regulation
Do you think the GMC has a duty of care to doctors being investigated? I acknowledged to you before that I have been twice investigated and I found that very stressful, so we completely recognise that these procedures are of course an added stress and indeed could sometimes be the cause of stress. We don’t doubt that for a moment. We are reviewing the tone of all our communications with doctors who are under our procedures. We don’t want it to be unduly officious or heavy- handed but they are legal documents and we are obliged to investigate every complaint so can’t duck our responsibility either. We just have to try and strike a balance. We need to walk that line between taking the complaint seriously and investigating but also taking a doctor’s health problems into account and try and manage that as best we can.
How do you think a national licensing exam would improve patient safety? I think there are two answers to that. First, if someone were to ask - can you assure me that every doctor graduating in all 32 medical schools in the UK is reaching a common standard – passing the same exam like a driving test or pilot’s licence – I wouldn’t be able to say that. I would have to say that universities examine their own students, as they do in a modern languages or a physics degree. Tere are some checks and balances in there: they have external examiners, they have a shared question bank. But nevertheless these are university exams. So I think we could better reassure the public with a single licensing assessment to ensure that all UK doctors reach a common standard. Second, at the moment some doctors
get into difficulties. I don’t think that is so surprising. What we want to understand better is if BME (black and minority ethnic) doctors who are born in the UK and educated and trained here seem to be over represented in our procedures – and I think we have some more work to do on that particular point. Researchers at Plymouth University
SUMMER 2015
recently published an independent review of 187 randomly selected cases and concluded that the process was fair. It was a detailed study of our decision-making during investigations. What we did find was that we didn’t always spell out our reasons clearly enough. So if we found somebody’s language or cultural context was wrong we should be spelling that out better.
coming from outside the EU take something called the PLAB exam, which is set at the level expected at the end of Foundation Year 1. But, if we had a single exam, that all our doctors have to take wherever they qualified in the world, it would make it simpler to reassure the public that doctors coming from overseas countries were reaching the same standards as our own graduates. It would also be an exam in English –
and in the context of UK practice. So all the medicines and the treatments, the consent and capacity issues, the medical, ethical and legal issues would reflect British practice.
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