners?

See Trainers Section for details of support provided to trainers.

Examiner Training. All selected examiners undergo a thorough induction and training process which includes a training day prior to beginning their tenure as an examiner. No examiner can start their appointment without this training. New examiners are also subject to a rigorous audit in their first year on all aspects of examination delivery. A structured appraisal is conducted at the end of year one.

Exam Plenary Sessions. During the examination periods plenary sessions are held between the end of the examining day and call over. These 45 minute to an hour long sessions cover a diverse range of examination subjects.

Publications. New Examination Regulations came into force in August 2009 and were widely circulated to Regional Advisors, College Tutors and posted on the website well in advance of this date. A full and comprehensive summary of all changes introduced, have been available on the College website since June 2008. The College publishes Guides to the FRCA examination. A third edition of the Primary Guide was published in February 2010, whilst The Guide to the Final published in June 08 is being revised. All Regulations and relevant sections of the CCT that contain the examinations and training curricula can be accessed on the College website: http://www.rcoa.ac.uk.

Domains 2,5,6,7,9 Domains 5,6,9 Domains 5,6,7,8

http://www.rcoa.ac.uk/

www.gmc-uk.org 8

Did the college/faculty identify any trends in examination outcomes (e.g. by PMQ, deanery, grade, etc)? Are the trends consistent across examinations or did the different exams have different trends?

See attached Statistical Report. Domains 2,3,5,7,9

How does each college/faculty set the standard for assessments?

MCQ. Methodology criterion referencing using modified Angoff for the MCQ papers both for the Primary and Final with triangulation against UK graduate first-time pass rate. The latter is much less valid for Primary than Final since the introduction of MMC and earlier entry into specialty training. Use of SEM to identify borderline candidates and reducing Angoff score by 1 SEM for all exams adjusts the pass mark to the candidates’ advantage.

SAQ. Examiner discussion on Standard Setting day and establishing criterion-references pass score for each question by working groups.

SOE. Use of 3-point performance scale with independent marking by 2 examiners for each section. The cohort size is small, but work is in progress re-balancing paper difficulty and curriculum coverage. RCoA is working toward a unified approach for Primary & Final FRCA which will be in place for 2012.

OSCE. Angoff referencing for expected scores, comparison of overall examiner impression of "pass" /"fail" with actual scores and Angoff scores. Summative score so that poor performance in one can be made up for by excellent performance in others.

Visitors to Examinations. 175 visitors including College Tutors, members of the Faculty of Pain, prospective Examiners, representatives from the West Indies and the Patient Liaison Group Attended the exams during the year. Feedback from the visitors was noted and discussed and enables the Board of Examiners to review the exams in accordance with the GMC Standards following feedback.

Examinerships. New examiners are recruited to the Board of Primary FRCA examiners, with upward progression to the Board of Final FRCA examiners. The number of Fellows applying to be examiners remains high and 15 new examiners were initially selected from the 75 applicants. Applications from potential examiners are invited early within the calendar year, and the process of selection continues for a number of months before applicants are notified if successful or not. A prospective examiner is required to be a Fellow in good standing, and have the expectation to give a long-term commitment to the role including the ability to devote a minimum of 15 days per academic year to examiner duties, whilst filling an SAS grade or consultant appointment in the NHS, or a comparable post. In the application, the applicant is expected to demonstrate a commitment to education and the work of the

Domain 5 Domain 5 Domain 5 Domain 5 Domains 2,5,7,8 Domains 5,6,7

www.gmc-uk.org 9

College and it is desirable if he or she has visited a Primary or Final FRCA examination. The selection rules are applied consistently and fairly across the board, and the College is keen to ensure that the composition of the Board reflects the demography of the profession.

Candidate feedback. A candidate feedback form will be introduced for 2010-2011 to enable review and audit of the FRCA, RCoA is developing a questionnaire for candidates to identify problems and feedback on exam process working toward the concept of "utility" of the this part of the exam rather than "reliability".

Domains 2,3,5,9

Please provide us with a narrative regarding the exam performance, including basic statistical info and the reliability coefficient for each exam (not by diet).

The Primary FRCA Examination. A total of 1,061 candidates entered the Primary MCQ examination; 54.1% of entrants passed in the 09-10 academic year. The reliability coefficient of this exam remains consistently high with a mean reliability score across the three exams of 0.929. The 3 sittings of the OSCE /SOE components were attended by 877 candidates; overall 421 candidates passed, thus completing the Primary exam (48% of all entrants). The greater variety of possible outcomes (complete fail, partial pass/fail or complete pass) combined with some candidates re-sitting only a single part of the exam at the January and May sittings, makes interpretation of the results more complex, with 8 different candidate results possible. Encouragingly the pass rate for a candidate re-sitting only one part of the exam in the Jan and May 2010 sittings was high at 75.3% for SOE only and 88.7% for OSCE only. To assess the effect of the changes in exam regulations candidates’ outcomes were compared under the old and new systems. The numbers advantaged or disadvantaged were comparable.

The Final FRCA Examination. A total of 971 sat the Final Written examination; 63.9% passed. 688 candidates sat the SOE; 65.7% passed, this is marginally reduced in comparison to the pass rate under the old system. The overall reliability of the September 09 and March 10 SAQ components were 0.74 and 0.77 respectively, with all questions used demonstrating a strong to very strong correlation to overall performance. The reliability coefficient of the MCQ component for September and March was 0.81 and 0.76 lower than the >0.9 previously seen. The Final MCQ Core Group continues to seek to improve the reliability of this part of the exam. The paper setting, standard setting and marking process of the SAQ continues to be refined.

Examinations Changes. The changes that are to come into force from the 1st September 2010 have been well publicised. These include changes to the rules for Guidance, introduction of Single Best Answer questions into the Final MCQ section of the Final FRCA Written examination and some changes to the marking guides of the Primary MCQ and Final SAQ and MCQ. Full details are available on the website.

Overseas Examinations. RCoA continues to send examiners to affiliated Colleges around the world including Bangladesh, Ireland, Hong Kong, Singapore, Sri Lanka and the West Indies. The reports submitted by visiting examiners are considered by the examinations committee. Detailed feedback is offered to the host institutions, and is considered helpful in maintaining standards. Satisfactory reports form the basis for continuing exemption from the College’s Primary FRCA examination. RCoA does not export the FRCA and it eligibility is limited to UK doctors in training or those who have previously been in UK training posts. This is considered essential in maintaining

Domains 2,5 Domains 2,5 Domains 2,5,7,9 Domain 2

www.gmc-uk.org 10

standards and keeping the FRCA relevant to UK practice in the NHS. Changes are being introduced to allow overseas applicants for ST3 jobs sit the Primary FRCA, but this will be strictly monitored to ensure that UK trainees are not disadvantaged when applying for the examination.

Guidance to unsuccessful Candidates. Guidance has been mandatory for a candidate who has failed the Primary OSCE and/or SOE on two occasions or the Final Written or Final SOE on three occasions before a further attempt at the relevant examination was permitted. The detailed examination results now made available by the Examinations Department have reduced the applicability of this process. A change to the regulations in regard to guidance has been published on the College website and will come into force in September 2010.

Number of Attempts for the Primary MCQ. From June 2009 the number of attempts allowed at the Primary MCQ was reduced from unlimited to five and the validity of a pass as part of the eligibility towards the Primary OSCE/SOE was reduced from three to two years.

The Primary OSCE/SOE Changes. This was the first year of examinations conducted under the revised 2009 regulations. To achieve an ‘overall’ pass in the Primary, candidates must now obtain an obligatory pass in both the OSCE and SOE. Changes to the conduct and assessment of the SOE came into force, whereby a candidate must obtain a total score of 37/48 or more from the summative score of an independent assessment of 4 examiners across the two SOE components.

Final Written Examination Changes. These were the first uncoupled, stand-alone written exams following the 2009 changes. The pass mark for the written paper became the sum of the percentage pass marks from the MCQ and SAQ papers.

The Final SOE Changes. Changes to the conduct and assessment of the SOE came into force similar to that in the Primary requiring a candidate to obtain a total score of 32/40 or more to pass.

Domain 3 Domains 2,5,6 Domains 2,7 Domains 2,5 Domains 2,5 Domains 2,5

Has the college/faculty identified any issues regarding the Annual Review of Competence Progression (ARCP)? Please include commentary on college/faculty involvement in ARCPs and academic training ARCPs.

