A critique of the specialty certificate examinations of the Federation of Royal Colleges of Physicians of the U.K.

The Federation of Royal Colleges of Physicians of the U.K. has developed a programme to deliver specialty certificate examinations. These are knowledge-based examinations to be passed by all senior trainees in most medical specialties seeking a Certificate of Completion of Training (CCT). These examinations have been evaluated on their validity, reliability, educational impact, cost effectiveness, acceptability and standard setting methodology on the basis of internal evidence and the results of a published pilot. The evidence so far suggests that though reasonable reliability (reproducibility) can be achieved, validity (testing what is intended) may be lacking. Educational impact, cost effectiveness, and acceptability require more evidence. Consistency in standard setting is difficult.