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Inter-examiner reliability of the clinical parts of MRCPsych part II examinations

Department of Psychiatry, University of Birmingham, Queen Elizabeth Psychiatric Hospital, Birmingham B15 2QZ, email: femi.oyebode{at}bsmht.nhs.uk

Sanju George, Consultant Psychiatrist

Birmingham and Solihull Mental Health NHS Trust

Veena Math, Specialist Registrar

Greater Glasgow Primary Care NHS Trust

Sayeed Haque, Research Fellow

Department of Psychiatry, University of Birmingham, Queen Elizabeth Psychiatric Hospital, Birmingham

Declaration of interest

F.O. was Chief Examiner, Royal College of Psychiatrists 2002-2005.

AIMS AND METHOD

The aim of the study was to investigate the interrater reliability of the clinical component of the MRCPsych part II examinations, namely the individual patient assessment and the patient management problems. In the study period, there were 1546 candidates and 773 pairs of examiners. Kappa scores for pairs of examiners in both these assessments were calculated.

RESULTS

The kappa scores for exact numerical agreement between the pairs of examiners in both individual patient assessment and patient management problems were only moderate (0.4-0.5). However, the kappa scores for agreement between pairs of examiners for the reclassified pass and fail categories were very good (0.8).

CLINICAL IMPLICATIONS

The poor reliability of thetraditional long case and oral examinations in general is one of the most potent arguments against their use. Our finding suggests that the College clinical examinations are at least not problematic from this point of view, particularly if global pass or fail judgements rather than discrete scores are applied.

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