External Advisers. RCoA provides external advisers to deaneries for ARCP panels. This offer is taken up by all deaneries and is working well.

College ARCPs Reports. RCoA has updated the ARCP external adviser’s report which is sent to the School and Deanery. The standard of ARCP has been high and the reports have been generally complimentary to the ARCP processes across all deaneries. The Peninsula deanery, in particular stood out in this regard.

Primary Exam Failure. A significant amount of Outcome 3 decisions at ARCP between CT2 and ST3 area result of exam failure. Data suggests that trainees who do not achieve an outcome 3 at this stage progress after 6 months additional training time and further opportunities to take and pass the Primary Examination.

Domains 2,5,6,7,9

Domains 2,5,6,7,9

Domains 2,5,6,7,9

www.gmc-uk.org 11

E-Portfolios


Please comment on the development and local implementation of the e-portfolios (e.g. links with deaneries?)

e-Portfolio SLA. A contract was signed with Premier IT in August 2010 to deliver the training e-Portfolio following development of a full statement of requirements. A pilot using 3 schools (Bristol, Northern Ireland and South East Scotland) started in October 2010.

Planned Roll Out. Full roll out of the e-Portfolio will take place in August 2011 to all schools. Full functionality will be developed in a phased approach and improvements to the system will continue after roll out.

Development of e-Portfolio Operating Procedures. The development of operating procedures is ongoing and this will encompass usage in trusts and schools. The pilot will identify the key issues concerning support of the system. It is likely that there will be some shortfalls in capability as a result of resources at trust level, including administrative staff, access to IT, broadband and internet access.

Usage. Some conflict with Virtual Learning Environments (VLE) in some Schools may create overlap and duplication. It is hoped that anaesthesia trainees will all use RCoA e-Portfolio as this will be accurately mapped to the training programme. Trainees registered with the College will not be charged to use the training e-Portfolio.

Domains 5,6,7,8,9 Domains 5,6,7,8,9 Domains 5,6,7,8,9 Domains 2,7,8

Trainers


Did the college identify any trends, concerns or notable practice in relation to trainers, locally or nationally (e.g. protected teaching time)?

Support to Trainers. There is continued concern on the support afforded to trainers, both in the delivery and the overall support for training. This includes work as RAs, CTs and for those acting as an external adviser on visits. The Joint statement from PMETB/GMC, COPMeD, and AoMRC has been of some help but continued pressure is required to support medical practitioners who actively seek to improve training quality. Trainers are under increasing pressure to justify supporting professional activities or those which may detract from direct clinical care contracts are under increased scrutiny from employers looking to achieve financial savings. The College continues to actively support trainers but more is needed to be done to formally protect these essential activities.

MSF for Trainers. A number of anaesthetic departments have introduced MSF for trainers over the past year. This has had a marked effect on the quality of training delivery and has resulted in consultants actively seeking to improve their training skills, which also forms an important aspect of the enhanced appraisal for revalidation.

Domain 6,9 Domains 2,6,9

www.gmc-uk.org 12

Please comment on any activity to support and develop trainers (e.g. briefing sessions on delivering the new curriculum). If you deliver any training courses please comment on participation and any trends.

RAs’ Meetings. RCoA hold 3 RAs’ meetings annually, training concerns are raised regularly at these meetings and discussed in detail. Curriculum concerns and implementation has been discussed at these meetings over the year and has proved an excellent forum in which to resolve concerns and confusion of curriculum related issues. . The FPM also runs two RA in Pain Medicine meetings annually, the first of which has an open invitation to Advanced Pain Medicine trainees to discuss training and careers issues. Attendance includes RAs, Heads of School (HoS) and TPDs.

CTs’ Meetings. The College holds an annual meeting for CTs during the summer much in the same vane as the RA meetings. This meeting provides the College the best opportunity to speak to all tutors and vice versa. Attendance is upwards of 300 and feedback is generally positive. It is here that RCoA is able to ascertain what the practical challenges of delivering the training programme are.

Training Programme Updates. RCoA produces regular TPUs on an as required basis. Records of these are available on the RCoA website.

New College Tutor Training Days. These courses are delivered to all newly appointed CTs and occur twice a year to help them with their role. The courses over 2 days cover issues such as mentoring, trainees in difficulty and workplace based assessments. Attendance at these meetings is mandatory and feedback from attendees has been very positive.

ACCS Trainers Day. An ACCS training day was held in Mar 10 for all specialty streams in ACCS. There was valuable discussion on best practice across the country and a number of key issues on the delivery of ACCS training discussed, including the management of rotations and the delivery of anaesthetic training.

Domains 2,6 Domains 2,6 Domains 2,5,6,7,9 Domains 2,5,6 Domains 2,5,6

Flexible Training


Did the college/faculty identify any trends, concerns or notable practice in relation to flexible training nationally for the specialty

Less Than Full Time (LTFT) Training. Anaesthesia is the 3rd largest specialty for LTFT trainees, 8% of trainees are training LTFT and 90% of these are female. The majority train at 60% and there have currently been no requests to train less than 50%. The College does not support <50% as and is keen to ensure deaneries offer LTFT training at 60-80% despite the difficulties involved in delivering this.

Domain 6

www.gmc-uk.org 13

(e.g. filling rota gaps)?

European Working Time Regulations (EWTR)


Please comment on the impact of EWTR on training nationally for the specialty.

RCoA EWTR Survey. The RCoA published the results of a post implementation EWTR survey in December 2009. This survey looked at compliance, recruitment, training and the effect on consultant and career grade workload. Concerns raised included the number of gaps on rotas that compromised compliance, difficulties in recruiting middle grade doctors and concerns about trainees failing to reach projected milestones.

Time Taken to Achieve Initial Assessment of Competence (IAC). Detailed investigation of training concerns looking at the time to achieve the initial assessment of competence demonstrated that although the WTR contributed to some delays, the reasons were multi-factorial. A more significant challenge appears to be gaining enough experience in obstetric anaesthesia at basic level within the two year basic training programme. Concerns raised by a trainee survey have been followed by a comprehensive trainers’ survey in conjunction with the OAA.

RCoA Input to the Temple Report. The College has shared their information with the DH and PMETB contributing to the Temple enquiry into the effects of the EWTR on training. Verbal and written reports were submitted and both consultant and trainee representatives participated in discussion forums.

Difficulty of Compliance to Rigid EWTR Rules. The recent GMC trainee survey reports EWTR compliance is still a challenge across all deaneries. Although the overall mean compliance is 90% the inter deanery range varies from 78.5-98%. Verbal feedback from College Tutors suggests that the rigidity of the EWTR rules are more difficult to manage rather than a reduction to 48 hours itself. Any potential reduction in trainee numbers is going to challenge this further especially in the current financial climate limiting consultant expansion.

Domains 1,2,5,7,9 Domains 1,2 5 Domains 2,5,7,9 Domains 1,2,5,7,9

Equality and Diversity


Please comment on any trends or issues you have identified

Trainees with Disabilities Ability to Complete the Training Programme. There are a number of trainees with disabilities in anaesthesia training. Their ability to cope with the specific demands of the specialty are actively managed. Although every effort is made to ensure their needs are met this must not be to the detriment of patient safety. Discussions are ongoing regarding wheelchair bound trainees and their ability to intubate

Domains 1,3

www.gmc-uk.org 14

regarding Equality and Diversity nationally for the specialty and any actions taken as a result (e.g. fail rates among non-UK PMQ. Is the college/faculty taking any action to support those trainees who are in UK training programmes?).

patients and react to emergency calls.

FRCA Examination Access and Support. RCoA FRCA examinations regulations are implicit in the provision of support required to trainees with specific needs. All information is available on the website and the Examination department are conversant with what can and cannot be provided.

IMG Examination Pass Rate. The pass rates for those trainees who have not attended UK medical school is significantly lower (see statistical report). However there is no significant difference in overseas trainees who have attended medical school in the UK. Training courses and guidance and advice are provided for all trainees to assist them in taking and passing the FRCA.

LTFT Training. LTFT Trainees are actively encouraged in the specialty (see section on LTFT Training in this report).

Domains 3,5 Domains 3,6 Domains 3,6

Academic training


Please comment on academic training nationally in relation to the specialty (e.g. participation rates or trends, concerns, notable practice).

Academic Post Numbers. There is limited clarity on the number of Academic posts nationally and their status. In terms of workforce planning this is an area of concern. MMC are keen to establish the extent of ‘fellowship’ posts that are effectively training posts by another names. There is evidence that such posts are creating gaps in the rota. RCoA is currently undergoing work to establish the extent of academic posts and whether these are approved under the GMC Form A or are OOPT.

