“Catastrophic” error left hundreds of doctors with incorrect exam results
BMJ 2025; 388 doi: https://doi.org/10.1136/bmj.r373 (Published 21 February 2025) Cite this as: BMJ 2025;388:r373
Doctors’ leaders have condemned a “catastrophic” error in the marking of a high stakes medical exam that left almost 300 candidates with an incorrect result.
The error affected nearly a fifth (283 of 1451) of the doctors who took the second written component of the membership of the Royal Colleges of Physicians of the United Kingdom exam in September 2023. Some 61 candidates who were originally told that they failed the MRCP(UK) exam have now been informed that they passed, and 222 candidates who were originally told they passed have now been told that they failed and will need to resit.
The exam is a major hurdle for doctors wishing to enter higher specialty training in medical subspecialties such as cardiology, geriatrics, and haematology. It is administered by the Federation of the Royal Colleges of Physicians of the UK, representing the colleges in London, Edinburgh, and Glasgow.
Doctors affected by the error who spoke to The BMJ described receiving the news as “devastating” and said the mistake had been compounded by a lack of information.
One of the affected doctors, who asked to remain anonymous, said they received an email informing them of the error at 5 pm, by which time there was no one answering the phone number that had been provided to call for support. They said, “I feel sick. I haven’t been able to eat or sleep since I got the news. There’s been no transparency about why our results have been overturned or why it has taken so long for the problem to be identified.”
They added, “I took the exam while I was pregnant and even booked the next sitting in case I failed because I knew how much harder it would be to revise once my second child was born. Eighteen months ago I invested a huge amount of time—my evenings, weekends, and annual leave—in order to sit this exam. The length of time that has passed since means that a resit now would be impossible. I have two small children and have recently been bereaved. Refunding our exam fees and apologising means nothing compared with the impact this will have on our lives.”
Another affected doctor, who also wished to remain anonymous, told The BMJ, “I have planned my life around these exams. Delayed my marriage for these exams. [I] only planned to have a child when I passed my MRCP. I have applied for two higher specialty training programmes and been longlisted for both of them based on having full MRCP. I don’t know what will happen next, and nothing is clear at the moment. I now have a baby, and resitting the exam is almost impossible for me in my current circumstances.”
In a statement on its website the federation said that the error was due to a “data processing issue” that had been identified by an internal audit process, and it sought to reassure candidates that the issue was isolated to this particular exam.1
In response to a request for further information, the federation told The BMJ that the error was identified after a recent audit of part 1 and part 2 written examination results, which found that the results of the affected candidates had been “incorrectly calculated and reported.” They were unable to comment further on the nature of the data processing issue, saying that this would be determined by a planned independent review looking into the error.
The federation said, “The MRCP(UK) examination is the gold standard of early physician assessment, and its standards are rigorously upheld. Regrettably, although the problem was not their fault, candidates who we now know did not pass must resit and pass the exam in order to be awarded the MRCP(UK) diploma and to progress in their training.”
Mike Jones, executive medical director of the federation, said, “We deeply and unreservedly apologise for this situation. We appreciate how distressing the candidates affected will find this, and for some it will create an additional burden to the hard and vital work they do.”
“Unacceptable” failure
The BMA described the error as “catastrophic.” Its chair of council, Philip Banfield, said, “The ramifications of this appalling situation are far reaching for doctors and patients. All doctors should have confidence in an exam result—they are central to their careers and to the skills they bring to medicine. There must be an immediate independent investigation into this, including how routine audit processes have taken so long to identify this error.”2
The resident doctors committees of the three royal colleges of physicians have written to the federation urging it to take full accountability for the error. Signatories to the letter said, “This error is unacceptable and undermines the integrity of the examination process. The incident, compounded by the apparent failure of quality assurance mechanisms leading to an inexplicable delay in its discovery, represents a serious breach of that trust. The consequences for affected doctors, who may have made critical career decisions based on incorrect results, are considerable and deeply troubling.”3
Omar Mustafa, registrar of the Royal College of Physicians of London, said, “While MRCP(UK) is administered by the Federation of the Royal Colleges of Physicians of the UK on our and the Scottish colleges’ behalf, the RCP is a key partner in that arrangement, and we apologise unreservedly to all the doctors affected.
“There are so many questions that still need to be answered about how this issue was allowed to happen, and that is why we are insisting on an independent review of the full exam process. We must do everything we can to ensure that our processes are as robust as possible so that something like this can never happen again.”4
The General Medical Council said that it was seeking assurance that its standards were being met and that there are no concerns about patient safety as a result of the error. Colin Melville, the GMC’s medical director and director of education and standards, said, “We are working closely with the federation to understand what happened, how they will support those affected, and what actions they will take to ensure this does not happen again.”
“I just sat in the car crying”
Katherine, an internal medicine trainee who asked for her surname not to be used, said she was “ecstatic” when she was originally told she had passed the MRCP(UK) exam, back in 2023. She has now been told that she failed and must resit it.
She told The BMJ that she had planned her career around the timing of the exam, electing to sit it while she was not in a training programme to ensure she had adequate time to prepare for and resit the exam if required. She described receiving the email informing her she had failed as coming “out of the blue.”
“I was so confused,” she said. “I thought at first that it must be a spam email or that it had been sent in error. When I realised the email was genuine I just sat in the car crying and trying to call the number we’d been given, but I couldn’t get through. The email they sent us had even less information than the statement they published on their website.
“I still haven’t been told what mark I actually got, and the online portal is still telling me I passed. It’s ironic, because this is the opposite of how as doctors we are taught to break bad news.
“We’ve been given the option of resitting the exam in a month’s time, which is just not enough time to prepare. The first time round I spent three or four months revising. I was turning down events with family and friends so I could dedicate time to revision. It’s undermining to suggest you can prepare for an exam like this in only a month.
“[The Federation of the Royal Colleges of Physicians of the UK] needs to be completely transparent about how this happened. They need to recognise that people base their life decisions on the results of these exams.”