Summative and MRCGP have merged and the whole assessment is known as nMRCGP (where n stands for new). The nMRCGP will start from August 2007.

Standards for Assessment are now set by the Postgraduate Medical Education and Training Board (PMETB). The RCGP has been responsible for producing the new Curriculum for Training for General Practice which meets the PMETB criteria for training and assessment. The PMETB is responsible for the approval of Training programmes, posts within the programmes and the assessment package.

Instead of the exam-based end-point assessment, PMETB have introduced an integrated assessment system, parts of which will take place at various times throughout the three years, which supports the curriculum and drives learning.

Summative assessment has been replaced by three assessment components:

• Workplace-Based Assessment (WBA), which will take place throughout the three years
• a machine-marked Applied Knowledge Test (AKT), which the candidates is expected have more freedom of choice to sit when they feel ready
• a Clinical Skills Assessment (CSA) which would normally take place in the third year, but timing is decided by the learner
• The difference between examinations and assessments in the workplace principally relates to the relationship between competence and performance. Competence (what a doctor can do) is necessary but not sufficient for performance (what a doctor does do), and as experience increases so performance based assessment in the workplace becomes more important.

The main part of Workplace-Based Assessment will be an Enhanced Trainer’s Report (ETR) which will set out clearly the competencies a Registrar is to acquire. This document will now be used throughout the three years as an e-Portfolio. The learner will be responsible for completing a number of assessments demonstrating their competence and for assembling documentation to prove it. Many of the methods of assessment used will be similar to assessments elsewhere, such as in the Foundation programme and in other specialities. For example, case-based discussions, observation of consulting skills, direct observation of procedures such as examination skills, resuscitation skills, and multi-source (360º) feedback. The trainer will not do all the assessments but will be responsible for the final signing off of the trainer’s report.

There will be some external moderation of these workplace-based assessments.

The Applied Knowledge Test will be a machine-marked paper multiple-choice type paper, with a range of question format. This is currently moving beyond testing whether you have an adequate knowledge-base to be a GP to seeing whether you can use your knowledge to deal with clinical or practice problems. There are fewer factual questions and this trend will continue.

The Clinical Skills Assessment is a new examination in OSCE format. It will resemble the current Simulated Surgery in that there will be a number of stations - probably 13 of 10 minutes each. The candidate will be expected to deal with typical GP problems demonstrating a synthesis of skills (clinical problem solving, communication, dealing with ethical issues, etc.). Simulated patients are likely to be involved in most or all cases.

The Royal College of General Practitioners (RCGP) - through its Certification Unit - will process all applications to practise as a GP in the UK on behalf of the Postgraduate Medical Education and Training Board (PMETB).

Doctors in training should register with the RCGP Certification Unit as soon as possible after starting their programme. There is a one-off administration payment of £350 which covers all submissions to the Certification Unit, and also includes associate membership of the RCGP. Once registered, applicants submit all VTR forms to the RCGP Certification Unit in order to document each training post as it is completed. In the last month of training the final VTR form is submitted. The Certification Unit check the application and then recommend to the PMETB whether the applicant is eligible for a CCT. The PMETB fee is £250.

Doctors who have done some or all of their training abroad will normally apply for a Statement of Eligibility for Registration.

Details can be found in Fact Sheet number 7: Vocational Training and Certification for General Practice available at http://www.rcgp.org.uk/information/publications/information/PDFFact/7OCT05.pdf

There is further information on the curriculum at http://gpcurriculum.co.uk and in the GP downloads section of the Deanery web site: http://www.wmdeanery.org/Downloads/downloads.asp#gp