Domains 2,3,5,6,7

Curriculum


www.gmc-uk.org 15

Did the college/faculty identify any trends, concerns or areas of notable practice regarding core and/or higher specialty training (if applicable)?

As stated previously in this report.

Please describe the colleges’/faculties’ plans and processes regarding the implementation of the 2010 Curriculum. Please comment on any engagement with deaneries.

2010 Curriculum Implementation. The College consulted with the Schools of Anaesthesia on how the curriculum should be implemented and what timelines should be followed. The implementation plan once agreed with the Schools was approved by PMETB.

Pain Medicine Curriculum: The FPM has been in liaison with its regional representatives during 2010 regarding the implementation of the new curriculum, which now requires a 3 month block of Higher training and includes 3 (soon to be 4) optional modules in the advanced year. The FPM has developed Study Days to cover the optional modules and will be developing Frequently Asked Questions.

ACCS Curriculum. The Intercollegiate Committee for ACCS Training (ICACCST) agreed a standard ACCS curriculum for 2010. This is fully compatible with the Anaesthetics Curriculum and reflects the training delivered.

Domains 5 Domain 5 Domain 5

Please describe any actions taken in relation to any remaining conditions on approval set in the Formal Review approval letter.

There are no outstanding conditions.

Please describe any actions taken in relation to any recommendations made (for example following the Formal Review).

The College reviewed the recommendations and a response was sent to the GMC along with our response to the conditions in a letter dated 16 April 2010 to the Head of Curriculum and Evaluation at the GMC (Appendix 2).

Responses to concern

www.gmc-uk.org 16


Please identify any concerns that the specialty wishes for the GMC to investigate and potentially take action on. Please provide evidence to support the referral.

None identified.

Please refer to sources of evidence but do not attach the evidence unless raising a specific concern for the GMC to investigate. Please do not include workforce or clinical issues that do not impact on training; the link to training needs to be explicit.

Section 4. Declaration

I confirm that the information given on this annual college/faculty reporting form is correct.

Signature:

Date: 8th December 2010

Position held: Director of Training and Examinations

Name

Specialty

Name of examination

DeaneryMale Female Asian Black

Chinese/ SE

AsianWhite Other Unknown UK graduate

Non-UK

graduate

Defence (Tri Services) 9 5 14 14

Primary FRCA SOE/OSCE 12 9 12 7 2 11 10

East of England 7 12 8 10 1 9 10

East of Scotland 1 3 1 1 2 2 2

Kent, Surrey and Sussex 12 6 6 1 11 10 8

London 56 65 35 4 10 58 14 92 29

Mersey 13 10 5 1 16 1 17 6

North of Scotland 5 3 1 6 1 7 1

North Western 17 18 7 1 26 1 30 5

Northern 19 12 10 2 19 21 10

Northern Ireland 3 1 1 3 1 3

Oxford 12 5 6 11 14 3

Severn 9 10 1 16 2 19

South East Scotland 5 2 3 3 1 2 5

South West Peninsula 9 11 2 17 1 18 2

Wales 14 9 8 15 17 6

Wessex 6 10 2 13 1 13 3

West Midlands 24 16 18 1 18 3 24 16

West of Scotland 8 12 6 14 13 7

Yorkshire and Humber 32 32 18 1 41 4 44 20

Total 273 251 150 8 14 320 32 0 378 146

524524

College / Faculty Exam Data 2009/10 Please provide examination data for each exam, but not for each

diet. If the college/ faculty currently does not collect data broken

down in this manner please include in the ASR what actions will be

taken to enable more detailed data collection in future years.

Section 1. Details of the College / Faculty

Royal College of Anaesthetists

Anaesthesia

Final FRCA SOE

Section 2. Headings under which the examination information / data is required

524

2.1 The number of trainees who have sat the examinations nationally and for each deanery

Candidate Gender Candidate Ethnicity Uk or non-UK graduate

Final SOE

2009 - 2010


Chinese/ SE


Non-UK

graduate

Defence (Tri Services) 6 5 11 11 -

East Midlands 8 6 5 6 3 9 5




London 44 53 24 2 6 52 13 77 20

Mersey 11 8 3 1 15 15 4

North of Scotland 3 3 5 1 6 -

North Western 13 12 3 1 20 1 23 2

Northern 18 11 10 19 19 10

Northern Ireland 2 1 3 1 2

Oxford 11 5 5 10 1 13 3

Pharmaceutical Medicine

Severn 9 10 1 16 2 19 -

South East Scotland 2 2 1 3 2 2


Wales 13 8 5 15 1 16 5

Wessex 5 7 11 1 11 1

West Midlands 15 12 7 1 17 2 20 7



Total 214 206 90 6 8 284 32 0 326 94

Uk or non-UK graduate2.2 The number of trainees who have passed the examinations nationally and for each deanery

420420

Candidate Gender Candidate Ethnicity

420

Final SOE

2009 - 2010

ST3-ST5

Deanery Pass Fail Pass Fail Pass Fail

Defence (Tri Services) 11 3

East Midlands 14 6 1

East of England 13 3 3

East of Scotland 4

Kent, Surrey and Sussex 12 3 2 1

London 2 1 94 22 1 1

Mersey 19 3 1

North of Scotland 6 2

North Western 25 9 1

Northern 1 28 2

Northern Ireland 3 1

Oxford 14 1 2

Severn 19

South East Scotland 4 3

South West Peninsula 1 17 2

Wales 1 15 1 5 1

Wessex 12 4

West Midlands 25 13 2

West of Scotland 11 9

Yorkshire and Humber 53 10 1

Total 5 1 399 97 16 6

CT1/CT2 LAT

6 22496

2.3 The level that the trainees are at in their training

524

Final SOE

2009 - 2010


Chinese /SE

AsianWhite Other

UK

graduate

Non-UK

graduate

Defence (Tri Services) 1 1 1

East Midlands 3 3 3

East of England 1 2 2 1 3

East of Scotland 1 1 1

Kent, Surrey and Sussex 1 1 1

London 4 5 6 1 1 1 2 7

Mersey

North of Scotland

North Western

Northern 1 1 2 1 1

Northern Ireland

Oxford

Severn

South East Scotland

South West Peninsula

Wales 1 1 1

Wessex

West Midlands 4 3 6 1 7


Yorkshire and Humber 1 2 2 1 1 2

Total 20 14 25 2 1 5 1 6 28

Uk or non-UK graduateCandidate Gender Candidate Ethnicity

2.4 The number of trainees taking examinations who failed (the same) examination more than three times

34 34 34

Final SOE

2009 - 2010

Name

Address

Job title

Telephone number

Mobile number

Email

Signature:

Date:

Position held:



Director of Training and Examinations

[email protected]



06-Dec-10

Richard Bryant

The Royal College of Anaesthetists


020 7092 1558

07545 586613

Final SOE

2009 - 2010


Name

Specialty

Name of examination


Chinese/

SE AsianWhite Other Unknown UK graduate

Non-UK

graduate


East Midlands 18 15 15 1 11 6 16 17

East of England 13 13 11 12 3 9 17


Kent, Surrey and Sussex 18 10 9 4 14 1 16 12

London 87 86 46 5 10 86 26 137 36

Mersey 15 10 5 1 18 1 19 6


North Western 17 25 9 1 31 1 35 7

Northern 22 16 12 2 24 26 12


Oxford 14 8 6 1 14 1 20 2

Severn 20 14 4 25 5 29 5



Wales 25 16 12 3 25 1 25 16

Wessex 7 9 2 1 13 14 2

West Midlands 33 21 26 2 1 21 4 29 25

West of Scotland 18 19 18 18 1 17 20


Total 387 327 208 17 17 412 59 1 492 222


714714714





down in this manner please include in the ASR what actions will

be taken to enable more detailed data collection in future years.



