Analysis of Severn 2010/11 MRCGP results by SoPC Patch

Why this analysis?

• It would be simple to produce percentage MRCGP pass-rates by Deanery and, for us, by Severn Patch.

• However but those raw data would be as meaningless as raw hospital mortality data.

Why this analysis?

• Where an ST qualified (UK, EU or IMG) affects the likelihood of succeeding in the MRCGP.

• Initial GPVTS selection scores affect the likelihood of exam success.

Why this analysis?

• Where an ST qualified (UK, EU or IMG) affects the likelihood of succeeding in the MRCGP.

• Initial GPVTS selection scores affect the likelihood of exam success.

• Women tend to do better than men.

Why this analysis?

• So, when comparing patch (or Deanery) MRCGP scores and pass rates, we need to place them in the context of – place of training, – gender and – selection score.

The data

• These data are for all Severn GP STs who took the AKT and/or the CSA for the first time in 2010/11.

• Patch MRCGP fail rates were too small for meaningful pass/fail comparisons.

The data

• The data aren't normally distributed:

Results by Severn Patch: AKT scores

Results by Severn Patch: CSA scores

But…

• We know that whether candidates are from the UK, EU or IMG affects likelihood of passing, as does their gender, particularly for the CSA.

• If a patch has more female, UK-trained candidates, we'd expect their MRCGP success rates to be greater.

Comparison by place of medical training

• Swindon clearly had the most culturally diverse GP STs in this cohort:

Comparison by gender

• And Somerset and Swindon were allocated less women than the other patches:

Comparison by selection mark

• One might expect that ST1s with a better initial selection score would have a higher chance of getting a good MRCGP grade subsequently.

Comparison by selection mark

• This is true to some extent to the AKT, where we find a reasonable correlation (r = 0.42) in Severn:

Comparison by selection mark

• It also applies to the CSA, where Severn has a higher correlation (r = 0.52):

Comparison by selection mark

• But isn't the selection mark a proxy for original medical school location and gender?

• Initial GPVTS selection scores themselves relate to country of medical school and gender.

• Taking those factors out, does the selection score from 3 years ago still act as a predictor of MRCGP marks?

Comparison by selection mark

• Charting the GPVTS selection scores of female, UK-trained Severn GP STs against their CSA score still shows some correlation (r = 0.31):

Comparison by selection mark

• So, we do need to take higher selection scores into account when comparing patches.

How can we interpret these comparisons?

• Bristol's GP STs started with better GPVTS selection scores and more favourable ethnicity and gender figures.

• Taking these into account, their MRCGP marks were slightly lower than expected.

• Possibly linked with the poorer feedback that the Bristol SP STs give on their hospital posts in our End-of-Post Survey.

How can we interpret these comparisons?

• Swindon GP STs gained slightly lower MRCGP marks.

• This can be predicted & explained by, their background, gender balance and GPVTS selection scores.

• Given this triple-whammy, Swindon has done well.

Discussion points

• Congratulations! • What can the other patches learn from you?• How can you do even better?

– in hospital?– in General Practice?