Regulating doctors, ensuring good medical practice

Gateways guidance: 3.3 The implications of the GMC guidance for careers in medicine

Anyone can graduate if they meet all the outcomes and curricular requirements set out in Tomorrow’s Doctors and meet the university’s regulations. On graduation, they will obtain provisional GMC registration, subject to the GMC being assured about their fitness to practise. Many students with a wide range of impairments, illnesses and health conditions successfully achieve the required standards of knowledge, skills and behaviours to become a doctor and practise at the high level required to ensure patient safety.

Some prospective medical students and some existing students may not be able to progress with their studies, even with an appropriate range of adjustments and support in place. This might be the case, for example, if a student sustains a serious brain injury with a loss of cognitive skills that makes it impossible to continue learning; or if a student sustains an injury that makes it impossible to carry out some of the required clinical and practical skills. The 2009 edition of Tomorrow’s Doctors includes a list of practical skills that graduates must be able to demonstrate from 2012.

After graduation, doctors may develop a physical, sensory or mental impairment, in which case the following guidance applies:

  • Reasonable adjustments may allow the doctor to continue to practise as they have been doing.
  • In some cases, the doctor may need to modify their practice.
  • If a doctor does modify their practice, there is no need for the GMC to be involved.
  • Having a health condition, an illness or an impairment does not make a doctor unsafe as long as they recognise and work within the limits of their competence, as any good doctor should do.

Notwithstanding the arrangements for doctors in practice, all students seeking to graduate and acquire provisional registration must at that point be able to demonstrate all of the outcomes set by the GMC in Tomorrow’s Doctors. The GMC has no legal ability to grant a conditional, restricted or limited licence to practise at the point of initial registration and the medical schools are not empowered to grant students dispensation from the requirements set in Tomorrow’s Doctors.