Anaesthesia

Final FRCA Written

Final FRCA Written

2009 - 2010


Chinese/

SE AsianWhite Other Unknown UK graduate

Non-UK

graduate

Defence (Tri Services) 9 5 14 14 0

East Midlands 14 9 13 8 2 12 11

East of England 9 13 10 10 2 8 14



London 57 73 35 5 10 65 15 104 26

Mersey 13 10 5 1 16 1 17 6


North Western 16 19 7 1 26 1 31 4

Northern 19 13 10 2 20 22 10


Oxford 12 4 5 11 14 2

Severn 10 9 1 16 2 19 0



Wales 14 14 9 19 20 8

Wessex 7 11 2 15 1 15 3

West Midlands 23 16 17 1 18 3 22 17



Total 281 267 154 9 14 337 34 0 397 151

2.2 The number of trainees who have passed the examinations nationally and for each deanery


548 548 548

Final FRCA Written

2009 - 2010

Deanery Pass Fail Pass Fail Pass Fail Pass Fail


East Midlands 22 8 1 2

East of England 1 16 4 5

East of Scotland 4 1

Kent, Surrey and Sussex 1 16 6 4 1

London 1 124 39 4 4 1

Mersey 22 2 1

North of Scotland 7 2 1

North Western 35 6 1

Northern 30 6 2

Northern Ireland 5 4

Oxford 14 6 1 1

Severn 19 3 2

South East Scotland 7 3

South West Peninsula 18

Wales 1 19 8 8 4 1

Wessex 19 7 1

West Midlands 37 13 2 2

West of Scotland 20 13 2 2

Yorkshire and Humber 1 65 7 1 2

Total 3 2 513 140 29 21 4 2


CT1/CT2 ST3-ST5 LAT Fixed Term Speciality

714

5 653 50 6

Final FRCA Written

2009 - 2010


Chinese

/SE AsianWhite Other

UK

graduate

Non-UK

graduate


East Midlands 5 5 1 4

East of England 2 1 3 3

East of Scotland


London 7 3 7 1 2 3 7

Mersey

North of Scotland 1 1 1

North Western 2 1 1 1 1

Northern 2 2 2

Northern Ireland

Oxford

Severn

South East Scotland

South West Peninsula

Wales 3 1 2 1 1 1 3

Wessex

West Midlands 3 3 5 1 6

West of Scotland 2 1 3 3

Yorkshire and Humber 2 1 3 3

Total 30 11 31 3 1 3 3 8 33

Candidate Gender Uk or non-UK graduate

41 4141

Candidate Ethnicity


Final FRCA Written

2009 - 2010

Name

Address

Job title

Telephone number

Mobile number

Email

Signature:

Date:

Position held:

06-Dec-10


020 7092 1558

07545 586613

[email protected]






Richard Bryant


Final FRCA Written

2009 - 2010


Name

Specialty

Name of examination

Deanery Male Female Asian BlackChinese/ SE


NonUK

graduate


East Midlands 23 19 9 2 27 4 33 9

East of England 18 8 4 3 13 6 21 5


Kent, Surrey and Sussex 35 40 15 4 1 40 15 55 20

London 68 100 33 2 10 100 23 149 19

Mersey 31 24 5 45 4 1 54 1

North of Scotland 1 7 1 7 7 1

North Western 27 27 5 1 42 5 1 51 3

Northern 16 13 5 22 2 20 9


Oxford 13 12 3 21 1 25

Severn 12 13 3 1 2 18 1 22 3

South East Scotland 12 7 1 18 18 1

South West Peninsula 22 18 2 1 34 3 35 5

Wales 29 24 11 1 2 34 5 32 21

Wessex 11 18 1 1 26 1 29

West Midlands 37 29 19 1 2 39 5 52 14

West of Scotland 11 23 1 2 29 2 32 2


Total 410 427 132 11 27 582 83 2 709 128

Please provide examination data for each exam, but not for each


down in this manner please include in the ASR what actions will

be taken to enable more detailed data collection in future years.



Candidate Gender Candidate Ethnicity Uk or nonUK graduate

College / Faculty Exam Data 2009/10



Anaesthesia

Primary FRCA MCQ

837 837 837

Primary FRCA MCQ

2009 - 2010

Deanery Male Female Asian BlackChinese/ SE


NonUK

graduate


East Midlands 13 10 4 1 15 3 19 4

East of England 11 6 4 3 6 4 13 4



London 54 58 21 1 5 67 18 101 11

Mersey 27 20 5 37 4 1 46 1

North of Scotland 1 4 1 4 4 1

North Western 20 13 2 30 1 31 2

Northern 9 4 2 10 1 10 3

Northern Ireland 4 5 9 8 1

Oxford 10 9 2 17 19

Severn 9 12 1 1 1 17 1 20 1

South East Scotland 10 5 15 14 1


Wales 16 15 6 2 22 1 23 8

Wessex 10 14 1 22 1 24

West Midlands 20 21 8 2 27 4 36 5

West of Scotland 8 17 2 21 2 24 1


Total 287 266 74 7 18 399 54 1 490 63

2.2 The number of trainees who have passed the examinations nationally and for each deanery


553 553 553

Primary FRCA MCQ

2009 - 2010



East Midlands 20 16 3 2 1

East of England 17 9

East of Scotland 3 1 1 1


London 94 50 14 6 2 2 2

Mersey 44 8 2

North of Scotland 1 3 3 1


Northern 11 11 1 5 1 1

Northern Ireland 8 16 1 3

Oxford 17 6 2

Severn 19 4 2



Wales 29 18 2 1 3

Wessex 24 5




Total 463 249 78 26 8 8 4 1

CT1/CT2 ST3-ST5 LAT Fixed Term Speciality

104712

837


516

Primary FRCA MCQ

2009 - 2010

Deanery Male Female Asian Black Chinese /SE White Other Unknown UK graduate NonUK

Defence (Tri Services)

East Midlands 1 2 2 1 2 1

East of England 1 1 1

East of Scotland

Kent, Surrey and Sussex 4 1 1 2 3 1

London 3 2 1 2 2 5

Mersey 1 2 2 1 3

North of Scotland

North Western 1 3 4 4

Northern 1 1 1

Northern Ireland

Oxford

Severn

South East Scotland


Wales 1 1 1 1 1 1

Wessex 3 2 1

West Midlands 1 2

West of Scotland 1 1 1

Yorkshire and Humber 1 3 1 2 1 3 1

Total 13 20 5 0 1 20 7 0 28 5



333333

Primary FRCA MCQ

2009 - 2010

Name

Address

Job title

Telephone number

Mobile number

Email

Signature:

Date:

Position held:

06-Dec-10



020 7092 1558

07545 586613

[email protected]






Richard Bryant

Primary FRCA MCQ

2009 - 2010


Name

Specialty

Name of examination


Chinese/

SE AsianWhite Other UK graduate

NonUK

graduate


East Midlands 20 14 8 3 22 3 28 6




London 53 45 14 2 3 81 86 12

Mersey 18 18 6 1 24 5 34 2


North Western 18 17 3 1 3 27 1 32 3

Northern 9 8 1 16 15 2


Oxford 8 9 1 13 16 1

Severn 7 13 3 1 15 1 19 1


South West Peninsula 20 10 3 1 1 24 1 24 6

Wales 17 16 9 2 22 20 13

Wessex 14 15 2 27 1 29

West Midlands 25 25 20 1 1 25 4 36 14

West of Scotland 11 16 1 2 23 1 25 2


Total 299 278 101 11 20 419 26 488 89



down in this manner please include in the ASR what actions will be

taken to enable more detailed data collection in future years.



Anaesthesia

Primary FRCA SOE/OSCE


577

Candidate Gender Uk or nonUK graduate

577 577

Candidate Ethnicity



2009 - 2010


Chinese/

SE AsianWhite Other UK graduate

NonUK

graduate


East Midlands 11 11 4 2 16 1 20 2

East of England 7 9 2 13 14 2



London 34 35 8 1 2 51 8 63 6

Mersey 15 12 4 1 19 3 25 2


North Western 13 13 1 1 3 20 1 24 2

Northern 6 7 13 12 1


Oxford 7 8 1 11 3 14 1

Severn 6 11 2 13 1 17



Wales 8 9 3 14 12 5

Wessex 12 13 1 24 25

West Midlands 19 18 14 1 1 19 3 27 10

West of Scotland 6 13 18 1 19


Total 208 201 51 6 11 316 25 368 41

2.2 The number of trainees who have passed the examinations nationally and for each deaneryCandidate Ethnicity

409 409409

Candidate Gender Uk or nonUK graduate


2009 - 2010



East Midlands 15 11 8 1 1

East of England 13 5 2 1 1 1

East of Scotland 2 1


London 39 18 30 10 1 1 1

Mersey 23 7 4 1 1

North of Scotland 1 1 4 2


Northern 12 2 1 2


Oxford 6 1 9 1

Severn 12 2 5 1


South West Peninsula 17 5 6 2

Wales 15 12 2 2 1 1

Wessex 17 3 8 2




Total 268 109 137 48 2 5 2 6


577

CT1/CT2 ST3ST5 LAT Fixed Term Speciality

377 185 7 8


2009 - 2010


Chinese

/SE AsianWhite Other Unknown UK graduate

Non-UK

graduate

Defence (Tri Services)

