Guidelines on Multiple Choice Questions (MCQ) assessment attempts

The Multiple Choice Questions (MCQ) assessment is composed of 2 MCQ papers which are available online.

They are the Professional Dilemmas (PD) paper (this is a Situational Judgement Test) and the Clinical Problem-Solving (CPS) paper. Assessments are held eight times a year at approximately six-week intervals.

The applicant must be registered with the HEE programme through the NRO and have been approved to sit the MCQ, where required, following a review interview by the designated HEE Educational Lead. The applicant is not required to be registered with the GMC to take the MCQ.

The applicant will be given access to the on-line learning resources after registration with the NRO and following approval to enter the scheme by the HEE Educational Lead. Following the review by the HEE local office Educational Lead, the applicant will be offered the option of an HEE observation placement in a GP practice (in exceptional cases this does not need to be an approved Training practice). This will be arranged by the HEE local office, the NRO and local NHS England team will be notified. The practice may claim a payment from the NRO to support this placement and the candidate must sign the observer’s agreement.

The MCQs can be sat online worldwide in HEE (NRO) approved assessment centres. Successful attempts at the MCQ remain valid for 12 calendar months from the date of the result, allowing further progression through the programme.

Candidates obtaining a Band 1 or 2 outcome may not progress and will be advised about their learning needs. It is recommended that a suitable interval is taken before the next attempt to allow time for the candidate to address their learning needs.

If a Band 1 outcome is obtained, then the candidate should defer their next attempt for at least 3 to 6 months. If a Band 2 outcome is obtained, then a resit should be deferred for at least 3 months to allow for further learning and knowledge.

If one MCQ paper has been passed the candidate is only required to re-sit the failed paper again.

A total of 4 attempts are permitted at each paper and the single pass is only valid for 12 calendar months.

If the applicant has not progressed to the next stage of the scheme within the permitted 12 months, they will be required to re-sit both of the MCQ papers. The Local HEE Educational lead may be able to consider exceptional mitigating circumstances, in a limited number of cases; and in consultation with NHS England local team together with the NRO, then a longer period may be permitted. Attempts at the MCQ papers are funded by NHS England.

All progression through the HEE programme is subject to final approval by the NHS England local team.

All candidates attaining a Band 5 in the MCQ

Candidates attaining a Band 5 in the CPS and a pass in the PD MCQ will be approved for direct entry to a one-month clinical placement, subject to GMC registration and inclusion on the Medical Performers List (MPL).

All candidates attaining a Band 3 or 4 in the MCQ

Candidates attaining a Band 3 in the CPS and a pass in the PD MCQ will be approved for direct entry to a 6-month clinical placement, subject to GMC registration and inclusion to the MPL. Those obtaining Band 4 may be able to complete a shorter 3-month placement.

All candidates attaining a Band 2 or 1 at their first attempt at the MCQ

Band 2 or 1 will be required to re-sit the MCQ and any passes in one paper remain valid for 12 calendar months.

Candidates attaining a Band 2 are advised that they may re-sit the MCQ after 3 months (i.e. not the next sitting at 6 weeks) and Band 1 outcomes are advised they should not attempt to re-sit until at least 6 months, to allow a suitable interval before the next attempt so the candidate is able to fully address their identified learning needs. The HEE Educational Lead should advise the applicant on their learning plan including further Observational placements (un-funded if they have already undertaken one).

Permitted further attempts at the MCQ (by candidates wishing to improve their outcome)

Where a candidate has already attained a pass at the MCQ but wishes to attain a higher Band outcome to change the placement recommendation period, they will be permitted to do so but will be subject to the full fee. A total of 4 attempts are allowed at each paper and a pass is only valid for 12 calendar months.