Dr Saal Seneviratne Expert Witness in Psychiatry

Review of Fitness to Practice

This Article Discusses The Referral Of Doctors To The General Medical Council (GMC) In The UK Based On The Author’s Assessment Of 124 Doctors Between 1990 And 2015. The Author Focuses On Three Categories: Psychiatric Problems, Substance Misuse, And Inappropriate Sexual Behaviour. The Article Emphasizes The Impact Of GMC Referral On The Mental Well-Being Of Doctors And The Need For Better Understanding Of This Process

Fitness to practise and the spectre of erasure: Some reflections from a psychiatrist assessor by John Bradley

Medico-Legal Journal Volume 90, Issue 4, December 2022, Pages 212-215 © The Author(s) 2022

This article discusses the referral of doctors to the General Medical Council (GMC) in the UK based on the author’s assessment of 124 doctors between 1990 and 2015. The author focuses on three categories: psychiatric problems, substance misuse, and inappropriate sexual behavior. The article emphasizes the impact of GMC referral on the mental well-being of doctors and the need for better understanding of this process.

The author highlights that most investigations by the GMC do not proceed beyond the initial triage stage, resulting in the case being closed. The article mentions the tragic statistic that five doctors died by suicide during the three-year period from 2018 to 2020 while under investigation or monitoring by the GMC.

Psychiatric problems were a common issue among the assessed doctors. Some had a history of severe mental illness, including schizophrenia, depression, and bipolar disorder. The author also assessed doctors with cognitive impairment and those experiencing anxiety and depression, often associated with burnout. The article suggests that support, counseling, or retraining could be beneficial for these doctors.

Substance misuse was another concern, with alcohol-related problems being more prevalent than drug-related issues. The article emphasizes the importance of doctors seeking help and addresses the GMC’s stance on reporting criminal offenses, including driving under the influence.

Inappropriate sexual behavior was identified as a category of concern, with some doctors convicted of offenses such as voyeurism, accessing pornography, and engaging in sexual relationships with patients.

The article concludes by emphasizing that GMC referral should be seen as an opportunity for counseling or retraining rather than solely as a disciplinary action. It notes that most referrals do not result in suspension or erasure. The author suggests that changes in the medical profession, including a more egalitarian and multi-professional approach, may encourage doctors to seek help earlier and prevent referrals to the GMC.

Overall, the article highlights the mental health challenges faced by doctors, the importance of seeking support, and the potential for early intervention to prevent GMC referrals.

Links: https://www.practitionerhealth.nhs.uk/