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Guidance on declaring health issues

When you apply to join the medical register, you need to tell us about any health conditions that could affect your fitness to practise.

When you apply for registration you’ll be asked a series of questions about your health, these are in the blue boxes below. Before you answer these questions, you should read this guidance carefully.

Contents

Why your health matters

Your health and patient safety

We understand that medicine is a challenging profession that is very rewarding, but it can also be stressful. Taking care of your patient is the first duty of every doctor – to do this, you need to look after your own health and wellbeing.

You don’t always need to tell us if you have a health condition. But this guidance explains when you do. Please read it carefully before answering the questions.

We don't provide a list of health conditions that you need to tell us about. This is because we need to know, not so much about the condition itself, but about the effect that it may be having on your ability to care for your patients.
The effect that a health condition has will vary from person to person. It will depend on the seriousness of your condition, the help you may be receiving, and how much insight you have into its impact on your practice. Your ability to work safely can be enhanced by the support network you have, whether that is at medical school, at work or at home from the clinician(s) treating you.

Even if you answer yes to one of the questions, if you can show that you are managing your health and that it will not affect patient safety, it is unlikely there will be an impact on the outcome of your application.

What does Good medical practice say about doctors’ health?

Paragraph 28 of Good medical practice says that if you know or suspect that you have a serious condition that you could pass on to patients, or if your judgement or performance could be affected by a condition or its treatment, you must consult a suitably-qualified colleague (an independent licensed doctor or health professional). You must follow their advice about any changes to your practice they believe necessary. You must not rely on your own assessment of the risk to patients.

Do I need to tell you about my health condition?

If any of the statements in the blue text boxes apply to you, you need to tell us about your health condition. To answer the statements you will need to read the definitions below.

Throughout this guidance, and in the fitness to practise declaration, we use the term ‘health condition’ to mean an illness, injury, disability, or impairment. This includes physical and mental conditions.

I have, or have had a health condition(s) which required me to change one or more aspects of my medical training or practice, to enable me to work safely with patients or to continue my training.

A ‘change’ in this context means that you have been advised or requested to change your practice, training or study. This could include adaptations to equipment, additional support, facilities or changes to your working arrangements such as less-than-full-time work. The change could be required or recommended by your medical school, foundation school, employer, occupational health service, treating physician/health professional, or you might have requested it yourself.

I have, or have had, a health condition(s) which has resulted in an interruption to, or breaks in my medical practice or studies, including retaking any part of my course or assessments/exams.

An interruption means one or more breaks that have had major impact on your medical practice, study or clinical placements due to a physical or mental health condition.

For medical students, this is most likely to mean breaks that have resulted in you becoming 'out of step' with your peers. For example, this might have meant that due to your condition, you will graduate a year later than planned, or you have had to stop your studies for a significant length of time and re-joined your course at a later point.

For established doctors, this is likely to result in you having taken a significant break from, or ended your employment or interrupted your training. If your physical or mental health condition was not a reason for an interruption or break, you don't need to declare it here.

I have, or have had, a health condition(s), which has resulted in conditions being placed or undertakings being agreed in relation to my medical practice, training or registration.

A ‘condition’ means certain restrictions have been placed on your practice (such as not performing a particular procedure).

An ‘undertaking’ is an agreement, usually between a medical regulator or a medical school and you, about how you will adjust your practice to ensure patient safety. Undertakings may also include restrictions on your practice.

I have, or have had, a health condition(s) which has been considered under fitness to practise proceedings whether in the UK or overseas.

‘Fitness to practise proceedings’ means a process to decide whether your fitness to practise is impaired, resulting from concerns about your ability to practise safely and effectively.

For students, this includes fitness to practise processes within medical schools, or any other medical school investigation into the impact of your health or ability to complete the course.

For established doctors, this may have been proceedings carried out by your employer or by a medical regulator either in the UK or overseas.

Is there anything about your physical or mental health, which could prevent you meeting the standards described in our guidance?

‘Our guidance’ includes Good medical practice and Outcomes for provisionally registered doctors (The Trainee Doctor).

Answering yes: what happens next

What will happen if I answer yes to any of these questions?

If you answer yes to any of the statements above, we’ll ask you to provide further information about your health condition on your online application. There is a text box where you can tell us about:

  • your health condition
  • how this has affected you
  • how this has affected your medial practice or studies
  • how you are managing it
  • any relevant dates of occurrences and treatment

Once we have your information, we’ll aim to assess it within five working days. If we need more information we’ll let you know within that timeframe.

In a small number of cases, we may ask for more information from a third party. For example, from an occupational health practitioner, a doctor or a health professional who is treating you. But if we do, we’ll ask for your consent.

Will you treat my health information confidentially?

We treat all matters about your health in the strictest confidence. We only share information with those who need it to deal with your application, such as the caseworker and the assistant registrar (the decision maker) who is dealing with your application. If the assistant registrar wants advice from a registration panel, your application will also be shared with the panellists.

Our staff and registration panellists have all had comprehensive training on keeping confidential information secure.

When will you make a decision on my application?

