Intended for healthcare professionals

Observations Ethics Man

The exam scam

BMJ 2014; 349 doi: (Published 28 July 2014) Cite this as: BMJ 2014;349:g4808
  1. Daniel K Sokol, barrister and medical ethicist, London
  1. daniel.sokol{at}

Medical royal colleges and faculties have a duty to provide a fair and affordable exam appeal process

To the two certainties of death and taxes should be added, for doctors, professional exams.

My client was a registrar undergoing a second attempt at her specialty examinations. If she failed, the prospects of pursuing her specialty were bleak. She duly paid the examination fee of about £1000 (€1300; $1700). Unforeseen circumstances arose in the exam that affected her ability to concentrate. She narrowly failed the exam and appealed the decision. She was invited to appeal to the faculty by paying a fee of £2780. As the saying goes, “In England justice is open to all—like the Ritz.” Still, such was her conviction that she exhausted her savings to pursue the appeal.

Over 400 years ago the precursor to the Royal College of Physicians, the London College of Physicians, imprisoned a Dr Bonham …

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