Registering with us for a licence to practise
Registration with conditions or restrictions
We cannot grant registration with restrictions or conditions.
At the point of registration our decision is binary – to either grant registration or not, without additional registration categories. This is different to a registered doctor, who can have conditions placed on their registration during their career.
Applying for provisional and full registration
The next step after completing an undergraduate medical degree is to undertake an acceptable programme for provisionally registered doctors. In the UK, this is the first year of the Foundation Programme (F1). On successful completion of F1, doctors fully register with us and continue to the second year of the Foundation Programme (F2).
To gain registration, medical graduates and doctors have to apply with us. All applicants are asked to complete a declaration about their health as part of the application process.
This declaration asks specific questions about the applicant's health, but not all health conditions or disabilities need to be declared. We don't provide a list of health conditions that need to be declared. Applicants can read through the questions and decide if they should declare anything. We only need to know about an issue that may affect the applicant's ability to practise or care for their patients. The effect a condition has on an individual, and any potential effect on their practice, will vary from person to person.
If an applicant answers yes to one of the declaration questions, we'll ask them to give further information on their application. The applicant can tell us more about their health condition, any relevant dates of occurrences and treatment, how they are managing it, and how this has affected them, their practice or studies. In a small number of cases, we may then ask for more information from a third party if they have the applicant's consent, for example from an occupational health physician.
Just because a student or a doctor is unwell, even if the illness is serious, it does not mean that their fitness to practise is impaired. Even if an applicant answers yes to one of the questions, if they can show that they are managing their health and that it will not affect patient safety, it is unlikely there will be an impact on the outcome of their application. You can find full guidance on the registration application process on our website.
Panel 4: How often do we refuse registration?
Extremely rarely. We have refused provisional registration in a very small number of cases; 39 cases in 2010–18, compared to around 58,000 applications received in the same period. Of these graduates, a substantial number re-applied in the following years and were granted provisional registration.
As the professional regulator, we rarely need information about a doctor’s health conditions or disabilities while they are practising. Doctors practise with short- or long-term health conditions and disabilities all the time, as in any other profession. Most of the time, a doctor’s health or disability is not a concern for us.
On a system-wide level, the Promoting excellence standards place requirements on organisations responsible for postgraduate training to support their learners. To make sure this is happening, we take proportionate action if concerns are raised to us that our standards are not being met.
Every licensed doctor who practises medicine must revalidate. Most doctors have a connection to a designated body, including locum doctors, and the responsible officer must support doctors in accessing appraisal and the systems for collecting supporting information. This includes putting specific arrangements in place for a disabled doctor to undertake their appraisal. We expect designated bodies to integrate equality and diversity considerations into all of their medical revalidation process, as set out in our Effective governance to support revalidation handbook.
Our requirements for revalidation are high level and not prescriptive. This allows flexibility for our requirements to be adapted to individual doctors' circumstances. For example, our says that a doctor does not need to have completed five appraisals to revalidate successfully, as they could have missed an appraisal due to ill health.
We can also give additional time in the revalidation process by guiding Responsible Officers to make a recommendation to defer for doctors who have been unable to meet all of the requirements by their revalidation date and again there are reasonable circumstances to account for this (see a case study on deferring a doctor's revalidation date).
We know that there are a small number of doctors who may not have a designated body and have to access their own independent appraiser. A doctor with a disability may find this challenging and in these circumstances we will help support them in meeting the requirements for their revalidation. Doctors who wish to discuss this or other revalidation queries can contact us at email@example.com.
Panel 5: Examples of revalidation support
A doctor had double vision as a result of a stroke and had not submitted his annual return.
The doctor advised they were struggling to complete this online. We offered to provide a hard copy in large print for the doctor.
A doctor was unable to attend the revalidation assessment in Manchester as they were unable to travel due to their disability. We undertook an assessment of what the doctor required. We arranged for the doctor to undertake the assessment in our London office instead and allowed additional time for them to complete the paper.
A doctor was struggling with all the requirements for their revalidation as they had dyslexia. We gave the doctor more time to meet the requirements and helped them in establishing if they had a connection to a designated body.
Panel 6: Health and fitness to practise addressing the perceived risk to patient safety
Having a health condition or disability does not automatically mean a doctor’s fitness to practise is impaired. Having a health or disability also does not mean there is an inherent risk to patient safety. A reasonable adjustment or support measure requested for a doctor with a health condition or disability is not inherently a risk to patients. This diagram explains how a doctor’s health, fitness to practise, and patient safety are related to each other according to our guidance.