British doctors should be nationally licensed

All British doctors should be licensed by taking a national examination according to research outlined in the online open access journal BMC Medicine. A UK-based research team assessed the performance of UK medical graduates from 19 British universities in the Membership of the Royal Colleges of Physicians (MRCP (UK)) exam, which forms a critical part of the training of aspiring specialist physicians in the UK.

As Dr McManus, who led the team explained, 'The General Medical Council (GMC) has explored the possibility of a national medical licensing examination in the UK, as exists in the US. Our study provides a strong argument for introducing one, as we have shown that graduates from different medical schools perform markedly differently in terms of their knowledge, clinical and communication skills.'

Medical graduates from Oxford, Cambridge and Newcastle universities performed better than average in the three-stage multiple choice and clinical examinations of the MRCP (UK), whereas those from Liverpool, Dundee, Belfast and Aberdeen did least well in terms of their performance. 83% of Oxford and Cambridge graduates passed the first part at their initial attempt, as did 67% from Newcastle, compared with 32% and 38% of those from Liverpool and Dundee, a two-fold difference between Newcastle and Liverpool.

However medical school of training was not the only factor influencing performance in the 5827 doctors included in the research. Males outperformed females on the multiple choice examinations, whereas females outperformed males on the clinically based PACES stage of the exam. McManus and his team also examined whether differences in medical school pre-admission qualifications could explain the differences between medical schools, and found that they did so only in part, suggesting that differences between the teaching focus, content and approaches of the medical schools themselves also play a role.

'Although the MRCP(UK) is a widely regarded exam that is carefully designed to assess a wide range of knowledge and skills required by a physician, it is possible that some medical schools teach other important skills that this examination does not assess,' emphasised McManus. 'However, our data do show that there is a real need for routine collection and audit of performance data of UK medical graduates, both in postgraduate exams such as the MRCP(UK) and probably also by a national licensing exam.'