We know how important it is to give you a quick decision on your application, so we make decisions on applications as soon as we can. Throughout the process we give you regular updates on how your application is progressing.

In most cases – about 80% – where a health condition has been declared we make a decision to approve an application within four weeks.

What about applications that take more time?

Some applications can take a bit longer for a number of reasons. For example if there are a number of complex factors to consider or if we are waiting for evidence from you. Or in some cases, an assistant registrar will decide that they need advice from a panel. If your application is referred to a panel for advice we will give you:

  • the date of the panel in advance
  • an opportunity to send further information
  • further information about what happens at the registration panels.

Very occasionally, in exceptional circumstances, we have to make the difficult decision to refuse an application. If we refuse your application, we’ll send you a detailed report to explain our decision. You’ll also have a right to appeal the decision. If your application is refused, you can make a further application and send evidence to show that you’ve addressed the concerns we identified in our decision.

This flow chart shows you how we’ll deal with your application and the possible outcomes:

How can I speed up the decision on my application?

Where we can grant a licence, we want to give you our decision early so that you are ready to take up your offer of employment. You can help by:

  • making your application in plenty of time – at least three months before you first need to start work.
  • giving us all the information we have asked for, promptly
  • keeping your contact details up to date by logging on to GMC Online.

If you do not send us the information we ask for in the timeframe we give you, or keep us up to date, then we may close your application.

Frequently Asked Questions

Is a disability considered a health condition for the purposes of this declaration?

The important thing is whether your health condition, illness or disability, impacts on your ability to work safely with patients. In many cases, doctors with a disability or health condition can practise medicine safely.

If, as a result of any health condition, illness or disability, you have answered yes to any of the statements above, you should tell us about it when you complete the declaration section of your application, relating to fitness to practise and health matters.

Who else might I need to tell about my health condition?

You have a duty to tell your employer about any health condition that may affect your ability to practise medicine.

If you are in a Foundation Programme year one post or a locum appointment for training post, you’ll need to make sure that your foundation school or employer knows about your condition(s). They may need to make reasonable adjustments so you can work safely with patients. The national transfer of information process is the best way to tell your foundation school that you need reasonable adjustments. You can find out more about this process on the Medical Schools Council's website.

If I have a health condition, will you refuse to register me?

Having a health condition is not, in itself, a reason for us to refuse to grant a licence. What we’re looking at, is whether your health affects your fitness to practise. Even if your illness is serious, it doesn’t necessarily mean that you can’t practise safely.

We do need to assure ourselves that you are managing your condition and that patients are protected. Sometimes we may ask for evidence to show that you are seeking appropriate support or treatment for your own benefit and to ensure your continued safe practice.

When do you need to request information from a third party?

In making your application for a licence to practise, you have agreed that we can make investigations. Sometimes, when dealing with matters of health, we will need to contact a third party for further information; in these cases we will ask for additional consent from you.

We will send you a copy of any information we receive from third parties and ask for your comments on it, before we make a decision on your application.

What should I do if I want you to share information about my application with a third party?

If you want us to share information with a third party (this might be your medical school, foundation school or employer) about what is happening with your application for a licence, you will need to give us your written consent.

What things do you consider when deciding if my health condition affects my fitness to practise?

If you tell us about a physical or mental health condition, we must decide whether it affects your fitness to practise. We ask ourselves questions such as:

  • Does your health condition affect your judgement or your ability to care for patients?
  • Have you sought independent advice and treatment for your condition from a suitably qualified independent healthcare professional?
  • If appropriate, have you followed their advice for managing the condition, including taking prescribed medication and making changes to your medical practice, so that you can work safely with patients?
  • If appropriate, have you told your employer or potential employer about your condition and about any adjustments you need so that you can work safely with patients?

What will happen if I don’t tell you about a relevant health condition?

We recognise that it can be difficult to decide whether you need to tell us about a health condition. We only need to know about those conditions where the statements set out in the Do I need to tell you about my health condition (above) apply.

Having read this guidance, if you decide not to tell us about a relevant health condition, it will raise additional concern if we find that your condition could impact on your fitness to practise.

In reaching that conclusion we will take the following into account:

  • Whether you gave a reasonable explanation for not telling us.
  • Whether you made a deliberate decision to conceal information relevant to your fitness to practise or you were trying to mislead us.
  • Whether you have insight into the effect of your condition, and are fully aware of the potential impact on your ability to work safely with patients.

What advice do you have on managing my health?

If you are managing a health condition or living with a disability whilst being a doctor, you may find the following links helpful.

Our Your health matters web pages

Our guidance on managing your health

Our gateways guidance on access to medical education for disabled people

Other useful guidance

You may also find the following links helpful

Good medical practice

Promoting excellence: standards for medical education and training

Outcomes for graduates (Tomorrow’s Doctors)

Outcomes for provisionally registered doctors (The Trainee Doctor)

Medical students: professionalism and fitness to practise

Gateways to the professions – advising medical schools: encouraging disabled students

Supporting medical students with mental health conditions

Equality Act 2010 – guidance