Dr Katherine Chin spent around four months preparing for a key exam in September 2023 that would help her become a senior doctor.
“It was the closest I’ve ever come to burnout in my career,” she tells The i Paper.
“I spent three to four months prep on top of my job where I’m also working nights and weekends, totally 48 hours a week on average. You don’t have time to revise at work so that’s all done at home. You make sacrifices – I missed things I wanted to go to.
“It’s the breadth of stuff you have to revise and the fact you’re doing it all in your spare time. Closer to exam time I’d be getting up early and doing a couple of hours revision before starting my working day before coming home and revising some more. It’s relentless.”
About six weeks later she was told the hard work had paid off and she had passed the exam. The assessment was part two of a three-stage exam series to gain the Membership of the Royal Colleges of Physicians of the United Kingdom diploma, which is essential for all physicians who train in a medical speciality in the UK.
Passing the exam is vital for any doctor pursuing routes such as intensive care medicine, cardiology, haematology or respiratory medicine to progress from being a resident doctor, formerly known as a junior doctor, to a registrar.
However, last week The i Paper revealed a “catastrophic” blunder had occurred that left 283 candidates being given the wrong result. Out of 1,451 candidates who took the exam on 6 September 2023, 61 candidates who were told they had failed have passed and 222 candidates who were told they had passed – including Dr Chin – had actually failed.
“The first I heard about it was the email out of the blue last Wednesday,” she says. “I just checked my emails as I was leaving work. I didn’t believe it at first as there was no inkling that anything was being looked into. And I wasn’t a borderline pass having gone 150 points over the pass mark. I was very happy with my result, so I just thought it was an error and they’d send another email retracting this.
“I didn’t know anyone else who had taken the same exam so there was no-one I could speak to about it. It wasn’t until I panicked, screenshot the email and sent it to a group of doctors I know that one person said they had received the same thing. That’s when I realised this didn’t sound good.”
The Federation of the Royal Colleges of Physicians, the body responsible for the exam, published an initial statement apologising for the error due to a “data processing issue” resulting in “incorrect examination results” being communicated to the group of candidates.
Dr Chin, 29, who graduated five years ago and currently works as an internal medicine trainee at a trust in the South East of England, says: “I just couldn’t believe that I had failed because of the mark I got. I tried to call the Federation but it was 5pm and no one was picking up. I was on hold for an hour until I gave up. As soon as it dawned on me it was real I just burst into tears.”
The majority of people Dr Chin has spoken to who have been caught up in the blunder had gone on to take their third and final part of the MRCP(UK) exams. Many have applied for promotion and in some cases have already taken on new jobs. But in the last few days several sources have told The i Paper that medics have been contacted to inform them their applications have been withdrawn and, devastatingly, job contracts torn up due to the blunder.
“They’ve gone to the graduations and got the photos and the certificates to prove they have their qualification only to be told this,” says Dr Chin. “It’s devastating. I haven’t yet gone on to take the third part yet, so fortunately it doesn’t mean any change in role or salary for me, but you can imagine how angrier other people are whose jobs have been affected.”
The Federation said the MRCP(UK) is the “gold standard” of early-physician assessment and that candidates who did not pass must re-sit and pass the exam to be awarded the MRCP(UK) Diploma to progress their training. However, Dr Chin believes they compounded their error by initially only offering one date at the end of March to do so.
“I was very stressed while revising for the exam. I don’t think I realised just how stressed until I’d done the exam and you look back at the last few months. To think I would have to go back to that position again was upsetting. I had to go on Twitter [X] to look for answers.”
Dr Chin says she still hasn’t spoken to anyone directly from the Federation, who sent out a form by email asking the affected medics details about where they work, and who their supervisors and employers are.
“I didn’t feel comfortable filling in the form. It felt like they were trying to collect information… It didn’t feel like a particularly supportive form. And then the last question was just a kick in the teeth asking us whether we would consider taking the exam on 26 March. They were obviously not in touch with just how stressful this exam is and what’s required to prepare for it while we all have full-time jobs.”
The Federation has subsequently offered extra dates to candidates on 21 May and 16 July.
“We are continuing to arrange online face to face meetings with candidates and senior clinicians in Federation to discuss their individual situations and circumstances,” it said in a statement.
The Federation is also planning to run a webinar with candidates whose examination outcomes were affected and representatives from the Federation and the colleges’ resident doctor committees.
On Wednesday, the Federation said it was “human error when uploading the answer data from the digital exam provider to the MRCP(UK) database” that had in fact caused the problem. It said all the data processes since 2021, when the current system was started for online exams, have been reviewed and no other error has been found.
The British Medical Association (BMA) is talking to the Royal College of Physicians and exploring options for support, compensation, and recompense with its legal team.
“The BMA believes those responsible should be held accountable. This is not the first time a royal college has made serious errors in examination processes and there must not be another,” the union said.
Dr Emma Runswick, BMA Deputy Chair of Council, urged medics not to withdraw any application to continue applying for jobs if they are affected. “If you are prevented from applying keep emails and screenshots,” she said.
Dr Chin still does not understand how the computer marking system could have been so inaccurate, having now been told her actual score with a 180 point fall taking her just below the pass mark.
“I know some people have dropped even further than that. What error could have happened to make the marks go down so much? In one section I went down from 100 per cent to 50 per cent. Initially, I thought it was a standardisation score, where your score depends on what the rest of the cohort gets, but if you get 100 per cent you should always get 100 per cent. It doesn’t really make any sense and leaves more questions than answers. We just want the federation to come out and be transparent with us all.”
All of the details behind the error and the delay in recognition will be subject to independent external review, the federation has said. It published a statement on Thursday saying the resident doctor committees of the three Royal Colleges of Physicians have written to the statutory education bodies (SEBs), who are responsible for developing and delivering healthcare education and training for the NHS, appealing their decision not to allow those affected by the exam to progress into higher specialty training.
“This decision, made with minimal notice, will have significant implications for the professional lives of all the doctors involved,” the letter stated. “The impact on their wellbeing and morale cannot be overstated.”
The SEBs referred to “decisions affecting patient safety” when coming to its decision but the Royal Colleges pushed back on this reasoning.
Their letter states: “We would question the link between failure to achieve MRCP(UK) Part 2 and risk to patient safety. These individuals have achieved MRCP(UK) Part 1 and PACES [the third part of the exam], and continue to progress through rigorous portfolio and appraisal assessment within the NHS. If this is indeed a concern, there are alternative methods to mitigate this alleged risk.”
Meanwhile, the fallout continues with Dr Chin saying she also feels for the 61 people who were given a fail when they had in fact passed, thus hampering their career progression.
“Some people have been sent emails in recent days saying they won’t be able to take up their position or they can’t interview for jobs,” she says.
“Someone, who I was very upset for on their behalf, was told that either they would have the job they’re in extended – which means delaying your progression – or they would be taken out of the training programme, effectively not having their job anymore, if they don’t pass this exam by appraisal time in the summer. That is crazy as people have waited 18 months to be told this error was happened.
“People are so upset because they think they might lose their job because of this or won’t be able to take up a job they’ve already been offered. I’m sure there are lots of discussions going on high up with various bodies, but don’t forget there are people on the ground who are scrambling around for answers and completely uncertain what their job prospects are now. They are heartbroken and outraged.”
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