RACP releases review of 2021 Aotearoa New Zealand Paediatric Clinical Examination

15 January 2025

The Board of the Royal Australasian College of Physicians (RACP) has accepted all recommendations of a critical review of its examination processes and appointed a working group to manage their implementation, some of which has already begun. 

In response to the report, RACP President Professor Jennifer Martin said,

“We acknowledge and apologise for the distress experienced by some candidates in the 2021 examination and the College commits to addressing the report’s findings, in particular those relating to the exam structure and unconscious bias, to improve transparency and equity.”

In 2023, the College of Physicians began a review of whether the structure, design and delivery of the 2021 Aotearoa New Zealand Paediatric Clinical Examination resulted in unconscious or inadvertent bias against groups of candidates on a racial basis. This followed receipt by the College of multiple anonymous complaints from 2021, 2022 and 2023.

The review was independently chaired by Maria Dew KC, Barrister, Aotearoa New Zealand, and the full report is now publicly available.

The conclusions, and 18 recommendations are set out in sections 8 and 9 of the Report.

Some of the recommended actions have already been taken and will continue to be built upon. For example, unconscious bias training for examiners was introduced in 2023 and expanded in 2024.

Some notable findings from the review include:

  • While COVID-19 increased dissatisfaction with the delivery of the examination, the review found that there were existing concerns with the structure and delivery of the clinical examination for some years prior and that the conclusions and recommendations apply to both Aotearoa New Zealand and Australia.

  • The Advisory Group was unable to make any assessment of individual candidates’ complaints of racism, as these complainants declined to come forward to the Review.

  • However, based on the evidence presented from participants and the acceptance of structural bias in the health sector more generally, the Advisory Group was satisfied that unconscious bias including racism, did likely exist in the clinical examination processes in both Aotearoa New Zealand and Australia in 2021 and in other years. 

  • There was delay in the handling of the trainees’ complaints by the College.

The key findings in the report highlight the need for the RACP to address issues of unconscious bias through cultural awareness training, transparency, and support within the examination processes to ensure fairness and equity for all candidates. 

Professor Martin said, “The RACP has accepted the report's findings and is addressing this matter with the utmost seriousness. Training colleges such as ours should promote an inclusive and culturally safe environment for the next generation of specialists – we are committed to making the necessary changes to ensure that is the case.”

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