Until 1996 the bar to entry into general practice was low. The MRCGP exam wasn’t mandatory, and as long as you were signed off by your trainer you could practise.
Stuart Murray had long harboured concerns about GP standards, and in 1990, when the Royal College of General Practitioners (RCGP) and training bodies decided to launch a national standardised assessment, Murray, who was then director of postgraduate general practice education at Glasgow University, seized his chance.
He and his team at Glasgow University developed an assessment tool that would ask one simple question: is this doctor competent to be a GP? Their tool had four components: multiple choice questions, an assessment of videotaped consultations, a written report, and the trainer’s judgment of the student. The project was piloted in the West of Scotland deanery in 1992 before being rolled out across Scotland the following year. In September 1996 summative assessment was launched throughout the UK.
To say that the new project had its critics is an understatement, and doctors who first tested it in Scotland were particularly angry about the video element. In the 1998 William Pickles lecture at the RCGP, Murray reflected on the “enormous backlash” from GPs and trainers in Scotland. “They certainly orchestrated a …
