GMC provides detail of its review into fitness-to-practise referrals for BME doctors

The GMC has published the terms of reference for its investigation into why a disproportionate number of black and minority ethnic (BME) doctors are subject to fitness-to-practise referrals.

The review, which is due to be published in early February 2019, is aiming to establish the reasons why the GMC receives a higher proportion of compliants about BME doctors and outline what constitutes good practice in terms of managing concerns about a doctor’s fitness to practise.

The GMC said that previous studies have found that its processes are fair and unbiased. However, research is yet to establish the reason why BME doctors are referred to the regulator more often that their white counterparts.

The GMC said: 'All the evidence available to us indicates that the source of disproportionality in our processes is in the pattern and nature of referrals and complaints that we receive about doctors.'

The review's terms of reference added: ‘Doctors with certain characteristics – including those who obtained their primary medical qualification outside the UK and/or those who are from a black and minority ethnic background – are more likely to be referred to us for fitness to practise concerns than their peers. Similarly, such doctors are more likely to end up being investigated by us and, ultimately, to receive a sanction.

‘We hope this research will provide practical recommendations that we and others can act on to help change current referral trends, and [allow] us to work more closely with clinical leaders to properly develop supportive, open and fair workplaces.’

What the research will address

The research, which is being led by Roger Kline, a research fellow at Middlesex University Business School and Dr Doyin Atewologun, a faculty member at Queen Mary University of London’s School of Business Management, will cover all four UK countries and examine a range of different types of organisations across primary and secondary care.

It will 'investigate the processes and assurance of decision making prior to and at the point of referral to the GMC across the organisations selected'.

The researchers will investigate a number of key questions including whether there are characteristics common to organisations with disproportionate levels of referrals to the GMC of BME doctors – and whether there are characterstics common to organisations that do not.

It will also look at factors that might influence referral to the GMC including perceived or actual differences between doctors, for example their English-speaking ability and whether they trained outside the UK, the working environment, the support available to doctors and the overal leadership and clinical governance within the organisations.

'Unconscious bias'

When plans for the research were first announced in April, BMA chair Chaand Nagpaul said: ‘This is an important area and it’s positive that the GMC is commissioning this work. The BMA believes that we must address and tackle all aspects affecting BME doctors in the NHS from different levels of attainment and increased levels of referrals for disciplinary and performance issues, to concerns regarding bullying and harassment, and unequal levels of achievement and career progression.’

The review comes two years after a separate GMC report found that BME medical graduates faced unconscious bias and were significantly less likely to pass exams than their white counterparts.

Read the full terms of reference here

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