The evolving Intercollegiate MRCS exam

created 01 December 2016

The Intercollegiate MRCS continues to evolve rapidly. It was Charles Caleb Colton (1780-1832) who said ‘Examinations are formidable even to the best prepared, for the greatest fool may ask more than the wisest man can answer’. The MRCS has grown and is a significant, quality surgical examination that is now much fairer and delivers reasonable, reliable and reproducible questions.

The first chairman of the ICBSE was David Rosin, followed by David Ward; these were the days of the sometimes unpredictable old style oral, communications and clinical exam. I became ICBSE chairman in 2008, at the point when the OSCE format was introduced; this was a time of some revolution and potential instability, with some colleges not keen on the OSCE and others wanting to modify or dismantle it. During the early days of the OSCE I fought hard to stabilize and quality assure the MRCS exam. A process of assessors’ development was started and has now become an essential part of fairness. The recent BAPIO challenge to the RCGP has further highlighted the requirement for transparent Equality and Diversity training and demonstration of fairness. I am also pleased that the MRCS exam has now widely gone overseas, “OSCE in a box” and that there are more examination centres in the UK and worldwide. The MCQ and OSCE scenarios have become much more robust under Kevin Sherman’s chairmanship and continual quality improvement.

In June of 2014 all the Intercollegiate MRCS assessors met in Glasgow to discuss the way that the assessment process had grown. The assessors are a body of experienced MRCS examiners who literally assess the exam; they do not examine. An ICBSE Assessors’ Code of Conduct has been written. The code is based on the Nolan Principles:

Selflessness Intercollegiate Assessors should act solely in terms of promoting the quality of the Intercollegiate Membership Examination. They should not do so in order to gain financial or other benefits for themselves or other organisations.

Integrity Intercollegiate Assessors should not place themselves under any financial or other obligation to outside individuals or organisations that might seek to influence them in the performance of their duties.

Objectivity In carrying out an Assessment, whether in the UK or abroad, Assessors should make their judgments on merit.

Accountability Intercollegiate Assessors are accountable for their decisions and actions to the Internal Quality Assurance Committee of the ICBSE. IQA will maintain an oversight of their activities.

Openness Intercollegiate Assessors should be as open as possible about all the decisions and actions that they take. They should give reasons for their decisions in their reports.

Honesty Assessors have a duty to declare any private interests that may influence their duties and to take steps to resolve any conflicts arising in a way that protects the integrity of the examination.

Leadership Assessors should promote and support these principles by leadership and example. Assessors must bear in mind they are representing ICBSE and are therefore responsible for maintaining its reputation. Assessors should be aware of their role as ambassadors when working outside the United Kingdom.

The Assessors are now a very important integral part of the MRCS exam; they will write reports on the exam scenarios, process and venue. A report is written after each diet and sent to IQA to act on if required. Any inappropriate examiner behaviour is reported on. These reports very much aid the standard setting process for OSCE final marking. Troublesome scenarios are eliminated or rewritten. Any aberrant examiners are retrained. The assessor process aids understanding and improvement of the whole exam performance.

Peter Brennan has been appointed as the next chairman of ICBSE from 2014-17. He is a consultant Oral and Maxillofacial Surgeon at Portsmouth Hospitals NHS Trust and honorary Professor of Surgery and Head of the Academic Department of Surgery at the University of Portsmouth. He has been Editor of the British Journal of Oral and Maxillofacial Surgery. He was Chair to the Court of Examiners at the Royal College of Surgeons of England for the MRCS Examination. Peter has a large basic science research portfolio but has an interest in human factors training. He has applied the human factor training to evaluate novel factors which determine care and support of examiners, defining the role of an examiner, defining the boundaries and rules of examinations. He has determined some significant factors which determine the stress and pressure that examiners have to resolve - it’s not just the candidates! I wish Peter every success in this exciting area of surgical assessment.

Chris Oliver, ICBSE Chairman 2008-11


Past, Incoming, Present Chairs ICBSE MRCS Exam

  • Prof Peter Brennan 2014-17
  • Mr Kevin Sherman 2011-14
  • Mr Chris Oliver 2008-11

Acronyms

  • MRCS - Membership Royal College of Surgeons
  • ICBSE - Intercollegiate Committee for Basic Surgical Examinations
  • OSCE - Objective Structured Clinical Examination
  • BAPIO - British Association of Physicians of Indian Origin
  • RCGP - Royal College General Practitioners
  • MCQ - Multiple Choice Questionnaire
  • IQA - Internal Quality Assurance

Lewis Ashman

(+admin +former tickbox admin)

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