Exams news and updates

The RCPsych has released an invitation to tender to develop an additional international centre in the Middle East to deliver the RCPsych’s clinical assessment of skill and applied knowledge (CASC) examination.

Please note that due to unforeseen circumstances, there has been a scheduling error for the 2023-3 Paper A exam, which was due to take place on 15 November 2023. 

 After consulting with the Psychiatric Trainees’ Committee (PTC) it has been agreed the most appropriate alternative date to offer candidates is Tuesday 14 November. We can ensure that all candidates will get a place on this diet. All candidates have been sent an email regarding this.

We recognise that this may be disappointing and apologise for the disruption this may have caused to your work and life commitments.

If you are unable to sit the exam on 14 November, please notify us by email (examinations@rcpsych.ac.uk) by 5pm on Friday 20 October to receive a refund of your exam fee.

 The next available diet will be held on 10 April 2024. The results for this diet will be issued before the September 2024 CASC application period.

We are looking into how this error arose to avoid it from happening again in the future. 

 

The 2023-2 diet of Paper B was sat on 13 June 2023 by 439 candidates. This was the second diet of 2023, which is the first year to have three written diets.

The results of the exam have been subject to extensive review by the Examinations Sub-Committee (ESC) to ensure that there were no errors or issues in the content of the exam, its delivery, standard setting, and calculation.

The ESC scrutinised the analysis and discussed the validity of the exam in context of its low pass rate. No anomalies were identified relating to the exam.

The ESC noted that:

• The pass mark was set by an experienced panel of subject matter experts and was within the expected range.
• There were no systematic issues in exam delivery.
• The key exam statistics were within ideal target ranges:
  • Reliability: 0.897*
  • SEM: 3.53%

*For postgraduate medical education assessments, written exams should aim to be above a reliability of 0.8.

Find out more about how the pass mark is calculated

The ESC was concerned by the reduction in pass rate but concluded that there were no issues with the administration of the exam. It was noted that this was the smallest cohort to ever take an MRCPsych written exam, meaning exam statistics may be more prone to fluctuation compared to a larger cohort. It was also the first exam diet since moving to a structure of three exam diets annually, meaning seasonality and cohort effects are still unknown. The College aims to have 30-40% new questions in each paper, and in this paper 40% of the exam questions were new.

The College recognises that exams are stressful, and we are mindful of the time and financial investment that trainees commit to pursuing a career in psychiatry. We will be closely monitoring exam performance, and we will continue to take active steps to ensure our exams remain fair.

The Psychiatrists’ Support Service (PSS) is available for anyone needing additional support by providing confidential peer support to psychiatrists of all grades. This service is open 9am-5pm GMT, Monday to Friday, and can be accessed via telephone at 020 8618 4020, or via email at pss@rcpsych.ac.uk.

How is the pass mark calculated?

The College uses the Modified Angoff method to set pass marks. In summary, a Standard Setting Panel comprised of subject matter experts will discuss the characteristics of a minimally competent candidate, individually evaluate each question, and estimate the proportion of these candidates who would answer the question correctly. These assessments are averaged for a question pass mark, and these are regularly reviewed and revised against actual candidate statistics. This process is designed to safeguard against large deviations in pass rates whilst ensuring the correct standard is set. The raw pass mark is calculated as the average of all question level scores.

The final pass mark is calculated as the Angoff-derived pass mark plus 2x Standard Error of Measurement to reduce the likelihood of false positives.

View full details of the marking scheme

How is the exam marked?

The exams are marked electronically. The results are then processed by an inhouse psychometrician, which is then quality assured by an external psychometrician to ensure accuracy.

Does the College make a profit from exams?

Income generated from exams can fluctuate. The College aims to make a small but necessary surplus budget in order to invest in improving the content and accessibility of these exams. In the unusual event the surplus exceeds 10%, this amount is set aside in a separate fund to be reinvested in trainees. We do not try to recoup costs from trainees on the rare occasions that exams generate a loss for the College.

Can I appeal my exam result?

Appeals are considered based on section 1.5.1 of the Appeals Procedure, which is evidence of administrative error or procedural failure.

Appeals are not considered based on disagreement with the exam result, a request to have answer sheets re-marked, or being mentally or physically unfit at the time of exam.

Please note that the low pass rate is not indicative of administrative error or procedural failure. The results of this exam have been heavily scrutinised and quality assured prior to release, therefore the pass rate in itself is not grounds for appeal.

While section 1.5.2 sets out a different ground for appeal, it is less relevant in this context.

How can I better prepare for subsequent exams?

We set the exam explicitly against the syllabus, and this should guide learning. As it is a postgraduate exam, there is no single source that will provide all the answers, and as is good practice we set questions with a range of difficulties. We use a wide variety of sources to set the questions.

In relation to Paper B, the College publishes a range of textbooks relating to clinical topics, with those in the Seminars series that are fairly recently updated particularly relevant, and there are specific books on critical review. There is definitely a gap in the market however for a text specifically directed at Paper B Clinical Topics.

But the advice has to be use multiple sources: Syllabus, MRCPsych course, text books, question banks, NICE guidance, and recent research findings, for example. Given the proportion of new questions in each paper (30-40%), a learning strategy based entirely on the use of question banks is unlikely to be successful.

In response to the new CASC syllabus, we held a webinar where you can find further details of what to expect.

View the CASC syllabus webinar

The MRCPsych examination regulations have been updated for 2023, providing more information on reasonable adjustments and removing written paper transition details that are no longer relevant.

