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The Royal College of General Practitioners (RCGP) remains confused over whether its Membership examination (MRCGP) is a qualification or merely an indication of "club membership". Non-Members are told not to refer to "MRCGP" and "qualification" in the same breath—although it would appear that the College can.

Back in 1998 it cost me in the order of £500 to sit all four modules for Membership of the Royal College of General practitioners by examination. To continue using the designation "MRCGP" I am asked to pay £417 per annum (2007–2008 rates). I wrote to the RCGP last month as follows:

I passed the MRCGP examination in 1998, and am currently applying (from NZ) to work as a locum in the UK. On the Performers List application I am asked for "medical qualifications", including qualification, institution, and date. Is the following acceptable, given that I am not a paid-up college member?

Qualification: MRCGP
Institution: RCGP, UK
Date: 15.07.98

In other words, does the MRCGP "count" as a medical qualification?

The RCGP replied as follows:

Use of the designation "MRCGP" is restricted to those doctors who are currently in good standing as Members (good standing in this context is taken to mean those who have paid their annual membership subscription fee). As you are not currently a paid-up Member, I confirm that you are not eligible to use the designation "MRCGP", nor can you state that "MRCGP" is a qualification—the letters mean "Member of the Royal College of General Practitioners" and do not of themselves denote success in the College's exam (the exam is not the sole route towards full Membership). While you can state that you passed the College's examination for membership on 15 July 1998, you should also indicate that you are not currently a College Member.

Banned from listing a qualification that isn't?

I understand and accept that "MRCGP" denotes contemporaneous payment of a fee. But I am confused as to why "MRCGP examination, date" is not a qualification—and so, it seems, is the RCGP! For example, on their website they state (emphasis mine):

The MRCGP qualification is undoubtedly a marker of quality...

They also spread this apparent disinformation to the public:

There are also two specialist but voluntary qualifications awarded by the RCGP: MRCGP — Member of the RCGP...

A College in confusion: the qualification that doesn't exist

Oh dear, they are in a muddle. They want MRCGP to be seen as a qualification, but they want to make sure we have to keep paying for it. In a subsequent e-mail to the RCGP I suggested that they revise the information on their website along the lines of the following:

The letters "MRCGP" do not denote a medical qualification, indicating only that the doctor has paid a membership fee to the College. The only recognised qualification for UK general practice is a Certificate of Completion of Training (CCT) issued to general practitioners once they have completed the appropriate training (or a Certificate of Equivalent Experience). Doctors who work in general practice following this training must be on the General Medical Council's GP Register; there is no requirement for Membership of the Royal College of General Practitioners (although this may be considered a marker of quality).

In response to this suggestion the RCGP had the following to say:

Well that says a lot really. The thing is it wasn't just a question of sitting a written exam (in May). My records show that consultation videos were also evaluated (another date in May) and an oral examination was taken on yet another date (in June). So that date I sat the written papers is not especially relevant, as it tells of success in only part of the total assessment. The most relevant date would thus seem to be the of the date of my admission to the College, the culmination of passes in all four modules (in July). It is a sad reflection on the College's priorities that they do not recognise this.

To use the designation once more all I have to do is fill in the application form to re-join and pay up. Now tell me; how is that a marker of quality? The money-making potential of this position is immediately clear. It is, however, attainment of Membership by examination or assessment—not the mere payment of annual fees—that denotes the reaching of a set standard.

I will continue to list the following in my CV under "Qualifications":

Membership of the Royal College of General Practitioners by Exam. — MRCGP
Royal College of General Practitioners, UK, 15 July 1998

I feel no obligation to state whether or not I am a currently paid-up Member; it's simply not relevant to a listed academic achievement.

Update 25.07.07:

On 02.07.07 the Director of Membership & Development for the RCGP wrote to me to "clarify the matter". In the context of restrictions on the right to use the MRCGP post-nominal the College stated:

The GMC lists as one of the duties of a doctor 'to be honest and trustworthy'. The GMC document Good Medical Practice, in its section on Probity, paragraph 48, states, 'If you publish information about the services you provide, the information must be factual and verifiable.' The GMC's advice on advertising (paragraphs 8 - 11) encourages GPs to make publicly available 'factual information about their professional qualifications', which 'must not include any statement which could reasonable  regarded as misleading.'

The joint publication by the RCGP and the General Practitioners Committee of the British Medical Association, Good Medical Practice for General Practitioners (2002), states (Section 7, pages 19 - 20), 'The information in your practice leaflet must be accurate and factual.' It gives as an example of unacceptable practice having a practice leaflet which is 'untrue or self-promoting.'

Repeating my position that my issue is with the College being hypocritical in referring to passing MRCGP examinations as a qualification when I am asked not to, I asked:

Given that the GMC and GPC both require doctors to publish information that is honest and factual, would you agree that the RCGP is being dishonest and misleading in referring to MRCGP as a "qualification" on its own website? If the MRCGP was not registrable as a qualification since 1997, this has been "untrue" for 10 years; there can be no excuse for that.

The College declined to comment.

I also asked:

On the same basis, by what verifiable measure does the College claim that *current* Membership is an indication of quality in general practice?

The College again declined to comment. I rest my case.

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