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Three months on from the results of the pilot Knowledge Based Assessment (KBA) examinations seems a good time to provide an update on progress with KBA.

What’s in a Name?
We seem to be turning full circle regarding the nomenclature for this form of assessment. Originally the term Knowledge Based Assessment (KBA) was favoured, but subsequently the Federation of Royal Colleges seemed to prefer the term Specialist Examination. However the term KBA is creeping regaining popularity and is the term I shall use throughout this article.

And then there were Four
The Federation’s original intention was that five of the “major” medical specialties would hold their first examination in May 2008: Geriatric Medicine, Cardiology, Neurology, Gastroenterology and Dermatology with the remaining 8 specialties holding their first examination in Autumn 2008. However Cardiology have since dropped out of the group of first wave specialties and will hold their first examination in Autumn.

Question Writing
I had an incredible response to my article in the March Newsletter and email request for question writers, to such an extent that I had to disappoint colleagues and create a waiting list.

I am extremely grateful to the colleagues who have volunteered to be trained, write best-of-five questions and contribute to building up a question bank.

The question writing group have been working to extremely tight timescales but in 3 months have submitted 333 questions (the second highest number of the four specialties) for consideration. Many thanks to Asan Akpan, Steve Allen, Brian Chapman, Lindsey Dow, Margot Gosney, Gabrielle Greveson, Adam Harper , Mike Horan, Kevin Kelleher, Brian MacInnes, Kyra Neubauer, Lucy Pollock, Siva Puthrasingam, Maeve Rae, Lakshmanan Sekaran, Louise Shaw, Sandy Thompson, Jonathan Treml, Chris Turnbull and Michael Vassallo for their much valued contribution.

The question writers attended a workshop on 14/15 June to edit and re-work questions and determine which were worthy of going forward to the bank and potentially being used for future examinations. This was both a lively and successful meeting, with several “friends phoned” to confirm answers to questions!

Although it was originally proposed KBA examinations would be paper based, the Federation now intends that they go online, with test centres in various locations in the UK utilising the expertise of the company delivering the theoretical part of the driving test for the DVLA. The KBA will consist of two papers, each of 100 questions sat on the same day.

Memorandum of Understanding
The Federation of the Royal Colleges propose a shared approach to KBA with specialist societies, and have proposed a Memorandum of Understanding outlining the potential costs and revenue of KBA.

At a meeting convened by the British Thoracic Society in May 2007, several of the specialist societies met to discuss the implications of the proposals for KBA made by the Federation. There was very strong agreement between the societies regarding the Federation’s proposals.

On 5th June 2007 our President and I met with representatives of the Federation to discuss the BGS’s involvement in KBA and the Memorandum of Understanding. At this meeting we raised several important points:

a) The Federation propose that candidates who hold the MRCP (UK) who pass their KBA will have the award MRCP (Geriatric Medicine) conferred. Those who do not hold MRCP (UK) will have the qualification DRCP (Geriatric Medicine) conferred.

Peter and I have relayed to the Federation members’ concerns that the award of DRCP (Geriatric Medicine) will cause confusion with the DGM and have urged the Federation to consider calling their award the Certificate of the Royal College of Physicians (Geriatric Medicine).

b) The BGS is very keen that KBA is seen as part of a portfolio of assessments for doctors in training in Geriatric medicine and not as a stand alone examination which anyone who is prepared to pay the fee could potentially sit. We therefore believe candidates should display their commitment to the specialty before pursuing this award by having undertaken training in Geriatric medicine for a defined period e.g. 6 months – 1 year beforehand.

c) The BGS are extremely concerned about the Federation’s proposed fees for the examination (£800 for UK candidates and £1000 for overseas doctors). We believe KBA should not be run at a significant profit and the fee for UK doctors should be set at broadly a “break even” cost. There is also a discomfiture at charging excess fees to overseas doctors, many of whom may come from developing countries where the development of services for older people is of extreme importance but who may be put off pursuing KBA if the fees are set too high.

As I write, Peter and I are still awaiting a formal response to our concerns from the Federation, but in the interim the question writers and I are working towards having a question bank in place to enable our specialty’s KBA to be held in May 2008.

Oliver J Corrado
Lead Physician
for KBA in geriatric medicine