The new CASC syllabus is mapped to the 2022 core psychiatry curriculum, providing more detail on the skills being assessed as well as added emphasis on personalisation of care and the interaction between mental and physical health.

In response to candidate feedback we have made some adjustments to the application periods for Diet 2 of Papers A and B. 

The application period for Paper B Diet 2 (June 2023) has been moved to 11 - 24 April 2023.

The application period for Paper A Diet 2 (July 2023) has been extended to 15 May 2023.

View our exam dates.

In our announcement about the oversubscription of the January CASC we advised that we would be running a special diet in May 2023 to accommodate those candidates who did not get a place. All places available at this diet have been allocated to those who did not get a place in January and we are unable to open this diet to additional candidates.

The next diet of the CASC will take place on 18 - 22 September 2023 in Sheffield, UK.

Following an extensive review of our assessment strategy, the College is announcing changes to the delivery of the CASC examination.  Subject to final GMC approval, from September 2023 the CASC will be delivered face-to-face in the UK, with international centres for face-to-face delivery being introduced in 2024.

Face-to-face delivery provides increased capacity and will enable candidates to better demonstrate that they meet the key capabilities outlined in the 2022 curriculum.

The review also approved a CASC syllabus that will be published soon, and which explicitly maps to the 2022 curriculum.  It includes a new emphasis on personalisation of consultations and interventions, as well as the interaction between mental health and physical health.

The College has undertaken an extensive review of its assessment strategy to evaluate the best delivery method for the CASC, align the new curricula to College assessments and review the current WpBA (formative) assessment system. The review recommendations have now received approval from the College’s Board of Trustees, including:

• From September 2023, moving to a face-to-face delivery model for CASC (subject to final GMC approval)
• Continuing the delivery of written exams, Papers A and B, via Pearson VUE test centres
• Creation of a new Assessment Oversight Committee to have strategic oversight of educational assessments, and report to the Education and Training Committee (ETC)
• Creation of a formative assessment working group to create a recommendations report by the end of 2023.

The Assessment Strategy Review (ASR) was implemented following Council’s approval in July 2021 after the successful migration of the College’s examinations online in 2020.  The ASR was led by Professor Subodh Dave, Dean; Dr Ian Hall, Chief Examiner; and Dr John Russell, Associate Dean for Curricula. The ASR group membership included representatives for trainees, patients and carers, trainers, examiners and an educationalist.

The review carried out extensive stakeholder consultation including focus groups with trainees in core and specialty training, supervisors in core and specialty training, examiners, CASC panel and ETC members, patient and carer representatives, and Medical Directors representing employers.

The Assessment Strategy Review and Recommendations report is now available to download.

Where in the UK will the CASC be held?

The September 2023 CASC will be held in Sheffield.

Where will the international CASC centres be held?

We are assessing where the CASC should be held, with consideration to where our candidates and members/potential examiners are based, as well as travel and local infrastructure.

I’m an overseas candidate, I have passed both written papers and this change will delay when I can sit the CASC, will my validity period be extended?

Yes. Validity periods will be extended according to individual circumstances and candidates concerned about this should write to examinations@rcpsych.ac.uk in the first instance.

I have a disability and need reasonable adjustments for my exams, how will you support me at a face-to-face exam?

We have extensive experience of supporting candidates with access arrangements for their face-to-face exams and we will continue to support candidates by agreeing adjustments on an individual basis that are recommended by an appropriate professional assessment. For example, we can set up a separate space for candidates with mobility difficulties that minimises movement between stations, provide extra time or a space with lower noise levels. 

Why is the College moving to face-to-face delivery?

We had to balance many factors in making this decision, but it was clear from our consultation with stakeholders that the validity and reliability of the examination was of prime importance.  It was also clear that face-to-face assessment is the optimal way to assess the clinical skills required for psychiatric practice.

Will the face-to-face exam be easier or more difficult than the online version?

The standard required to pass the examination remains the same.

When will the new syllabus be available?

The new syllabus will be published on the website once final GMC approval has been received.

Will the College be offering any further online CASC diets?

Not after August 2023

Why won’t the College be offering online CASC diets after face-to-face delivery is introduced?

Firstly we have concluded that face-to-face assessment is the optimal way to assess the clinical skills required for psychiatric practice.  Furthermore, GMC approval is central to the MRCPsych, the 2023 face-to-face CASC cannot be delivered in exactly the same way online, so it is not possible to have GMC approval for both delivery methods.

The College has received an unprecedented number of applications for the January 2023 diet of the CASC (a 61% increase on January 2022).  Despite a significant increase to CASC capacity in the last two years, including the recruitment of 170 new examiners, we regret that we have not been able to meet demand, and have heard from many examiners that they are unable to examine due to workforce pressures.

The College recognises the extreme pressures our workforce is under, and this was the primary driver for the way places have been allocated for the January 2023 CASC. In consultation with College Officers and the Psychiatry Trainees’ Committee, we prioritised, first, applicants that did not receive a place at the September 2022 CASC diet, then all applicants that applied for ST4 national recruitment for August 2023 entry. The remaining places were allocated on a first-come, first-served basis.

The College will be running an additional CASC in May 2023 and candidates not allocated for January 2023 will have first priority for this diet. The date of the exam, and application window, will be confirmed shortly and unallocated January 2023 applicants will be notified by email.

The Assessment Strategy Review has made recommendations to the College Council and Board of Trustees on a strategy that will significantly increase CASC capacity from September 2023, subject to their approval.