East Midlands 1

East of England 1 1

East of Scotland


London 1 1 1 1 2

Mersey

North of Scotland

North Western 1 1 1

Northern

Northern Ireland

Oxford

Severn

South East Scotland 1 1 1


Wales 1 1 1 1 2

Wessex 1 1 1


West of Scotland 1 1 1


Total 12 6 9 0 1 6 2 0 11 7



1818 18


2009 - 2010

Name

Address

Job title

Telephone number

Mobile number

Email

Signature:

Date:

Position held:

06-Dec-10



020 7092 1558

07545 586613

[email protected]






Richard Bryant


2009 - 2010


1

FRCA Examinations

Annual

Statistical Report

2009/10

2

Table of Contents 1. SUMMARY OF DATA ............................................................................................................ 3

2. PRIMARY MCQ ..................................................................................................................... 4

2.1 Component Breakdown ............................................................................................... 5

2.2 Gender ........................................................................................................................10

2.3 Area of Qualification ....................................................................................................11

2.4 Candidate Primary History ..........................................................................................12

2.5 Regional Centre Performance Variation ......................................................................14

2.6 Reliability ....................................................................................................................15

2.7 Historical Data ............................................................................................................16

3. PRIMARY OSCE/SOE ..........................................................................................................19

3.1 Pass Rate ...................................................................................................................20

3.2 SOE Component Breakdown ......................................................................................22

3.3 Gender ........................................................................................................................26


3.5 Candidate History .......................................................................................................28

3.6 Reliability ....................................................................................................................29

3.7 Historical Data ............................................................................................................30

4. FINAL WRITTEN ..................................................................................................................33

4.1 Component Breakdown ..............................................................................................34

4.2 Gender ........................................................................................................................38


4.4 Candidate History .......................................................................................................40

4.5 Historical Data ............................................................................................................42

5. FINAL SOE ...........................................................................................................................44

5.1 Component Breakdown ..............................................................................................45

5.2 Gender ........................................................................................................................49


5.4 Candidate Final History ...............................................................................................51

5.5 Historical Data ............................................................................................................53

3

1. SUMMARY OF DATA

SEPTEMBER 09 FEBRUARY 10 JUNE 10 TOTAL

Primary MCQ Attendees 314 259 488 1061

Passed 574 54.10%

Failed 487 45.90% OCTOBER 09 JANUARY 10 MAY 10 TOTAL

Primary OSCE/SOE Attendees 261 314 302 877

Passed 421 48.0%

Failed 456 52.0% SEPTEMBER 09 MARCH 10 / TOTAL

Final Written Exam Attendees 460 511 / 971

Passed 620 63.9%

Failed 351 36.1% DECEMBER 2009 / JUNE 2010 TOTAL

Final SOE Attendees 289 / 379 668

Passed 439 65.7%

Failed 229 34.3%

TOTAL Attendees 3577

PASS54%

FAIL46%

Primary MCQ

PASS48%FAIL

52%

Primary OSCE/SOE

PASS64%

FAIL36%

Final Written

PASS66%

FAIL34%

Final SOE

4

2. PRIMARY MCQ

SEPTEMBER 09 FEBRUARY 10 JUNE 10

Attendees 1061 314 259 488

Passed 574 54.10%

Failed 487 45.90%

PASS54%

FAIL46%

Primary MCQ

5

2.1 Component Breakdown Below are several graphs showing the breakdown of the component parts of

the Primary MCQ Examination.

The average scores are as follows,

Pharmacology Physiology Physics & Clinical

Management

Overall Mark

Mean 78.5% 78.4% 78.8% 78.6%

We can see from the average marks that all of the sections are very closely

matched with regard to difficulty over the year.

2.1.1 Overall Marks

We see that the range of overall scores was from 56.89% to 92.89%.

We see the normal range (50% of candidates) scored between 74.44 and

83.56%,

We have 15 candidates scoring low outlying results (in red) across the

year.

This data is shown expanded on the following bar chart:

6

0

50

100

150

200

250

300

350

0-5 6-10 11-15 16-20 21-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 61-65 66-70 71-75 76-80 81-85 86-90 91-95 96-100

No

. Of

Can

did

ate

s

%

Frequency of Overall Scores

7

2.1.2 Pharmacology Component Marks

We see that the range of scores was from 50.67% to 94.67%.

We see the normal range scored between 73.33 and 84%.

We see 7 low outlying candidates (in red).

2.1.3 Physiology Component Marks

We see that the range of scores was from 52 to the 96.

We see the normal range (50% of candidates) scored between 74 and 84.

We spot 16 low outlying candidates (in red.

8

2.1.4 Physics and Clinical Management Component Marks

We see that the range of scores was from 52.67 to the 94%.

We see the normal range scored between 74.67 and 84%

We see 14 low outlying candidates (in red).

2.1.5 Proportion of Marks for each section

The graph below shows the proportion of marks awarded to each candidate

across the sections. As you can see they are very well balanced with no section

outperforming another.

9

2.1.6 Correlation Between Component Marks and Final Score

Performance in each section is a good indicator of overall performance with no component section

performing significantly badly/well in comparison with the final mark for a candidate.

This is confirmed in the correlation coefficients calculated for each section:

Pharmacology: 0.808 Physiology: 0.806 P&CM: 0.837

We see a slightly higher indication of success in a candidates performance in the Physics and Clinical

measurement section, however this difference is not large.

10

2.2 Gender

The gender breakdown of attendees is as follows:

Attendees: 1061 Male: 514

Female: 547

Over the entire year we see a 9% higher pass rate from the male candidates

compared with the female, although the female enjoy a higher attendance

rate.

11

2.3 Area of Qualification

Attendees 858 50 153

Pass Rate 58.0% 42.0% 35.9%

Fail Rate 42.0% 58.0% 64.1%

From the graph as you would expect we can see our highest number of candidates came from the UK, they also enjoyed the highest pass rate, 4% above the examination pass rate (54%). The candidates from Europe were our lowest attendees and suffered a pass rate 12% lower than the exam pass rate. Numbers of candidates from outside of Europe were also significantly lower than that from the UK with the lowest pass rate, 18% below the examination pass rate.

12

2.4 Candidate Primary History

The majority of our candidates are on their first attempt however there is also a

large proportion on their 2nd and 3rd attempts. This can greatly alter the pass

rates for examinations which is why it is useful to look at 1st attempt pass rates,

which in this sitting is slightly higher than the overall examination pass rate.

The table below shows the candidates previous attempts at the Primary MCQ

and their pass rates:

Attempt No 1 2 3 4 5 6

PASS 376 58% 135 51% 47 46% 13 37% 3 30% 0 0%

FAIL 270 42% 131 49% 56 54% 22 63% 7 70% 1 100%

Total 646 266 103 35 10 1

As we can see from the table above the large majority of our candidates (61%)

are on their first attempt and only 10 candidates were on their final, fifth,

attempt. 1 candidate was offered an extra attempt and failed.

13

The graph below shows the correlation between the pass rate and the attempt

number:

The data shows that there is a negative correlation between the number of

attempts and a candidate’s chance of success.

14

2.5 Regional Centre Performance Variation

Regional Centre Fail Pass Total Belfast 29 11 40

Birmingham 81 85 166

Cardiff 41 66 107

Edinburgh 46 62 108

London 198 256 454

London (RCOA) 32 15 47

Sheffield 60 79 139

There was very little variation in the pass rates across the country, with the

exception of Belfast and the smaller London group at the RCOA who suffered

lower pass rates.

15

2.6 Reliability

As the MCQ is a dichotomous choice test the reliability coefficient is calculated

using the Kuder-Richardson formula (KR-20). The reliability scores of the Primary

FRCA MCQ examination for the past three years are as follows;

Examination Reliability Score (KR-20) No. Of Candidates Apr-07 0.975 267

Jun-07 0.97 241

Sep-07 0.974 290

Nov-07 0.967 163

Feb-08 0.979 301

Jun-08 0.978 356

Sep-08 0.932 270

Feb-09 0.935 294

Jun-09 0.922 464

Sep-09 0.916 314

Feb-10 0.931 259

Jun-10 0.940 488

As you can see we have maintained a reliability in the Primary MCQ of over 0.9

for the past three years.

