A Doctors ‘Never Event’.
Higher examinations are hurdle for Doctors in medical and surgical specialities.
I sat mine in 3 stages between 1983 and 1986; the Part 1 exam was a tough ‘Basic Sciences’ test of the knowledge acquired, and largely then forgotten, in the first years of Medical school. The second task was a log diary of 50 clinical cases, plus long commentaries on 2 subjects of choice. Finally, the Part 2 written examination, if passed, was followed by a clinical examination and viva. All this was undertaken whilst working as a Junior Doctor, on call every 3rd night and, for Part 2, whilst I was the senior resident in a busy Maternity unit. Studying for Part 2 took up every spare hour of my non-work time for around 18 months.
I remember the joyous day in 1986 when, at the age of 32, I realised that I had finally taken my last examination and obtained the MRCOG. It had been a very stressful process and one which I am glad I do not have to repeat.
The Royal College of Physicians recently admitted had made a catastrophic error in the MRCP Part 2 results from September 2023. 283 doctors (around 20% of those who sat the examination) were given the wrong results. I found this revelation quite shocking. It has potentially derailed their careers.
But what is the real impact on these 283 Doctors?
Workload and Career Progression
The errors went both ways. 222 doctors were incorrectly told they passed, and will have moved on with their careers on that basis. Their future is now uncertain; they may have to leave higher training programmes. They may require additional training, which could delay their career progression. They will certainly have to sit the examination again.
However, the 61 doctors who were wrongly told they have failed, may have unnecessarily repeated an examination they had already passed, at considerable financial cost, with additional study time and loss of leisure time with their families.
Stress and Burnout
I am concerned about the effect of this error on the workload, career progression, stress levels, and risk of burnout of these Doctors.
Doctors who thought they had passed, but actually failed, are facing this devastating news 18 months after the examination. The effects cannot be overstated, and include stress, anxiety, and a loss of confidence in their abilities and their chosen career path.
Doctors who were told they failed but had actually passed, have experienced additional and unnecessary stress and self-doubt for over a year, which is equally damaging. Some who thought they had failed despite giving it their best shot may, in the emotional toll of failure, have abandoned their medical careers altogether, having lost confidence in their ability to advance.
For both groups, having to now reconsider their career trajectories could contribute significantly to burnout and mental health issues.
What happens next?
Equitable solutions to this crisis are yet to be fully disclosed, but must start with support and counselling to all affected Doctors. An email and phone helpline has already been set up by the RCP who have pledged ‘to make sure that they are given support, including from a senior physician one to one, and that the impact on their career aspirations is minimised’.
Career Adjustments are essential for the 288 Doctors who progressed based on incorrect results. Those who actually failed must be allowed to continue in their current positions while they retake the exam, to minimise disruption to their careers and the service. Resit fees should be waived.
For those who retook an examination they had already passed, their exam fees and expenses must be refunded and the RCP must compensate doctors for lost earnings, lost leisure time and unnecessary stress due to this error.
Flexibility in training program deadlines should be granted to affected doctors, so that they do not miss out from this mistake.
Finally a thorough, independent review of the examination process must be conducted to prevent future occurrences and restore trust in the examination system, which has been seriously eroded by this error.
It is crucial that the medical community and regulatory bodies work together to support these Doctors and implement safeguards to prevent such devastating mistakes in the future. This is a ‘Never Event’ and an unforgivable failure by the Royal College of Physicians. It must never happen again.
But whilst this error may not have cost all 283 doctors their careers, it has undoubtedly caused significant professional and personal distress. The long-term impact on these individuals' careers and mental health well-being cannot be underestimated.
The stresses of higher examinations, where intense study is undertaken alongside an already busy working life, are significant at the best of times. This is however the worst of times for these individuals. It comes when stress in the NHS has never been greater. Covid recovery, high demand, long waiting lists, understaffing, colleague absences and general public anxieties about the NHS are contributing to overall stress levels and the ability of NHS staff to cope. Exam errors just make things worse.
Many Doctors are close to burnout, and some are leaving medicine altogether.
I would invite any of these 283 Doctors to seek help from an Executive Coach, as I believe that coaching is the way to establish your renewed goals and career plans.
If you have been affected by the RCP exam announcement please consider a free no obligation 30 minute on-line conversation with me. You can book your session here. If I am not the right Coach for you, I will recommend somebody else who might be.
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