Intended for healthcare professionals

Education And Debate

Oral examinations—equal opportunities, ethnicity, and fairness in the MRCGPCommentary: Oral exams—get them right or don't bother

BMJ 2000; 320 doi: (Published 05 February 2000) Cite this as: BMJ 2000;320:370

Oral examinations—equal opportunities, ethnicity, and fairness in the MRCGP

  1. Celia Roberts, senior research fellowa,
  2. Srikant Sarangi, senior lecturerb,
  3. Lesley Southgate, professor (,
  4. Richard Wakeford, staff development officerd,
  5. Val Wass, senior lecturere
  1. a Centre for Applied Linguistic Research, Thames Valley University, London W5 5AA
  2. b Centre for Language and Communication Research, Cardiff University, Cardiff CF1 3XB
  3. c Centre for Health Informatics and Multiprofessional Education, University College London, London N19 5NF
  4. d University of Cambridge, Cambridge CB2 1TT
  5. e Department of General Practice and Primary Care, Guy's, King's and St Thomas's Medical Schools, London SE11 6PT
  6. School of Primary Care, University of Manchester, Rusholme Health Centre, Manchester M14 5NP
  1. Correspondence to: L Southgate
  • Accepted 11 August 1999

Oral examinations are widely used in undergraduate and postgraduate medical examinations, including those for membership of royal colleges. In recent years the validity and reliability of oral examinations have been questioned and they have been dropped from many assessment programmes.1-4 The Royal College of General Practitioners has a tradition of reflecting on these issues and has improved its membership examination through the careful selection and training of examiners, the use of an examination blueprint, the development of clear questions and criteria for marking, and continuing discussion of techniques and problems.5 None the less, the debate about equal opportunities and the possible discriminatory outcomes of the examination has continued as failed candidates and their colleagues have suggested that their lack of success might be due to racial discrimination.

Ethnographic and sociolinguistic discourse analysis

Discourse analysis is the detailed study of language in use. Unlike many traditional ways of assessing communication that use coding schemes, it examines the finegrained detail of interaction—sentence structure, intonation, taking turns, and non-verbal communication—as well as the content18

Ethnographic method involves observing and interviewing, taking the informant's perspective as far as possible in order to understand the cultural and communicative patterns which inform his or her behaviour and perceptions

Sociolinguistics examines variety in language use and, in this context, studies how differences in talk and self presentation can lead to negative assessments and possibly to racial discrimination

A study in 1995 showed that although the success rate among British Asians was not in question, Asian doctors trained abroad did less well than other groups.6 They were relatively more likely to fail the written examination, which meant that they were not called for the oral examination. But even among those called for the oral examination, ethnic minority candidates trained overseas did proportionately less well. The examination board's commitment to …

Correspondence to: A Esmail

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