16

2.7 Historical Data

Summary of Results for Primary FRCA [October 1996 to May 2007]

Sitting No cand sat

MCQ No cand

eliminated % Eliminated No cand passed

% passed SOEs

% passed overall

Oct-96 141 0 0 53 39 38

Apr-97 215 0 0 96 46 45

Jul-97 215 0 0 104 50 48

Oct-97 225 0 0 95 46 42

Apr-98 364 47 13 151 48 42

Oct-98 345 69 20 131 48 38

Apr-99 306 66 22 132 56 43

Jul-99 278 60 22 127 58 43

Oct-99 199 43 22 93 60 47

Feb-00 245 45 18 98 49 40

Jun-00 326 64 20 139 54 43

Oct-00 232 49 21 97 53 42

Feb-01 283 65 23 119 55 42

Jun-01 341 74 22 139 52 41

Oct-01 253 47 19 124 60 49

Jan-02 308 70 23 126 53 41

May-02 337 69 20 137 52 41

Oct-02 236 47 20 189 61 48

Jan-03 340 66 19 151 56 44

May-03 325 70 22 150 60 46

Oct-03 286 60 21 136 60 47

Jan-04 339 71 21 163 62 48

May-04 360 75 21 161 58 45

Oct-04 316 61 19 151 60 48

Jan-05 381 79 21 163 55 43

May-05 464 95 20 223 61 48

Oct-05 355 72 20 186 67 52

Jan-06 500 198 40 198 66 40

May-06 566 211 37 235 66 42

Oct-06 478 172 36 210 69 44

Jan-07 508 177 35 216 66 43

May-07 272 105 39 109 69 40

17

Summary of Results for stand-alone Primary MCQ under New Regulations [June

2007 – Present]

Attendance Pass Fail % Pass

Jun-07 241 107 134 44

Sep-07 290 168 122 58

Nov-07 163 60 103 37

Feb-08 301 152 149 50

Jun-08 356 246 110 69

Sep-08 270 157 113 58

Feb-09 291 148 143 51

Jun-09 464 222 242 48

Sep-09 314 207 107 66

Feb-10 259 105 154 41

Jun -10 488 262 226 54

As we can see since 2005 the pass rate has fluctuated around 50%,

examinations held towards the end of the year normally perform better than the

earlier exams. This is shown more clearly on the following graph;

18

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

0

100

200

300

400

500

600O

ct-9

6

Ap

r-9

7

Jul-

97

Oct

-97

Ap

r-9

8

Oct

-98

Ap

r-9

9

Jul-

99

Oct

-99

Feb

-00

Jun

-00

Oct

-00

Feb

-01

Jun

-01

Oct

-01

Jan

-02

May

-02

Oct

-02

Jan

-03

May

-03

Oct

-03

Jan

-04

May

-04

Oct

-04

Jan

-05

May

-05

Oct

-05

Jan

-06

May

-06

Oct

-06

Jan

-07

May

-07

Jun

-07

Sep

-07

No

v-0

7

Feb

-08

Jun

-08

Sep

-08

Feb

-09

Jun

-09

Sep

-09

Feb

-10

Jun

-10

Attendance Pass Rate

19

3. PRIMARY OSCE/SOE OCTOBER 09 JANUARY 10 MAY 10

Attendees 877 261 314 302

Passed 421 48.0%

Failed 456 52.0%

Nuffield Prize Winners

OCT 2009 - Dr Fergusson, Russells Hall Hospital, Dudley

JAN 2010 - Dr Noons, Barnsley District General Hospital

MAY 2010 - Dr Gray, Nottingham City Hospital

PASS48%

FAIL52%

Primary OSCE/SOE

20

3.1 Pass Rate

Below is the breakdown of candidate pass rates depending on the components

of the OSCE/SOE sat on the day.

Candidates sitting …

Result

Pass Fail Osce Pass SOE Pass

Both sections 297 205 126 97

OSCE only 63 8 - -

SOE only 61 20 - -

We see high pass rates for single components across the year, although we

need to bear in mind that single component candidates would only have been

present in the last two exams of the year.

297

63

61

205

8

20

126

97

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

BOTH OSCE only SOE only

SOE Pass

OSCE Pass

Fail

Pass

21

3.1.1 1st Attempt Pass Rate

With the introduction of single component passes, the overall examination pass

rates can be significantly skewed with the inclusion of this data. The regulations

state that at the first attempt both components must sat together, as such this

group of candidates should give a good representation of examination

performance.

518

CANDIDATES BOTH OSCE SOE

Pass 232 44.79% 71 13.71% 83 16.02%

Fail 132 25.48%

This data is shown in the graph below;

As you can see 1st time candidates have a 3% lower pass rate than the overall

examination, approximately half of those candidates who failed are leaving

with a partial pass.

22

3.2 SOE Component Breakdown Below are several graphs showing the breakdown of the component parts of

the SOE Examination.

The average scores are as follows, with the overall average equalling a FAIL.

Pharmacology Physiology Clinical Physics Overall

Mean 9.0 8.6 9.9 9.0 36.5

Physiology appears to be the worst performing section with the lowest average

and Clinical achieving the highest.

3.2.1 Overall SOE Examination Marks

We see that the range of scores was from 2 to the maximum, 48.


There were 16 outlying candidates shown in red.

This data is shown expanded on the following frequency chart:

0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48

OVERALL

23

0

10

20

30

40

50

60

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48

Fre

qu

en

cy

Total SOE Mark

Total Mark Frequency

24

3.2.2 SOE Component – Pharmacology



We have 3 outlying candidates shown in red.

3.2.3 SOE Component – Physiology



We see 5 outlying candidates shown in red.

0 1 2 3 4 5 6 7 8 9 10 11 12

Pharmacology

0 1 2 3 4 5 6 7 8 9 10 11 12

Physiology

25

3.2.4 SOE Component – Clinical



We see 28 outlying candidates, shown in red.

3.2.5 SOE Component – Physics



We see 40 outlying candidates shown in red.

0 1 2 3 4 5 6 7 8 9 10 11 12

Clinical

0 1 2 3 4 5 6 7 8 9 10 11 12

Physics

26

3.3 Gender



Female: 406

We see similar pass rates for the genders although the male candidates were

slightly lower pass rate but with a slightly higher attendance.

Fail54%

Pass46%

Male Pass Rate

Fail50%

Pass50%

Female Pass Rate

27



Pass Rate 53.14% 29.73% 27.14%

Fail Rate 46.86% 70.27% 72.86%

From the graph as you would expect we can see our highest number of candidates came from the UK, they also enjoyed the highest pass rate, above the examination pass rate by 5%. The candidates from Europe were our lowest attendees and had a pass rate 18% lower than that of the overall examination. Candidates from outside of Europe were greater than those from Europe and have the lowest pass rate 21% below the examination pass rate.

28

3.5 Candidate History

The table below shows the candidates previous attempts at the Primary FRCA

and pass rates:

Attempt No 1 2 3 4

PASS 232 44.79% 141 53.41% 38 54.29% 10 40%

FAIL 286 55.21% 123 46.59% 32 45.71% 15 60%

Total 518 264 70 25


are on their first attempt and only 5% of candidates are on their final, fourth,

attempt. The graph below shows the correlation between the pass rate and the

attempt number:

Unlike the Final examinations there is an increase in pass rate for those on their

second and third attempt, this may be due to the experience of the OSCE/SOE

format gained in their first attempt.

29

3.6 Reliability The OSCE examination is conducted twice on 17 candidates each giving a

maximum cohort of 34. This is a similar situation to the SOE which examines 24

candidates in each cohort. According to PMETB Guidance 09/1 “Reliability

issues in the assessment of small cohorts” January 2009,

“Reliability (and hence the Standard Error of Measurement) cannot be

measured in assessments where there are small cohorts”

As previously stated the OSCE and SOE examinations do not reach the kind of

level required to calculate the reliability, the minimum number has been

variously calculated between 100-300 (Dr Gareth Holsgrove, Reliability issues in

the assessment of small cohorts p 9) and as such reliability coefficients are not

available for these examination components.

