The papers are designed and written by a team of experienced General Practitioners who are experts in the assessment and training of people for work in General Practice. There was a painstaking development process which included rigorous reviews, statistical trials and validation against required competencies. They are devised to identify the candidates who are most likely to be successful at the more intensive stage 3 assessments.

The questions present clinical scenarios and require the exercise of judgement and problem solving skills to determine appropriate diagnosis and management of patients. The paper is not a test of knowledge, but rather the ability to apply it appropriately. The topics are taken from areas with which a Pre-Registration House Officer or Foundation Programme Year 1 doctor could be expected to be familiar. There are no questions requiring a specific knowledge of general practice.

Questions are presented in a variety of formats and the task is to choose the best of the given responses using clinical judgement. One point is awarded for each correct answer. Where more than one response is required for a question a point is awarded for each correct response chosen.

There were 99 questions in the paper. One item was not scored due to a printing error. The maximum number of points attainable was 103.

The questions present scenarios which a second year foundation doctor might meet. Each scenario encapsulates a professional dilemma and the appropriateness of different ways of dealing with it. The paper is designed to assess understanding of appropriate behaviour for a doctor in difficult situations and requires the application of competencies such as professional integrity, coping with pressure, and empathy and sensitivity. It does not require specific knowledge of general practice but does assume general familiarity with typical primary and secondary care procedures.

There were 50 questions in the paper. Some required the ranking of 4 or 5 options; others required the selection of 2 or 3 responses. Scoring was based on matching the keyed responses. There were between 10 and 20 points available for a question. Answers which exactly matched the keyed responses gained maximum points. Responses which differed slightly from the keyed response (e.g. reversed the order of two options) gained a high number of points and responses which had little in common with the keyed response received few or no points. The maximum number of points available was 784.

Raw scores for each paper were allocated to four bands. A score in band 2 or above on each paper was required for shortlisting.

The tables below show the psychometric properties of the two papers and the allocation of scores to bands.

In interpreting your score remember the following points:

• You are being compared to qualified doctors who will typically have the same experience as you. The standard has to be challenging.
• Some Units of Application received many more applicants than there were available Selection Centre places. A higher score was required to be shortlisted in these Units than elsewhere.
• The papers are designed to assess your potential for work in General Practice. If your scores are low, you may find another speciality is more suited to your approach.

Table 1: Psychometric Properties of Papers

Table 2: Allocation of scores to bands