Regulating doctors, ensuring good medical practice

Gateways guidance: 1.3 The need for this advisory guidance

A research report from the Higher Education Academy concluded that:

  1. ‘Generally, there appears to be a positive swell of opinion regarding the admission of disabled individuals to the study of medicine.’ 1 

Despite this, the interviews that informed this advisory guidance revealed that there is still some way to go and a wide variety of perceptions:

  1. ‘In medicine, doctors don’t want to see other doctors as ill. The interaction is complicated.’
  2. Trainee
  3. ‘Their attitude was that medicine is a stressful profession and given that I had mental health problems, I was better off out of it.’
  4. Medical student
  5. ‘The whole blame culture in medicine needs to be shifted and, in particular, doctors and students with disabilities should be encouraged to be open, not penalised for being so.’
  6. Member of Doctors' Support Network
  7. ‘I was told by my supervising consultant that I should come into work even when feeling unwell as I had to “act and be professional”.’
  8. Member of Doctors' Support Network
  9. ‘I was told by the course director not to ask for reasonable adjustments because it would set a precedent he didn’t want.’
  10. Medical student

But there were also many positive comments:

  1. ‘I was given a reduction of hours, a reduction of daytime on-call duties and no night time duties, no weekend calls and had very supportive consultants, occupational health and a psychiatrist who never had any doubt that I can and will continue my career.’
  2. Member of Doctors' Support Network
  3. ‘I had the needs assessment today and, as well as quite a bit of DSA [Disabled Students’ Allowance] funded stuff I didn't realise [what] I was entitled to. The recommendations included provision of reasonable adjustments such as clinical attachments being suitably located where possible, written exams being done in a small room as opposed to a large sports hall... and also to try and time OSCE exams so mine are earlier rather than later in the day. The assessor also suggested I have a mentor. It was a very useful meeting and I would never in a million years have thought to ask to be able to do my exams in a smaller room.’
  4. Medical student

Disabled students and trainees made it clear that they want:

  • good quality confidential medical care
  • good quality occupational health supervision
  • timely and accurate information
  • reasonable adjustments to teaching and learning, and assessment
  • understanding and supportive seniors
  • the offer of help
  • a representative who understands the rights of disabled people
  • protection from discrimination
  • a ‘disabled friendly’ environment
  • unprejudiced career advice.

This advisory guidance forms part of the GMC’s commitment to valuing diversity and promoting equality and to ensuring that its processes and procedures are fair, objective, transparent and free from unlawful discrimination.