Those trainees who have entered GP training since August 2010 are restricted to 4 attempts at both the AKT and the CSA. This limit of 4 includes any attempt made out of training. This restriction means that trainees should plan carefully when attempts at either of these exams are to be made in order to optimise chances of success.

Note that the AKT can only be sat in ST2 or ST3 years and the CSA in the ST3 year.

Further information can be found in the RCGP Exam regulations.

Mitigating circumstances to allow a further (5th) attempt

The RCGP exam regulations are clear around the issue of mitigating circumstances, details can be found on the RCGP site. Below are some examples that the RCGP has produced of possible mitigating circumstances and the supporting documentation that would be required for them to be agreed and another attempt to be allowed.

  • Exceptional personal circumstances which might lead to underperformance in an exam. 
    e.g. Bereavement or family illness. Normally this should be declared in advance and the trainee should withdraw from the exam. In exceptional circumstances this might be considered in retrospect when there should be evidence that the trainee has declared a problem, such as might be provided by a screen shot from the e-portfolio documenting an event and the educational impact. Copies of death certificates and travel documents confirming travel disrupting preparation may also be required. These events would normally be within a short period before the exam as otherwise the candidate should have withdrawn and thus reserved an attempt for a more stable time.
  • Illness which might not have been completely apparent at the time of the exam but which in retrospect could have had an adverse affect on performance. Confirmation by a medical attendant will be required. Occasionally if the condition is one that might affect performance but which does not preclude normal attendance at work confirmation by Occupational Health may be required.

Candidates should note that most practitioners suffer adverse personal circumstances at one time or another during their working life and it is part of demonstrating fitness to practice that one makes an assessment about how much the event might have an effect on ones performance. If a circumstance is likely to have affected your performance in an exam we would expect you to have contemporaneous documentation in your e-portfolio of discussions with your educational supervisor about your fitness to be working.

GMC Good Medical Practice and Duties of a Doctor cover presenting for work, educational activities and training including postgraduate medical examinations and it is implicit in the guidance.  Doctors are expected to recognise and work within the limits of their competence.  If that is temporarily limited due to mitigating circumstances such as bereavement or illness, doctors would be expected to have the professional insight to recognize their fitness to practise may be impaired and withdraw from their duties including examinations. 

Appeals for additional attempts following a complaint about the process of the exam

These will be considered by the Head of Examinations, the Chief Examiner and the relevant Clinical Lead and allowed if it was felt that a problem or fault with the exam process could have affected performance adversely such that another attempt free of change should be allowed.