30

3.7 Historical Data Summary of Results for Primary FRCA Combined Examination

[October 1996 to May 2007]

Sitting No cand sat

MCQ No cand

eliminated % Eliminated No cand passed

% passed SOEs

% passed overall

Oct-96 141 0 0 53 39 38

Apr-97 215 0 0 96 46 45

Jul-97 215 0 0 104 50 48

Oct-97 225 0 0 95 46 42

Apr-98 364 47 13 151 48 42

Oct-98 345 69 20 131 48 38

Apr-99 306 66 22 132 56 43

Jul-99 278 60 22 127 58 43

Oct-99 199 43 22 93 60 47

Feb-00 245 45 18 98 49 40

Jun-00 326 64 20 139 54 43

Oct-00 232 49 21 97 53 42

Feb-01 283 65 23 119 55 42

Jun-01 341 74 22 139 52 41

Oct-01 253 47 19 124 60 49

Jan-02 308 70 23 126 53 41

May-02 337 69 20 137 52 41

Oct-02 236 47 20 189 61 48

Jan-03 340 66 19 151 56 44

May-03 325 70 22 150 60 46

Oct-03 286 60 21 136 60 47

Jan-04 339 71 21 163 62 48

May-04 360 75 21 161 58 45

Oct-04 316 61 19 151 60 48

Jan-05 381 79 21 163 55 43

May-05 464 95 20 223 61 48

Oct-05 355 72 20 186 67 52

Jan-06 500 198 40 198 66 40

May-06 566 211 37 235 66 42

Oct-06 478 172 36 210 69 44

Jan-07 508 177 35 216 66 43

May-07 272 105 39 109 69 40

31

Summary of Results for Primary OSCE/SOE [October 2007 – October 2009]

Attended Passed %

Oct-07 143 85 59%

Jan-08 258 164 64%

May-08 222 143 64%

Oct-08 242 185 76%

Jan-09 271 184 68%

May-09 203 117 58%

Oct-09 261 122 47%

Summary of Results for Primary OSCE/SOE under new regulations allowing for

component pass [January 2010 – present]

Attended Candidates

Sat… RESULTS

Pass Fail Osce Pass SOE Pass Jan-10 314 Both 100 72 45 45

OSCE only 22 2 SOE only 20 8 Mar-10 302 Both 75 63 39 25

OSCE only 41 6 SOE only 41 12

The graph on the following page shows a comparison of the overall

examination pass rate, those candidates walking away at the end of the day

with a Primary FRCA. As you can see we have had a decrease in pass rate since

the uncoupling of the Primary MCQ and Primary OSCE/SOE, this decrease has

slowed and we must also now take into account 90 candidates in the most

recent sitting have achieved a partial pass.

32

0

50

100

150

200

250

300

350

400

0

10

20

30

40

50

60

70

80

90

100

Oct

-96

Ap

r-9

7

Jul-

97

Oct

-97

Ap

r-9

8

Oct

-98

Ap

r-9

9

Jul-

99

Oct

-99

Feb

-00

Jun

-00

Oct

-00

Feb

-01

Jun

-01

Oct

-01

Jan

-02

May

-02

Oct

-02

Jan

-03

May

-03

Oct

-03

Jan

-04

May

-04

Oct

-04

Jan

-05

May

-05

Oct

-05

Jan

-06

May

-06

Oct

-06

Jan

-07

May

-07

Oct

-07

Jan

-08

May

-08

Oct

-08

Jan

-09

May

-09

Oct

-09

Jan

-10

Mar

-10

Att

en

dan

ce

Pas

s R

ate

Series1 Series2

33

4. FINAL WRITTEN Attendees 971

Passed 620 63.9%

Failed 351 36.1%

PASS64%

FAIL36%

Final Written

34

4.1 Component Breakdown

4.1.1 Overall Marks

Below are several graphs showing the breakdown of the component parts of

the Final Written Examination.

The average scores are as follows,

MCQ SAQ Overall Mark

Mean 77.8% 64.1% 142.1%

We see that the range of overall scores was from 108% to 169%.

We see the normal range (50% of candidates) scored between 136 and

149%, indicating a very narrow distribution of marks.

We can see the cohort is evenly distributed with the median sitting with

the mean.

We have seven low outlying candidates (in red) although still very close to

the main pack.

This data is shown expanded on the following page.

126 candidates (13%) that passed the overall written examination failed the

MCQ and 65 candidates (7%) failed the SAQ component but passed overall.

0 20 40 60 80 100 120 140 160 180 200

OVERALL

35

0

50

100

150

200

250

300

350

400Fr

eq

ue

ncy

Overall Score

Frequency of Overall Scores

36

4.1.2 MCQ Component Marks

We see that the range of scores was from 63.78% to 88%.


80.44%, indicating a very narrow distribution of marks.

We can see the cohort is very evenly distributed with the median sitting in

the middle of the normal data with the mean.

We 16 low outlying candidates (in red), and a single high outlier.

4.1.3 SAQ Component Marks

We see that the range of scores was from 40.42 to 83.75% (Two

candidates scored 0% as they failed to answer all 6 questions, these

candidates’ data were excluded from the calculations).


69.59.

We see ten low outlying candidates (in red).

0 10 20 30 40 50 60 70 80 90 100

MCQ

0 10 20 30 40 50 60 70 80 90 100

SAQ

37

4.1.4 SAQ Component – ‘Poor Fail’ Analysis

As per the Primary and Final FRCA Examination Regulations “candidates who

get poor fails in three or more questions will have their examination papers

reviewed by the examiners”. In this sitting of the examination the number of poor

fails achieved by candidates were as follows:

The green bars indicate candidates who achieved poor fails and still passed the

overall examination. 45 candidates achieved 3 or more poor fails with one

candidate scoring 6 poor fails and still passing the paper overall.

4.1.5 Proportion of total marks from each section

As you can see candidates get a slightly higher proportion of their marks from

the MCQ on average.

0

50

100

150

200

250

300

1 2 3 4 5 6 7 8 9 10 11 12 13

No

of

Can

did

ate

s

No of Poor Fails

Total

Pass

MCQ, 0.548964508 SAQ, 0.449884206

0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1

38

Fail28%

Pass72%

Female Pass Rate

4.2 Gender



Female: 398

As you can see the female candidates enjoy a significantly higher pass rate

than the male candidates. Whereas male candidates have a higher

attendance.

Fail42%

Pass58%

Male Pass Rate

39



Pass Rate 73.36% 47.73% 51.98%

Fail Rate 26.64% 52.27% 48.02%

From the graph as you would expect we can see our highest number of candidates came from the UK, achieving the highest pass rate, 9% above the examination pass rate (66%). This is consistent with previous sittings. The candidates from Europe were our lowest attendees and suffered a pass rate 15% lower than the exam pass rate. Attendance of candidates from outside of Europe was down from last sitting but again had a much lower pass rate, 18% less than the examination pass rate.

40

4.4 Candidate History

4.4.1 Candidate Final History

The table below shows the candidates previous attempts at the Final FRCA and

pass rates:


PASS 410 70% 96 53% 73 62% 26 51% 10 42% 5 63%

FAIL 178 30% 86 47% 45 38% 25 49% 14 58% 3 37%

Total 588 182 118 51 24 8


are on their first attempt and only 8 candidates are on their final, sixth, attempt.


number:

As you can see there is a slight negative correlation between the number of

attempts and success rate, although the points are quite random.

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

1 2 3 4 5 6

Chance of Success vs Attempt

41

4.4.2 Candidate Primary History

Below is data regarding the Area in which the candidates acquired their Primary

qualification:

Pass Rate Fail Rate TOTAL

UK Primary 533 72.42% 203 27.58% 736

Irish Primary 76 36.71% 131 63.29% 207

Sri Lankan Primary 9 50.00% 9 50.00% 18

FCPS Primary 2 25.00% 6 75.00% 8

European Diploma 0 0.00% 2 100.00% 2

Shown in graphical form we can see those candidates who have the UK Primary

enjoy the highest success rate, followed by the in the Sri Lankan, Irish and FCPS.

