Assessment Strategy for 2021 Anaesthetics Curriculum

Published: 12/01/2023

Standard setting: Monitoring and Reviewing

The RCoA monitors pass rates of candidate cohorts including, but not limited to, ethnicity, anaesthetists in training, non-anaesthetists in training, number of attempts, and deanery/schools, to ensure that examinations are in line with GMC expectations. This process also attempts to identify other instances of differential attainment not currently captured.

Ethnic differences in attainment are a constant feature of medical education in the UK. The RCoA has a sharing agreement in place with the GMC and provides line-by-line candidate data to the GMC on an annual basis. This information is used to monitor the differential attainment gap for all college and faculty high-stake examinations. The RCoA is not an outlier in this respect, and the differential attainment gap seen in FRCA examinations remains in line with the majority of other colleges and faculties.

At the end of each academic year, the Chairs of the Primary and Final examinations submit an annual summary report on the performance of their examinations, which is published on the RCoA website. These annual reports are of value to examiners, Royal College departments, the GMC, trainers, anaesthetists in training and the public in general.

The FRCA examinations committee conduct in-house reviews of the examinations structure, standard setting methods, and the processes, policies and regulations used to ensure that FRCA examinations are as robust, valid, fair and up-to-date as possible.

The next Examinations Review Executive Group (EREG) is to be formed in January 2020, which will include internal and external members. The aim of the EREG is too oversee and conduct an in depth review of the FRCA examinations’ purpose, validity, reliability, fairness and concordance with best practice. The EREG will submit a report on the findings and make recommendations for change to the Examinations Committee, Education, Training & Examinations Board, RCoA Council and Board of Trustees.

Interim changes to FRCA examinations

The RCoA is aware that the majority of medical colleges and faculties have now replaced MTF questions with SBAs and other MCQ item formats. The RCoA agree with the GMC’s view that MTF questions do not lend themselves to testing the application of knowledge and problem solving that is so essential in clinical practice. Although, SBAs have been used in the FRCA MCQ examinations since 2011, the RCoA remains committed to replacing all MTFs with SBAs by September 2023. It is proposed that the move away from MTFs in both Primary and Final MCQs will be conducted in three separate phases:

  • Phase one: To increase the number of SBA questions in the Final and Primary FRCA MCQ examinations and reduce the number of MTFs by amending the MCQ structure to 45 MTF questions and 45 SBA questions (50/50 split) with effect from September 2020.
  • Phase two: To increase the number of SBA questions in the Final and Primary FRCA MCQ examinations and further reduce the reliance on MTFs by amending the MCQ structure to 60 SBA questions and 30 MTF questions with effect from March 2022.
  • Phase three: To cease the use of MTF questions in the Final and Primary FRCA MCQ examinations with effect from September 2023.

The EREG in consultation with respective core groups reserve the final decision in regard to the overall examination structure of both Final and Primary FRCA MCQ examinations and the exact format of the items that will be used to replace MTFs.