Surgery
GMC apologised to Mr Karim for the length of time that the fitness to practise investigation had taken to complete and said that it remained “committed to working hard with health leaders to remove inequalities where they exist.” It also said that it will “continue to work hard to eradicate the disproportionate referral of black and minority ethnic doctors from employers.”8 The BMA responded with a statement that
the initial concerns raised by Mr Karim about his treatment by the GMC “remain valid” and added that it would support him as he considers potential next steps, “including the possibility of an appeal of the decision of the appeal tribunal”.9 Speaking at Future Surgery, Mr Karim commented: “Conditions on your registration destroy your life…I became unemployable”. He lost his NHS job, his private practice, and the family home. Mr Karim described the experience as “devastating”. “There were many times, when I was driving on the motorway, when I thought ‘why don’t I just crash the car, so my family can claim the insurance?’ But I had a young family; I knew I had been wronged and I knew they had picked the wrong person. That was how I maintained my wellbeing – by not letting them get away with it.” He is now calling for greater scrutiny of the
current system. There are two things that need to be addressed, according to Mr Karim: the treatment by doctors within NHS Trusts, and the GMC. He asserted: “Within an NHS Trust, there isn’t a level playing field. A doctor accused of conduct or capability issues may face an MHPS (Maintaining High Professional Standards) investigation by an investigator appointed by the NHS Trust.” This not only means that the investigation may
not be impartial, but Mr Karim also believes that white colleagues are more likely to be believed, over colleagues from Black, Asian and Minority Ethnic (BAME) backgrounds. “We need accountability from the GMC,” he commented. “Doctors should be innocent until proven guilty. In order to maintain this, there needs to be anonymity of the FTP process. Salacious media interest can destroy a doctor’s career.
“Most importantly, we need to raise the
burden of proof against doctors to beyond reasonable doubt. At present, if you have two or three managers in a Trust saying you did something, they will be believed.”
Changing the culture The topic moved on to harassment and the culture within surgical teams, with the discussion led by Higher General Surgical Trainee, Greta McLachlan. Dr. McLachlan is the Co-Founder of Women
Speakers and Healthcare, an Inaugural Member of the Pride In Surgery Forum at the Royal College of Surgeons (RCS) England, and a member of the Women In Surgery Forum at RCS England. Most recently, she has been the Trainee Lead for the Working Party on Sexual Misconduct in Surgery, which published a survey into the experiences of surgeons in the UK with regards to sexual harassment, assault and rape. The survey, which was published in the British Journal of Surgery, garnered international press and revealed that one in three female surgeons have been sexually assaulted in hospital operating theatres. In addition, compared with men, women were significantly more likely to report witnessing, and be a target of, sexual misconduct.10
The anonymous online survey
included 1,434 participants (51.5% women) from the surgical workforce and found that:
I have had lots of talks about aseptic technique, but I have never had a talk on what are unacceptable behaviours and what might happen if I cross that line. Less than 10% of hospitals have a specific
policy on sexual harassment. Greta McLachlan, Higher General Surgical Trainee.
20
www.clinicalservicesjournal.com I April 2024
l Two-thirds of women (63.3%) had been the target of sexual harassment from colleagues, along with almost a quarter of men (23.7%).
l 29.9% of women had been sexually assaulted (versus 6.9% of men).
l The majority of participants (89.5% of women, 81% of men) said they have witnessed some form of sexual misconduct by colleagues.
l 10.9% of women experiencing forced physical contact for career opportunities (a form of sexual assault) versus 0.7% of men.
l Being raped by a colleague was reported by 0.8% of womenversus 0.1% of men (1.9% witnessing versus 0.6% of men).
l The study also found there is a widespread lack of faith in accountable organisations’ ability to deal with sexual misconduct. Only 16% of those impacted by sexual misconduct made a formal report.
Dr. McLachlan highlighted the example of a member of staff who frequently exposed themselves at work. It became normalised, as it happened so often, and it went unchallenged – the view was that “he was a good trainer” and “good with patients”. “His behaviour was minimised and put in such a light that it became ‘acceptable’. However, this behaviour had never been ‘acceptable’ - it had been ‘accepted’. When people perform these acts, jokes and comments, the research shows that it becomes normalised,” she commented. Dr. McLachlan added that if it isn’t challenged (because these people are in positions of power), we create a system within the culture that accepts these behaviours. She pointed out that people who are offended by inappropriate behaviours are often labelled as ‘not being able to take a joke”. “People go through the system, learning that
is ‘how to be to be a surgeon’,” she commented. Furthermore, when we have survived a ‘broken system’, these behaviours can become
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