FPM statement in response to the Independent Review of the Assessment Processes of the RCoA

The Faculty of Pain Medicine welcomes the publication of the independent review of all examinations delivered by the Royal College of Anaesthetists, conducted by Professor John McLachlan in 2022. We are committed to delivering fair, robust, and high-quality examinations, and this report will inform our developmental roadmap for the future.

We understand that postgraduate examinations are high stakes assessments that have a significant impact on candidates’ personal and professional lives. We also recognise the hard work of candidates, trainers, examiners and the RCoA exam team in making the FFPMRCA exam successful as a measure of attainment against stringent standards of knowledge, skill, attitude and critical thinking inherent to a high performing pain physician. The review sought to capture the experiences and opinions of all these stakeholders, and we are grateful to everyone who has participated in the review process, and to Professor McLachlan for conducting the review.

We will implement changes with care over the next few years, taking into account the needs of candidates. We will ensure exam candidates are given at least 12 months’ notice of any significant changes to the exam in order to facilitate good preparation and support. Therefore, doctors in training and prospective candidates should not change the way they prepare for the current sets of exams until formally notified of such changes.

Scope of the independent review

The Royal College of Anaesthetists commissioned the review to provide independent assurance and insights into the development and delivery of all its assessment processes across the FRCA, FFICM and FFPMRCA exams. It includes consideration of an error in the delivery of the September 2021 FRCA Final Written Exam and an unexpectedly low pass rate for the October 2021 FFICM Objective Structured Clinical Examination (OSCE).

We welcome the all-encompassing nature of this review and acknowledge the recommendations. While there is no explicit mention of the FPM exam, the recommendations provide an opportunity to improve processes and methods to further develop the purpose and validity of the FFPMRCA exam and improve the candidate experience.

We have published an Executive Summary and proposed timetable for implementation of the changes resulting from the review, and we highlight some key themes relevant to the FFPMRCA exam here.

Our programme of improvement

The FFPMRCA, now mature at 10 years old, has been subject to a process of continued quality assurance, and while rightly proud of its performance to date, we recognise that this is a timely opportunity to develop and improve the exam. In considering the recommendations from the review and implementing any subsequent changes, we will:

• Invest additional resources in our examinations function to implement the recommendations of the review and strengthen our capacity to deliver exams.
• Work closely with the RCoA and the Faculty of Intensive Care Medicine in delivering relevant changes to the FFPMRCA exam through a newly formed group, the Exam Development and Assurance Group. This group will lead the development, quality and alignment of exam processes across all exams delivered by the RCoA – where appropriate – to ensure they are delivered in line with best practice in assessment for each medical specialty. We believe this group, tasked with implementing expertly informed recommendations, will help the FFPMRCA exam develop and remain world class for the future.
• Give candidates and doctors in training a greater role in our assessment processes, including more representation on College and Faculty committees engaged in assessment. These representatives will also play a central role in supporting communication with candidates.
• Review the purpose of our assessments in accordance with the changes made in the curriculum and the changing nature of clinical practice in our specialties. We will consult with members and stakeholders to define this.
• As part of the Examinations Development and Assurance Group, we will contribute to the implementation of a unified approach to the use of, and training in, standard setting across all exams delivered by the RCoA.
• Use the findings of new research undertaken to inform our assessment design process. For example, in relation to validity and the impact of gender, ethnicity and educational background on exam performance.

Your feedback

We understand that members may have questions about the independent review, the applicability to FPM and the actions we are taking as a result. We welcome your feedback and encourage you to attend our Let’s Talk member engagement online event on 8 March at 19.00.  

• Register to attend Let’s Talk

Members can also share their feedback in writing using our online form. This feedback will be shared with the new Examinations Development and Assurance Group. 

Dr Lorraine de Gray, Dean of the Faculty of Pain Medicine