Those with European Diplomas were unsuccessful. The Sri Lankan and FCPS

Primary and European Diploma values however should be interpreted with

caution as they have an extremely low attendance.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

UK Primary Irish Primary Sri Lankan Primary

FCPS Primary European Diploma

Pass Rate by Primary Qualification

Pass

Fail

42

4.5 Historical Data

Summary of Results for Final FRCA [Winter 1996 to Summer 2009]

Summary of Results for Final Written Exam under New Regulations [Winter 2009 –

Present]

Number Sat Number Passed % Pass

Winter 2009 460 303 66%

Summer 2010 511 317 62%

Number

Sat Number

Eliminated %

Eliminated Number Passed

% SOE candidates

Passed Overall % Passed

Winter 1996 378 103 27% 179 65% 47%

Summer 1997 416 111 27% 197 65% 47%

Winter 1997 323 82 25% 172 71% 53%

Summer 1998 393 148 38% 166 68% 42%

Winter 1998 381 97 25% 197 69% 52%

Summer 1999 455 113 25% 251 73% 55%

Winter 1999 370 105 28% 188 71% 51%

Summer 2000 395 94 24% 201 67% 51%

Winter 2000 353 91 26% 186 71% 53%

Summer 2001 385 90 23% 216 73% 56%

Winter 2001 291 92 32% 138 69% 47%

Summer 2002 350 85 24% 192 72% 55%

Winter 2002 330 86 26% 173 71% 52%

Summer 2003 378 106 28% 191 70% 51%

Winter 2003 346 94 27% 192 76% 55%

Summer 2004 396 122 31% 194 72% 50%

Winter 2004 409 102 25% 215 71% 53%

Summer 2005 473 147 31% 241 74% 51%

Winter 2005 412 143 35% 188 70% 46%

Summer 2006 459 113 25% 245 71% 53%

Winter 2006 489 145 30% 246 72% 50%

Summer 2007 533 145 27% 388 77% 56%

Winter 2007 467 119 25% 258 74% 55%

Summer 2008 574 179 31% 284 72% 50%

Winter 2008 569 151 27% 306 73% 54%

Summer 2009 512 119 23% 286 74% 56%

43

As you can see we have a drop in both attendance and pass rate with the introduction of the new regulations.

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

0

100

200

300

400

500

600

700

W 1

99

6

S 1

99

7

W 1

99

7

S 1

99

8

W 1

99

8

S 1

99

9

W 1

99

9

S 2

00

0

W 2

00

0

S 2

00

1

W 2

00

1

S 2

00

2

W 2

00

2

S 2

00

3

W 2

00

3

S 2

00

4

W 2

00

4

S 2

00

5

W 2

00

5

S 2

00

6

W 2

00

6

S 2

00

7

W 2

00

7

S 2

00

8

W 2

00

8

S 2

00

9

W 2

00

9

S 2

01

0

Attendance

Pass Rate

44

5. FINAL SOE DECEMBER 2009 JUNE 2010


Passed 439 65.7%

Failed 229 34.3%

Awards

MAGILL MEDAL (DEC09) - Dr V L Hill, CRN 669731, of Royal Preston Hospital

MACINTOSH MEDAL (JUN10) - Dr M D Spiro, CRN 679927, of Whittington

Hospital

PASS66%

FAIL34%

Final SOE

45

5.1 Component Breakdown Below are several graphs showing the breakdown of the component parts of

the SOE Examination.

The average scores are as follows, with the overall average equalling a PASS.

Long Case Short Case Science Overall Mark

Mean 10.28 9.97 12.54 34.62

5.1.1 Overall SOE Examination Marks



We have 16 outlying candidates (in red).

This data is shown expanded on the following bar chart:

0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40

OVERALL

46

0

20

40

60

80

100

120

140

160

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40

No

. Of

Can

did

ate

s

Score

Overall Score Frequency

47

5.1.2 SOE Component – Long Case



We have 14 outlying candidates (in red)

5.1.3 SOE Component – Short Case



We have 17 outlying candidates (in red).

0 1 2 3 4 5 6 7 8 9 10 11 12

LONG

0 1 2 3 4 5 6 7 8 9 10 11 12

SHORT

48

5.1.4 SOE Component – Science



We 16 outlying candidates (in red).

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

SCIENCE

49

Fail30%

Pass70%

Female Pass Rate

5.2 Gender



Female: 299

As you can see the female candidates enjoy a slightly higher pass rate and the

male candidates a higher attendance rate.

Fail38%

Pass62%

Male Pass Rate

50



Pass Rate 78.90% 66.67% 41.74%

Fail Rate 21.10% 33.33% 58.26%

88

7

134

329

14

96

0

50

100

150

200

250

300

350

400

450

UK(1) Europe (2) Other (3)

Pass/Fail by Area of Qualification

Pass

Fail

From the graph as you would expect we can see our highest number of candidates came from the UK, they also enjoyed the highest pass rate, 13% above the examination pass rate (65%). The candidates from Europe were our lowest attendees and had a pass rate very similar to the examination pass rate. Candidates from outside of Europe however although making up almost 34% of our attendees had the lowest pass rate, 24% below the total pass rate for the exam.

51

5.4 Candidate Final History

The table below shows the candidates previous attempts at the Final FRCA and

pass rates:


PASS 302 74% 83 62% 32 46% 15 43% 5 28% 2 40%

FAIL 104 26% 51 38% 38 54% 20 57% 13 62% 3 60%

Total 406 134 70 35 18 5


are on their first attempt and only 5 candidates are on their final, sixth, attempt.


number:

As you can see there is a significant negative correlation between the number

of attempts and the chance of success.

0

10

20

30

40

50

60

70

80

1 2 3 4 5 6

Chance of Success vs Attempt

52

5.4.1 Candidate Primary History

Below is data regarding the Area in which the candidates acquired their Primary

qualification:

Pass Rate Fail Rate TOTAL

UK Primary 488 84.72% 88 15.28% 576

Irish Primary 57 74.03% 20 25.97% 77

Sri Lankan Primary 9 69.23% 4 30.77% 13

FCPS Primary 1 50.00% 1 50.00% 2

Shown in graphical form we can see those candidates who have the UK Primary

enjoy the highest success rate, followed by the in the Irish, Sri Lankan and FCPS

Primary Candidates. The Sri Lankan and FCPS Primary values however should be

interpreted with caution as they have an extremely low attendance.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

UK Primary Irish Primary FCPS Primary Sri Lankan Primary

Fail

Pass

53

5.5 Historical Data

Summary of Results for Final FRCA [Winter 1996 to Summer 2009]

Summary of Results for Final SOE under New Regulations [Winter 2009 – Present]

Number Sat Number Passed % Pass

Winter 2009 289 176 61%

Summer 2010 379 263 71%

Number

Sat Number

Eliminated %

Eliminated Number Passed

% SOE candidates

Passed Overall % Passed

Winter 1996 378 103 27% 179 65% 47%

Summer 1997 416 111 27% 197 65% 47%

Winter 1997 323 82 25% 172 71% 53%

Summer 1998 393 148 38% 166 68% 42%

Winter 1998 381 97 25% 197 69% 52%

Summer 1999 455 113 25% 251 73% 55%

Winter 1999 370 105 28% 188 71% 51%

Summer 2000 395 94 24% 201 67% 51%

Winter 2000 353 91 26% 186 71% 53%

Summer 2001 385 90 23% 216 73% 56%

Winter 2001 291 92 32% 138 69% 47%

Summer 2002 350 85 24% 192 72% 55%

Winter 2002 330 86 26% 173 71% 52%

Summer 2003 378 106 28% 191 70% 51%

Winter 2003 346 94 27% 192 76% 55%

Summer 2004 396 122 31% 194 72% 50%

Winter 2004 409 102 25% 215 71% 53%

Summer 2005 473 147 31% 241 74% 51%

Winter 2005 412 143 35% 188 70% 46%

Summer 2006 459 113 25% 245 71% 53%

Winter 2006 489 145 30% 246 72% 50%

Summer 2007 533 145 27% 388 77% 56%

Winter 2007 467 119 25% 258 74% 55%

Summer 2008 574 179 31% 284 72% 50%

Winter 2008 569 151 27% 306 73% 54%

Summer 2009 512 119 23% 286 74% 56%

54

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

0

50

100

150

200

250

300

350

400

450

W 1996

S 1997

W 1997

S 1998

W 1998

S 1999

W 1999

S 2000

W 2000

S 2001

W 2001

S 2002

W 2002

S 2003

W 2003

S 2004

W 2004

S 2005

W 2005

S 2006

W 2006

S 2007

W 2007

S 2008

W 2008

S 2009

W 2009

S 2010

Pas

s R

ate

SOE

Att

en

dan

ce

Attendance Pass Rate

Documents

The Royal College of Anaesthetists Annual Specialty Report … · Kirsty White Head of Quality Regent's Place 350 Euston Road London NW1 3JN 8 th December 2010 Dear Kirsty, The Royal