In August 2024, a judicial review found that the RCGP’s policy on late diagnosis and exams was irrational. The RCGP has subsequently updated its policy in line with the judgement, but prior to that GP registrars were not allowed re-sits or additional exam attempts where they received a late diagnosis of a disability and had failed previous exam attempts without the benefit of the reasonable adjustments that would accompany their diagnosis.
When this issue was first brought to our attention, alongside lobbying the RCGP to update its policy, we also made contact with the other royal colleges to confirm their positions on exam resits / nullification and late diagnosis. At that time, fewer than half of colleges / exam groupings had clear policies which allowed for resits of nullification.
This has improved significantly since we began lobbying colleges and the Academy of Medical Royal Colleges, with the Academy subsequently publishing guidance which suggested candidates in this situation should receive the full number of attempts with adjustments.
We are now pleased to confirm that all royal colleges / exam groupings offer some form of nullification or resits in case of late diagnoses.
The table below summarises each college’s policy and links to the relevant info on their website (if available). We strongly urge those colleges that have not published their policy on their website to do so.
| College / exam grouping and web link (if available) | The college position |
|---|---|
| Royal College of Anaesthetists (RCoA) | “On late diagnosis of a condition that requires reasonable adjustments, all previous attempts at an examination component taken prior to the diagnosis can be discounted and the attempts reset.” |
| Royal College of Emergency Medicine (RCEM) (page 8) | “Candidates with a late diagnosis of a neurodiverse condition (such as dyslexia, ADD, ASD) and who have previously sat an examination component without agreed reasonable adjustments may apply to the Dean to expunge such attempts. Such cases will be dealt with on a case by case basis at the discretion of the Dean, whose decision is final.” |
| Royal College of GPs (RCGP) | “Where after an unsuccessful attempt a candidate receives a diagnosis of a disability of which they were previously unaware, the RCGP may void any previous attempts which they took while having that disability without the appropriate reasonable adjustments.” |
| Royal College of Obstetricians & Gynaecologists (RCOG)(Policy not on website) | “Candidates who receive a new or previously undeclared diagnosis of a condition requiring reasonable adjustments—and who have failed previous attempts at an exam component without the benefit of these adjustments—may apply to be considered for additional attempts at that exam component. Each request will be reviewed on a case-by-case basis by a dedicated panel”. |
| Intercollegiate Committee for Basic Surgical Exams (ICBSE) | “ICBSE have agreed that, in such circumstances, candidates will have their previous attempts expunged.” |
| Joint Committee on Intercollegiate Examinations (JCIE) | “In the event of a late diagnosis of a disability supported by an appropriate specialist assessment recommending reasonable adjustments, failed previous examination attempts without the benefit of reasonable adjustments will be nullified.” |
| The Royal College of Paediatrics and Child Health (RCPCH) (section 13 of the college's exam rules and regulations) | “For late diagnoses of SPLDs, the RCOphth adheres to the AoMRC’s Principles for nullification and number of attempts” |
| Membership of the Royal College of Physicians (MRCP) (Policy not on website) | MRCP have informed us that if, for example, 4 attempts were taken prior to the late diagnosis, a candidate may be given the equivalent number of additional attempts. The MRCP UK ‘Limits on attempts’ guidance does not contain the policy that MRCP have shared with us but states: “If you have already undertaken attempts at the examinations and receive a late diagnosis of any condition which requires reasonable adjustments to support them to sit, and which they had not previously received, should contact MRCP(UK) (via [email protected]) to discuss this situation.” |
| Royal College of Psychiatrists (RCPsych) | “Candidates who have had a late diagnosis (for example of autism or attention deficit hyperactivity disorder) and have sat an MRCPsych exam without their agreed reasonable adjustments, may have grounds to apply for extension of validity or additional attempts at the exam. Requests will be considered on a case by case basis by the Chief Examiner…” |
| Faculty of Public Health (FPH) (Policy not on website) | “Our policy is that we can give extra attempts (beyond the usual maximum of six attempts) when requested in these cases, including candidates receiving late diagnoses… we would prefer to keep an ad personem approach to reasonable adjustments, rather than introduce blanket policies as we feel this is the most appropriate way to deal with them.” |
| Royal College of Radiologists (RCR) (Policy to be published on website shortly) | “If a candidate receives a new or changed diagnosis for a pre-existing condition leading to a change in the recommendation for adjustments - and this is accepted in accordance in our reasonable adjustment policy - then previous failed attempts will be annulled and the number of remaining attempts calculated accordingly (up to our maximum of six)” |
| Faculty of Sexual and Reproductive Healthcare (FSRH) | “In the event of a new diagnosis of a condition that requires a reasonable adjustment, the College will nullify a candidate’s previous attempt(s) based on the information stated in the diagnosis documents. However, previous attempt(s) will remain on the candidates record and it will be noted that new information has led to additional attempt(s) being granted.” |