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GMC considering ‘targets’ for tackling FTP bias against ethnic minority doctors


FTP referral


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.

Last year, GP trainees also demanded tougher action from Health Education England (HEE) to tackle racism during medical training.

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.

READERS' COMMENTS [7]

terry sullivan 20 April, 2021 11:05 am

yet more anti-white discrimination

time for the gmc quango to be fully funded by govt

Not Arvind Madan 20 April, 2021 12:00 pm

Anti white discrimination?

Go and have a look at the FTP list and you will see how silly your comment is.

Its not a race to the bottom

Jane Boskovic 20 April, 2021 12:29 pm

Agree my BAME Colleagues face hurdles… but its not only about race.
White immigrants face an awful lot of nastiness as well. A great trick in the NHS in dysfunctional units is to gang up and frankly lie when a doctor is disliked or tries to bring in clincal changes etc. The real answer is to reduce blame, stop abusing staff with understaffed and stop making meals out of mole hills!

Jane Boskovic 20 April, 2021 12:32 pm

Previous comment mixed metaphor deliberately utilised!!!

Patrufini Duffy 20 April, 2021 2:09 pm

The British go around the world hoovering up other countries staff with “golden dirty handshakes” for lack of their own home recruitment, or any desire to care for their own and then they get shafted for just turning up to the perversely patient-centred job, when their English is a bit off, or upper lip not so stiff. Kids want to be in marketing, advertising and tech, so be it. But the “institute” sticks BAME “workers” in jobs with no training numbers, made to work in the desolate sticks, churning out hours and shifts on understaffed wards, with condescending managers pushing their warped weight. The problem is more stupid the more one thinks about it, if you can think about it, and some sit on the high horse saying, you’re not good or safe enough. How hippocritical. Perhaps thhr patient themselves isn’t “safe” or “effective” anymore. Look at that? The NHS will always need BAME “workers”, but don’t talk about them like slaves, or “workers”. It’s a WHS – world system, keeping the British privilege going.

David Jarvis 20 April, 2021 5:35 pm

Not a GMC apologist but I do wonder if patients are more likely to complain about doctors with foreign accents or different skin colour. The ungrateful gits

Hank Beerstecher 21 April, 2021 12:32 pm

The GMC commissioned a study to prove they were not racist. The same way a prison warden does not have to be racist if the prison is filled disproportionately with ethnic minority, or the guards at Auschwitz processed the trains arriving do not have to be antisemitic. The GMC responds to referrals and the institutional bullying culture in the NHS generates the referrals. Foreign graduates and ethnic minorities make easier targets for prejudice and bullying. GMC should examine the sources of the referrals and the history of the sources of the referrals, locally virtually all single handed practices were referred to CQC or GMC by NHS England over 15 years. In the recent MPTS cases there was a locum ED consultant accused of not giving 50% dextrose for hypercalcaemia, turns out there was no 50% dextrose available, so put up a 10% drip instead, GMC referred to MPTS you could not make it up.
(COI: I was referred with a false allegation of dishonesty – GMC will refer all dishonesty allegations to MPTS hearing*. COI: although a foreign graduate I pass for white having 25%/75% ethnic/caucasian genes.)
https://www.youtube.com/watch?v=veLGakjY9SU -26 minutes mark