High Court rules RCGP exam attempt policy unlawful

The High Court has ruled the Royal College of GP’s refusal to grant additional exam attempts to disabled doctors was ‘irrational’ and unlawful.

The RCGP had a policy of not allowing additional attempts or resits to GP registrars (trainee GPs) who were diagnosed with disabilities after one or more unsuccessful exam attempts, without the reasonable adjustments they would have been entitled to if they had known about their disabilities before. 

The BMA supported a GP candidate in bringing legal action, in this case specifically challenging the college’s policy on the AKT (applied knowledge test). The GP candidate successfully argued the college was acting unlawfully and putting disabled trainees receiving a late diagnosis at a significant disadvantage.  

The court ruled ‘the college has failed entirely to provide a coherent justification for its policy’ and that the legal grounds underpinning its ruling are ‘applicable in principle to the generality of candidates for membership of the college’.

The BMA said: ‘This plainly supports the BMA’s long-standing conviction that the RCGP’s relevant policy on exam attempts was unlawful and unfair to disabled trainees.’

The policy for the AKT has been quashed as a result of the High Court judgment and must now be replaced.

The court did not, however, find the policy to be discriminatory under the Equality Act 2010, which had been argued by lawyers for the BMA and the candidate.

The BMA says the judgment has ‘vindicated’ its legal challenges, which followed long-standing efforts by the association to persuade the RCGP to revise its exam attempt policies as they relate to disabled doctors who receive a late diagnosis.

Following BMA lobbying, the AoMRC (Academy of Medical Royal Colleges) produced new guidance in 2023, which states medical royal colleges should consider granting additional attempts to candidates for whom a later diagnosis of disability was ‘likely to have affected all previous [examination] attempts'.

The BMA then urged medical royal colleges, faculties and exam bodies to implement policies, which provided fair opportunities for all candidates, in line with that guidance. However, the RCGP did not change its stance.

In August last year, the college changed part of its rules on exam attempts by increasing the maximum number of attempts available to doctors entering GP training on or after 2 August 2023 from four to six on the applied knowledge test and simulated consultation assessment.

In December last year, the BMA GP registrars committee wrote an open letter to RCGP chair Kamila Hawthorne urging her to amend the college's policies in line with the AoMRC’s recommendations.

In presenting its case to the High Court, the association’s legal team labelled the RCGP’s ‘point-blank refusal’ to cancel out previous unsuccessful exam attempts as ‘unreasonable and perverse’ and a ‘deliberate decision not to treat disabled candidates fairly’.

After the judgment, a BMA spokesperson said: ‘The BMA is delighted the court has vindicated our efforts to stand up for disabled doctors who have been treated unfairly by the RCGP.’

The spokesperson added: ‘While today’s judgment is welcome and will pave the way for disabled trainee GPs to receive much fairer treatment over examinations, it is hugely disappointing that legal action was necessary to achieve this outcome.

‘The college’s intransigence towards change that would promote fairness for disabled trainee GPs in the UK left us and the candidate in this case with little alternative. We are proud to support our disabled colleagues and sincerely hope this judgment serves as a warning to other medical royal colleges to ensure they treat all their trainee doctors fairly and make suitable adjustments for those who need it.’

A spokesperson for the Royal College of GPs said: “We will be considering the finer detail of today’s judgment before deciding on our course of action.”