02 July 2025
Last week, we were deeply concerned to learn about the technical disruptions experienced by many trainees during the Rheumatology Specialty Certificate Examination (SCE). We recognise the significant distress and uncertainty this has caused at a crucial point in trainees’ professional development. In response, the British Society for Rheumatology has written to the Federation of Royal Colleges to formally express our concerns and to seek urgent clarity on how this situation will be addressed. You can read the full letter below.
Dear Sir/Madam,
Significant issues in the delivery of the Rheumatology SCE on 25 June 2025
As communicated to you on the evening of Wednesday 25 June 2025, the British Society for Rheumatology (BSR) was quickly made aware of significant issues in the delivery of the Rheumatology SCE that day and the distress and anxiety those issues had caused to candidates.
We have continued to receive multiple examples of a breakdown in the technology used to host the exam, inadequate support arrangements in place, and a lack of clarity for individuals that continues to cause them concern. We appreciate the Federation’s investigation into this matter and, in the interests of supporting that investigation, we want to share some of the examples and experiences we have been made aware of. We hope that this can also form the basis for our discussions on Thursday 3 July, when we hope to come away with an understanding of:
- What went wrong ahead of the day: communications/instructions, testing of the systems, contracts with external providers and contingency planning.
- What went wrong on the day: with the system and with the support available to candidates
- What the forward plan and actions need to be for the candidates affected and for the exam in future.
Issues with technology
The remote delivery of the exam is new to the rheumatology specialty. We understand that the platform used for this is outsourced from the Federation to Surpass, and the technical and connectivity requirements are complex.
We have heard from at least 60 candidates across the UK who experienced technical difficulties during the exam, which suggests that the issues were widespread and not related to local internet connectivity. As issues emerged, candidates contacted the proctors, platform provider and the Federation, outlining problems with camera connectivity, repeated notifications and error messages, forced full restarts of the platform, and the mobile phone application. As we have asked all those who contacted BSR to share their experiences with the Federation, we will not repeat those here, but trust that they are being dealt with line by line with Surpass, the platform provider.
Key issues BSR would like to address with the Federation are:
- The extent of the testing of the platform by the Federation and Surpass and particularly testing for a full roll-out of the system to a large cohort of candidates. BSR and rheumatology specialty trainees are keen that this is not something another diet has to face.
- What consideration is being given longer-term to the roll-out of remote examinations? Rheumatology trainees have communicated a complete breakdown in trust with the delivery of a remote examination. Other specialties will be watching these events with concern. We hope that an investigation into this incident provokes a longer-term review of delivery of examinations by the Federation.
Communication and support
BSR has been disappointed to hear of the inadequate communication and support provided by the proctors, Surpass and the Federation during the exam as issues emerged and became extremely disruptive. There appears to have been no contingency in place for any issues emerging on the day of the exam.
Key issues we would like to address with the Federation are:
- Whether better IT support can be made available when it becomes clear that the issues are at scale. Candidates have told BSR that immediate IT support was only available through a chat function. They could wait over 25 minutes (mid exam) for a reply via the chat. Some were told that there was no telephone number to contact in the event of persisting problems. If a system had to restart, the candidate would return to find issues repeated and would have to start again on the chat function with a new IT adviser. The new adviser would not be aware of what measures had already been put in place and would take the candidate back to square one, repeating what they might try as a fix. Resolution took a huge amount of exam time and fixes were often temporary.
- The training and support given to Federation staff on the front line of exam-related phone calls. We have received different examples of the experiences of contacting Federation staff. Those experiences are highly variable suggesting that there is not common understanding of procedure should problems arise with an online exam, different interpretation of Federation policy, and basic issues with communication and customer service:
- One candidate rang the Federation team twice and got the same person on each occasion. When they explained their situation, the member of staff ended the call on both occasions.
- Some members of staff answering the phone calls gave out a generic email address to candidates and told them to get in touch via that address, seemingly unaware that the exam was in progress and emailing a group email account was not the level of urgency the situation required.
- Most members of staff on the phone seemed unaware that there was a systemic failure in the delivery of the exam and there was clearly no agreed messaging in place for candidates.
- One candidate was met with the response that they would be “investigated” for misconduct given that the platform was reporting errors with their camera and that this could lead to their exam being voided. This was before the member of staff could possibly have investigated whether there were technical issues at fault but sought to immediately cast shade on the candidate.
- The exam started at 8.00 but Federation staff were not available until 9.00.
- Some candidates were given one set of instructions or information only to find that the opposite had occurred (eg. being given additional time to sit from one member of staff and then their exam voided by another member of staff).
- The information shared with candidates in advance of the exam. Some candidates claim that the exam start time was not included in their information whilst others have said that there was no information about what to do in the event of technical difficulties.
- Whether adequate escalation procedures are in place between external contractors and the Federation in the event of multiple issues during an exam. BSR became aware of issues via social media and then emails from concerned trainee representatives and distraught candidates. We reached out quickly to the Federation senior team. Given the issues were being raised with the proctors, the platform provider, and the Federation throughout the day, BSR could and should have been notified by the Federation rather than having to make the initial contact.
- The role and training of the online proctors. Candidates were in frequent contact with the proctor (or vice versa) as issues emerged but several expressed concern at the total lack of empathy shown by their proctor or their ability to tackle the recurring technical issues.
Immediate and lasting impact on the wellbeing of rheumatology trainees
The emails received at BSR have been a tough read. Like the Royal Colleges, BSR is committed to supporting professionals throughout their career, and particularly during the pressured days of assessment.
We know that the Federation does not underestimate the amount of sacrifice specialty trainees make to prepare for the exam. We have heard multiple cases of people forgoing time with their young children and families to revise. There are at least two cases where candidates may not CCT at huge personal, professional and financial cost.
The stress caused during the exam itself is likely to remain with these candidates for a long time. Every effort must now be made to ensure that they have the support and clarity about their individual situation. We are keen to work with the Federation to provide this.
Key issues we would like to raise with the Federation are:
- What communication have candidates had about their individual circumstances? From the examples we have received, no two candidates seem to have the same set of problems or response to the issues they faced. Some were unable to complete the exam, some are deeply concerned that they will fail as there were not able to complete it effectively (checking their answers etc).
- What options are available for resits? We understand that the Federation is working out a process for refunds and resit. Rheumatology trainees have already been in touch with us to say that they would not feel comfortable sitting the exam online again and would like to know whether alternative arrangements will be made.
- That a pass will not be called into question and that assessment is sensitive to the issues faced. Candidates have been made aware that any camera issues are considered a “major violation” and that their exam will be voided in those circumstances. Given that issues are multiple and appear to be with technology rather than human-error clarity is needed quickly for those individuals who are concerned that their exam results will be voided because of repeated notifications that their camera was not working to the required standard. There needs to be sensitivity in the marking given the multiple interruptions and delays for many of the candidates.
We appreciate the steps being taken to keep BSR informed and look forward to meeting with you on Thursday 3 July 2025 to discuss the investigation and the resulting actions.
Yours sincerely,
Dr Jo Ledingham, President, British Society for Rheumatology
Sarah Campbell, CEO, British Society for Rheumatology
Dr Anastasia Madenidou, Chair of the Trainees Committee, British Society for Rheumatology
Dr Iain Goff, Co-Chair, Rheumatology Specialty Advisory Committee