Respiratory specialty specific examinations in the south west

Specialty specific examinations (SCEs) were first piloted in 2006 by the Joint Royal Colleges Postgraduate Training Boards (JRCPTB) and are now a compulsory requirement for Certificate of Completion of Training (CCT) for UK trainees in most medical specialties.¹ Design of the questions is a rigorous process requiring extensive scrutiny.² Although there is information regarding the reliability and validity of the assessment,^1,3 to our knowledge there is no published evidence which evaluates the opinions of trainees who have taken, or are considering taking, the respiratory specialty certificate exam (RSCE), and there is little published data in other specialties. Using the RSCE as a generic model for SCEs, we conducted a regional qualitative study to explore the opinions of respiratory higher specialist trainees (RHSTs) regarding the RSCE in south-west England. All RHSTs holding a national training number in the south-west region were invited to complete an anonymised online questionnaire.⁴

The response rate was 84% (32/38). 41% (13/32) of respondents had taken the RSCE already. 92% of these (12/13) agreed that taking the exam had been useful primarily to enhance career progression and increase knowledge. One RHST did not feel it was useful and questioned whether RSCE performance correlated with clinical competence. 85% (11/13) agreed that the examination had been set at the right level. 57% of all respondents (10/32) would have taken the examination even if it had not been compulsory. The most common reason for not wanting to sit the examination was financial concerns. 53% felt that an exam cost of up to £300 was acceptable, a 65% reduction from the current rate of £861 for UK candidates.⁵

This regional qualitative study confirms that the RSCE is regarded as a useful assessment particularly for career progression and knowledge enhancement. The results of this survey are more positive than published data from pilot SCEs, in which only 25% of examinee comments were broadly supportive.² The cost of the RSCE remains an important concern for RHSTs, although most recognise some financial outlay is unavoidable. These findings may have applicable generic value by proxy to other medical specialities regarding the SCE and can inform those involved in commissioning and delivering the SCE as well as postgraduate deaneries. Of course, the results of this regional specialty-specific study require validation in a national and cross-specialty study.