How are the Professional Development and Clinical Problem Solving scores interpreted?

Scores for the Professional Development (PD) and Clinical Problem Solving (CPS) papers are converted into standardised scores, to aid interpretation.

Final scores in the CPS test are grouped into the five bands below to help interpretation of these standardised scores with regards to recommendations for the programme whilst the scores for the SJT are pass/fail only; pass in the SJT is a standardised score 42 and above.

The allocation of final scores to bands based on expected performance.

The defined cut score is agreed through means of a standard setting exercise which involves a group of expert GP trainers and trainees, who individually and collectively defined the score at which a “minimally acceptable” candidate should perform (see Q.5).

In January 2024, a further standard setting exercise was undertaken on the assessments following the expert review. The standard setting process involved 15 GPs; three of which were recent programme graduates. Based on this standard setting exercise the minimum passing score is 42. A review of the banding also took place, taking into account overall performance of the programme cohort, and small revisions were made to the placements of the bands.

The scores indicate a candidate’s general level of performance. Expectations with regards to performance for each band are explained below.

Below minimum standard required

Band 1

Where a score is in Band 1, it is likely that the candidate will require significant support and preapplication advice prior to reapplying for a place on the programme. Band 1 scores on either paper suggest substantial deficiencies in performance. Candidates are advised that they should not normally re-sit the paper until they have undertaken education and work in a supervised clinical situation, such as an NHS Hospital post, for at least 6 months.

Band 2

Where a score is in Band 2, it is likely that the candidate will require some support prior to reapplying for a place on the programme. Band 2 scores on either paper suggest deficiencies in performance that need to be addressed. Candidates are advised that they should not normally re-sit the paper until they have undertaken education and work in a supervised clinical situation, such as an NHS Hospital post, for at least 3 months.

Band 1 and Band 2 scores on the CPS paper suggest a need to improve clinical knowledge. Some candidates will find their knowledge has deteriorated through lack of use or that their knowledge is now outdated due to changes in practice. Low scores on the CPS paper can also be due to poor problem-solving skills, that is difficulty applying knowledge in clinical situations. This can include difficulties in identifying the key issues in a situation, poor integration of knowledge, or failure to determine the most likely or critical possibilities in a situation.

Band 1 and Band 2 scores on the PD paper suggest a difficulty in identifying the best response to situations. This may be the result of inappropriate assumptions about the role of a doctor working in a NHS General Practitioner post, both in the provision of care and as part of an organisation providing clinical care. This can include a poor understanding of professional ethics, or use of less patient-centred approaches to the provision of care. Candidates with scores in these bands can sometimes fail to take account of how others are feeling, have difficulty making decisions under pressure, or cope less well with the stresses and strains of being a medical practitioner.

Just above minimum standard required

Band 3

Where a score is in Band 3, there are likely to be development needs which might be addressed during participation in the programme. Based on performance at the next stage of assessment, candidates may be asked to complete a recommended minimum of 6 months (whole time equivalent) of supervised clinical sessions in General Practice, as well as workplace-based assessment, and educational guidance.

Band 3 scores on the CPS paper suggest that the candidate will need to improve their clinical knowledge. This may always have been an issue for the candidate, or their knowledge may have deteriorated since their initial training, or last period of practice. Lower scores on the CPS paper can also be due to poor problem-solving skills, where candidates have difficulty applying their knowledge in clinical situations. This can be due to difficulties in identifying the key issues in a situation, poor integration of knowledge, or inability to determine the most likely or critical possibilities in an ambiguous situation.

Band 3 scores on the PD paper suggest that the candidate does not always identify the best response to situations. This can be the result of poor insight or inappropriate assumptions about the role of a doctor working in a NHS General Practitioner post, both in the provision of care and as part of an organisation providing clinical care. Factors such as a poor understanding of professional ethics or use of less patient-centred approaches to the provision of care can contribute to lower scores. Candidates with scores in Band 3 may have less understanding of, or take less account of, how others are feeling. They can have difficulty making decisions under pressure and/or cope less well with the stresses and strains of being a medical practitioner.

Well above minimum standard required

Band 4

Where a score is in Band 4, there are likely to be some development needs which might be addressed during participation in the programme. Candidates may be asked to complete a recommended minimum standard induction of 3 months (whole time equivalent) of supervised clinical sessions in General Practice, as well as workplace-based assessment, and educational guidance. Scores in Band 4 show a good level of performance.

Band 5

Where a score is in Band 5, there are likely to be very few development needs that need to be addressed during participation in the programme. Candidates may be asked to complete a recommended minimum one-month induction into General Practice. Scores in Band 5 show an excellent level of performance.

Candidates who score Bands 4 and 5 in both papers will be automatically offered a place on the programme subject to agreement and approval by the Lead NHS England team RO/MD.