Dr. Katherine Chin invested approximately four months of intense preparation for a pivotal exam in September 2023, a crucial step towards her goal of becoming a senior doctor. She shares her experience with The i Paper: “It was the closest I’ve ever come to burnout in my career. I spent three to four months preparing, all while working nights and weekends, averaging 48 hours a week. There simply wasn’t time to revise during work hours, so all my study had to be done at home. This meant making significant sacrifices—I missed events I wanted to attend.”
“The sheer volume of material I had to review was overwhelming, especially since I was doing it in my spare time. As the exam date approached, I would wake up early to squeeze in a couple of hours of revision before starting my workday, only to come home and study some more. It felt relentless.”
About six weeks later, she received the gratifying news that her hard work had paid off: she had passed the exam. This assessment was the second part of a three-stage examination series required to earn the Membership of the Royal Colleges of Physicians of the United Kingdom diploma—an essential credential for physicians training in medical specialties throughout the UK. Passing this exam is critical for doctors aiming to transition from resident, previously known as junior doctors, to registrar roles in fields such as intensive care medicine, cardiology, haematology, or respiratory medicine.
However, a shocking revelation emerged last week when The i Paper reported a “catastrophic” error that affected 283 candidates who were mistakenly given incorrect exam results. Out of the 1,451 candidates who took the exam on September 6, 2023, it was revealed that 61 candidates who had been informed of their failure had actually passed, while 222 candidates, including Dr. Chin, who believed they had succeeded were actually failures.
“The first I heard about the error was through an unexpected email last Wednesday,” Dr. Chin recounted. “I was checking my emails as I was leaving work, and I couldn’t believe it at first. There had been no prior indication that anything was amiss. I had scored significantly above the passing mark—150 points over—so I thought it must be a mistake and assumed they would send a follow-up email retracting the news.”
“Not knowing anyone else who had taken the exam, I felt isolated. It wasn’t until I reached out to a group of fellow doctors and shared a screenshot of the email that I realized others had received the same troubling news, and that’s when my anxiety began to escalate.”
The Federation of the Royal Colleges of Physicians, the governing body responsible for the exam, published an initial statement acknowledging the error, attributing it to a “data processing issue” that led to incorrect examination results being communicated to a group of candidates.
Dr. Chin, who is 29 and has been working as an internal medicine trainee for five years at a trust in the South East of England, expressed her disbelief: “I just couldn’t fathom how I could have failed given my score. I attempted to contact the Federation, but when I called at 5 PM, no one was available. I was on hold for an hour and ultimately gave up. When the reality of the situation sank in, I burst into tears.”
Many of the individuals Dr. Chin has spoken to who were affected by the blunder had already taken their third and final part of the MRCP(UK) exams. Some had even applied for promotions or accepted new job offers. Disturbingly, in recent days, several sources have informed The i Paper that these medical professionals have been notified that their job applications were invalidated and, in some cases, their job offers rescinded due to the error.
“They have attended graduations, taken photos, and received certificates to prove their qualifications, only to have this happen,” Dr. Chin lamented. “It’s absolutely devastating. Fortunately, since I haven’t yet taken the third part of the exam, my role and salary remain unchanged. However, I can only imagine the anger and frustration of others whose careers are now at stake.”
The Federation emphasized that the MRCP(UK) is the “gold standard” for early physician assessment and stated that candidates who did not pass would need to retake and pass the exam to obtain the MRCP(UK) Diploma, which is necessary for their training progression. However, Dr. Chin believes that the Federation compounded its error by initially offering only one resit date at the end of March.
- “I was very stressed while preparing for the exam,” she admitted. “Looking back, I didn’t realize just how much pressure I was under until after I completed the exam. The thought of having to revisit that stressful situation was incredibly upsetting. I even took to Twitter [now known as X] to seek answers.”
Dr. Chin mentioned that she has yet to speak with anyone directly from the Federation, which sent out a form via email requesting details about where the affected medics work, as well as information about their supervisors and employers. “I didn’t feel comfortable filling out the form; it seemed as though they were simply gathering information. It didn’t feel supportive at all. To top it off, the last question felt like a kick in the teeth, asking if we would consider taking the exam on March 26. They clearly do not grasp how stressful this exam is and what it entails to prepare for it while also managing full-time jobs.”
In response to the backlash, the Federation has since added extra dates for the resit on May 21 and July 16. “We are continuing to arrange online face-to-face meetings with candidates and senior clinicians in the Federation to discuss their individual situations and circumstances,” the Federation stated in an official announcement.
On Wednesday, the Federation clarified that “human error during the upload of answer data from the digital exam provider to the MRCP(UK) database” was the root cause of the problem. They also reported that all data processes since 2021, when the current online examination system was implemented, have been scrutinized and no other issues have been identified.
The British Medical Association (BMA) is in discussions with the Royal College of Physicians and is exploring options for support, compensation, and restitution with its legal team. “The BMA believes those responsible should be held accountable. This is not the first instance in which a royal college has made serious mistakes in examination processes, and it’s imperative that it does not happen again,” the union emphasized.
Dr. Emma Runswick, BMA Deputy Chair of Council, urged affected medics not to withdraw their job applications. “If you are denied the opportunity to apply, make sure to keep all emails and screenshots as evidence,” she advised.
Dr. Chin remains perplexed about how the computerized marking system could have been so flawed, especially after learning that her actual score had dropped by 180 points, placing her just below the passing threshold. “Some candidates have seen even greater drops in their scores. What could have caused such significant discrepancies? In one section, my score plummeted from 100 percent to 50 percent. Initially, I thought it might be a standardization score, where your score can fluctuate based on the rest of the cohort, but if you achieve 100 percent, you should always retain that score. This situation doesn’t add up and leaves us with more questions than answers. We simply want the Federation to be transparent with us.”
All details surrounding the error and the subsequent delay in recognition will be subject to an independent external review, as stated by the Federation. They released a statement on Thursday indicating that the resident doctor committees of the three Royal Colleges of Physicians have formally appealed to the statutory education bodies (SEBs) responsible for developing and delivering healthcare education and training for the NHS, contesting their decision not to allow those affected by the exam to advance into higher specialty training.
“This decision, made with minimal notice, will have profound implications for the professional lives of all the doctors involved,” the letter asserts. “The impact on their well-being and morale cannot be overstated.” Although the SEBs cited “decisions affecting patient safety” when making their ruling, the Royal Colleges contested this rationale.
“We question the correlation between failing to achieve MRCP(UK) Part 2 and a risk to patient safety. These individuals have already passed MRCP(UK) Part 1 and PACES [the third part of the exam] and continue to progress through rigorous portfolio and appraisal assessments within the NHS. If patient safety is indeed a concern, there are alternative measures that could mitigate this alleged risk.”
Meanwhile, the fallout continues, with Dr. Chin expressing her empathy for the 61 candidates who received a failing grade when they had actually passed, jeopardizing their career trajectories. “Some individuals have received emails recently stating they will not be able to take up their positions or interview for jobs,” she noted. “I was particularly upset for one candidate who was told that they either had to extend their current job—delaying their progression—or risk being removed from the training program if they don’t pass this exam by appraisal time in the summer. It’s outrageous, especially since many have waited 18 months to learn of this error.”
“People are heartbroken and outraged because they fear losing their jobs or missing out on positions they have already been offered. I’m sure discussions are taking place at high levels with various bodies, but we mustn’t forget that there are individuals on the ground who are desperately seeking answers and feeling uncertain about their job prospects. This situation is devastating for many.”
