MRCPsych CASC Pass Mark
To meet the minimum standard required in the
CASC exam, candidates must meet or exceed the total borderline
regression score and achieve the passing score in a minimum of 12
stations. Candidates must meet both criteria to be successful. The
reason candidates have to meet both criteria is to ensure that they
have demonstrated an acceptable level of performance across a broad
range of stations that reflect the breadth of core training.
Candidates who score highly in some stations cannot use this to
compensate for low performance in other stations.
The Borderline Regression Method is considered
to be the most objective way of setting the standard for practical
exams. Each CASC station is marked by an appropriately-trained
examiner, who provides two sets of scores: (1) 5 point ‘analytic’
global domain scores ranging from 1 (Poor) to 5 (Excellent) for
between three and five domains and (2) One 6-point overall global
judgement which comprises Excellent Pass, Pass, Borderline Pass,
Borderline Fail, Fail, or Severe Fail (refer to
Grade Descriptors). The total weighted domain scores are
regressed onto their global scores to produce a linear equation for
each station for all candidates. The total domain score for
borderline candidates, determined through this line of best fit
becomes the pass mark for that station. The pass mark for the whole
exam is the average of the station pass marks for that day.
It is important for reasons of policy and
patient safety only to pass candidates who are clearly competent.
All examinations are therefore subject to a ‘standard error of
measurement’ (SEM). So, for the CASC exam, the initial indication
of a standard is raised by an estimate of measurement error.
Passing a station is dependent on the station
score. Overall judgements for each station are used only to set the
pass mark via the regression equation e.g. an examiner can give an
overall judgement of Borderline Fail but a candidate can still pass
the station. Therefore, the secondary passing criteria of 12
stations is based on station cut scores and not the overall
judgement of examiners.
The minimum of 12 stations has been set on the
basis that the five history taking and five examination stations
cover basic clinical skills (information gathering, mental state
examination, communication, etc) and that a borderline candidate
should be expected to pass eight out of these ten stations.
The six management stations are intended to test higher level
clinical management skills (clinical analysis, reasoning, decision
making, etc) and that a borderline candidate should be expected to
pass four out of six stations. Stations in both circuits are
not all of equal difficulty. In recognition of this the
Examinations Sub Committee has set a minimum total number of
stations to pass across the whole exam rather than separate
thresholds for history, examination and management stations.
In addition, any candidate who receives two or
more marks that indicate a severe fail in a station will have their
overall performance reviewed by the Examinations Sub Committee
(ESC) and may fail the examination, irrespective of their total
test score or whether they have achieved the passing score in a
minimum of 12 stations. The ESC sets the final pass/fail criteria
based on due consideration and analysis after the examination,
taking account of station difficulty, candidate and examiner
performance and other relevant considerations. Examination results
will need to be ratified by the Education and Training Committee
(ETC) prior to publication.
The MRCPsych Exam Regulations and exam
standard settings are subject to change from time to time and
candidates are advised to check the Examination pages of the
College website for up to date information.