The GMC has said it will consider proposals to establish ‘measures and targets’ to mitigate bias against ethnic minority doctors in fitness-to-practise (FTP) referrals.
It will also look at proposals to address the ‘attainment gap’ faced by medical students and trainees from Black, Asian and minority ethnic (BAME) backgrounds, it said.
However, the GMC is yet to give any indication of what these ‘targets’ might be.
GP leaders called for ‘concrete proposals’ rather than further empty promises from the regulator, amid the scant details on the plans.
Submitting a case study to a Professional Standards Authority for Health and Social Care (PSA) report published last week, the GMC said it has renewed efforts to reduce ‘race-related differentials’ amid ‘compelling’ evidence that further action is needed.
It said: ‘Our Council will soon be considering proposals to establish measures and targets around FTP referrals and differential attainment to focus energy and highlight system-wide progress on improving these outcomes more clearly.’
In 2020, 38% of licensed doctors in the UK were BAME but this is growing – with 61% of new doctors joining the register in 2020 being BAME, compared with 42% in 2017 – according to the report.
The GMC said: ‘As the number of BAME doctors in the UK workforce grows, the evidence is clear that they continue to experience disadvantage and differential treatment – in particular, BAME students/trainees experience an attainment gap in medical education and training and employers are significantly more likely to refer BAME doctors to the GMC for FTP concerns than their white peers.
‘Both issues have been longstanding concerns for the GMC.’
The regulator will seek to make working environments ‘more inclusive and supportive’ so as to promote ‘fairer outcomes’, it added.
It said: ‘The reality is that those in the “out group” enjoy lesser protective factors than the “in group”. This manifests in reduced quality and frequency of feedback and limited informal mentoring and sponsorship.’
The GMC concluded that although the issues are ‘complex’ and efforts to mitigate them could place a ‘burden’ on doctors, they ‘cannot be ignored’.
It said: ‘We know that making meaningful change requires others to commit their resources to addressing the underlying issues and that this work will risk being perceived as a burden on a pandemic-exhausted system and profession.
‘[But] the pandemic has highlighted more than ever that a professional’s individual health and well-being is central to their ability to deliver good care and we must focus our attention on supporting the right environments to enable doctors to do so.’
Dr Chandra Kanneganti, chair of the British International Doctors’ Association (BIDA), called for more detailed proposals to reassure ethnic minority doctors that GMC processes are ‘fair’.
He told Pulse: ‘More needs to be done and every time we bring up this issue about disproportionate referrals of ethnic minority doctors for FTP reviews, the GMC comes out with some kind of study or professor coming and looking at the data. I don’t think I have ever seen any concrete proposals from GMC on how to mitigate this.
‘The only thing we don’t want is one more study – we want key actions on what they think they’re going to implement.’
Dr Kanneganti added: ‘GMC has to learn about how they actually make ethnic minority doctors reassured that their systems and processes are fair. That takes a long time and it’s been promised a number of times, but nothing concrete has ever come through.’
However, the GMC declined to share further details of the plans at this stage.
Dr Ramesh Mehta, president of the British Association of Physicians of Indian Origin (BAPIO), told Pulse it is ‘unfortunate’ the GMC is ‘taking time’ to look into the ‘really significant problem’ of differential attainment.
He added that the GMC – which is ‘responsible and accountable for all the undergraduate and postgraduate training and assessment’ – must act now as ‘hardly anything has changed’ since BAPIO took the RCGP to court over its MRCGP exam in 2013.
At the time, BAPIO said it would not appeal the High Court’s decision that the MRCGP exam was lawful, but said the organisation would be willing to challenge the RCGP ‘if no solution is found’ – and again threatened the RCGP with legal action in 2019.
Dr Mehta said: ‘What are they doing? Why are things not changing when it is so obvious that there is blatant discrimination against ethnic minority doctors?
‘They agree that there is a problem [and] things must change, but in real life nothing happens. We don’t want the talk.’
BAPIO is calling for a replacement of the final three-hour clinical skills assessment (CSA) exam with rolling assessment across the three years of training, for videos to be taken of the exam and for two examiners instead of one.
It comes as the PSA report also said that the backlog in GMC hearings caused by the lockdown will create ‘unavoidable’ stress for GPs facing investigation.
In January, the GMC said it has learned ‘a great deal’ about supporting doctors’ wellbeing from the high-profile 2018 legal case concerning Dr Hadiza Bawa-Garba – including on BAME doctors being more likely to be subject to FTP complaints.