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The Royal College of Psychiatrists Improving the lives of people with mental illness

MRCPsych CASC Pass Mark

To meet the minimum standard required in the CASC exam, candidates must meet or exceed the total borderline regression score and achieve the passing score in a minimum of 12 stations. Candidates must meet both criteria to be successful. The reason candidates have to meet both criteria is to ensure that they have demonstrated an acceptable level of performance across a broad range of stations that reflect the breadth of core training. Candidates who score highly in some stations cannot use this to compensate for low performance in other stations.

The Borderline Regression Method is considered to be the most objective way of setting the standard for practical exams. Each CASC station is marked by an appropriately-trained examiner, who provides two sets of scores: (1) 5 point ‘analytic’ global domain scores ranging from 1 (Poor) to 5 (Excellent) for between three and five domains and (2) One 6-point overall global judgement which comprises Excellent Pass, Pass, Borderline Pass, Borderline Fail, Fail, or Severe Fail (refer to Grade Descriptors). The total weighted domain scores are regressed onto their global scores to produce a linear equation for each station. The total domain score for borderline pass candidates, determined through this line of best fit becomes the pass mark for that station. The pass mark for the whole exam is the average of the station pass marks for that day.

It is important for reasons of policy and patient safety only to pass candidates who are clearly competent. All examinations are therefore subject to a ‘standard error of measurement’ (SEM). So, for the CASC exam, the initial indication of a standard is raised by an estimate of measurement error.

Passing a station is dependent on the station score. Overall judgements for each station are used only to set the pass mark via the regression equation e.g. an examiner can give an overall judgement of Borderline Fail but a candidate can still pass the station. Therefore, the secondary passing criteria of 12 stations is based on station cut scores and not the overall judgement of examiners.

The minimum of 12 stations has been set on the basis that: (i) the eight single stations cover basic clinical skills (information gathering, mental state examination, communication, etc) and a borderline candidate should be expected to pass seven out of eight single stations; and (ii) the 10 minute linked stations are intended to test higher level clinical management skills (clinical analysis, reasoning, decision making, etc) and a borderline candidate should be expected to pass five out of eight stations. Stations in both circuits are not all of equal difficulty. In recognition of this, the Examinations Sub Committee has set a minimum total number of stations to pass across the whole exam rather than separate thresholds for single and linked stations.

In addition, any candidate who receives two or more marks that indicate a severe fail in a station will have their overall performance reviewed by the Examinations Sub Committee (ESC) and may fail the examination, irrespective of their total test score or whether they have achieved the passing score in a minimum of 12 stations. The ESC sets the final pass/fail criteria based on due consideration and analysis after the examination, taking account of station difficulty, candidate and examiner performance and other relevant considerations. Examination results will need to be ratified by the Education and Training Committee (ETC) prior to publication.

The MRCPsych Exam Regulations and exam standard settings are subject to change from time to time and candidates are advised to check the Examination pages of the College website for up to date information.

 

Examinations Unit

19 June 2015

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