28 Apr 2010 00:00:00.000
Doctors who are male, from lower income groups and have experienced academic difficulties at medical school are more likely to find themselves in front of the General Medical Council (GMC) for professional misconduct, according to research published on bmj.com today.
The study was carried out by Janet Yates, a research fellow in the Medical Education Unit and Emeritus Professor David James, Foundation Director of the Medical Education Unit in Nottingham Medical School. They emphasise that this is a small study and that the findings are preliminary and should be interpreted with caution.
While only a relatively small number of doctors are found guilty of serious complaints, a number of high profile cases have led to significant media coverage and public concern about doctors who fail to maintain adequate professional standards. It is important, says the study, that research into this area is ongoing in order "to protect the integrity of the professional and maintain the public confidence."
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The authors compared the applications and medical school progress of 59 GMC misconduct cases with 236 individuals who had not been referred to the GMC. The personal details of all participants were fully anonymised before their student progress files were sent to the authors for analysis. The majority of individuals (69 per cent) had completed their medical courses between 1968 and 1987.
The results show that GMC misconduct cases were more likely to be male and from lower social class groups and they were more likely to have failed exams, repeated parts of their courses or had a lower overall performance than their peers. The misconduct cases were also possibly less likely to have achieved Consultant status or to be on the GP Register.
Professor James said: “This small preliminary study provides the first evidence in the UK that male students and those who perform poorly in the early years of the course might be at slightly increased risk of subsequent professional misconduct. Lower social class background (as estimated from the father’s occupation at course entry) was also an independent risk factor in this retrospective study.”
The authors say that the “lower social class background is a sensitive finding” and one that they cannot explain. However, they stress that they are not suggesting “that such students should be viewed differently to any others because we have demonstrated only a relative risk, and the absolute risk for an individual from any background is small.” The majority of individuals potentially at risk will not actually have any problems.
They maintain that the data must be viewed in context, saying: “Eighty six per cent of the doctors in our study graduated at least 20 years ago when life at medical school and in the profession may have been different. Also social class is both notoriously difficult to define and subject to frequent re-evaluation.”
The authors conclude that poorly performing students should receive additional support and mentoring and that more detailed research in this area needs to be carried out.
Professor Ian Hall, the Dean of Nottingham Medical School commented: “Only a very small proportion of students entering medical schools are subsequently referred to the GMC after they qualify. This study looked at students entering medical school some time ago, and there have been significant changes over recent years to medical school courses which I believe will have helped support students who perform less well in the early stages of their courses. Nonetheless, it is in the interests of students, doctors and patients if we can continue to develop the best possible support for all our students. The recent GMC guidance on professionalism contained in Tomorrow’s Doctors 2009 will also help medical schools develop in this area”.
Click here to view paper under embargo: http://press.psprings.co.uk/bmj/april/students.pdf
URL for readers to click on once embargo lifted: http://www.bmj.com/cgi/doi/10.1136/bmj.c2040
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Notes to editors
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More than 90 per cent of research at The University of Nottingham is of international quality, according to RAE 2008, with almost 60 per cent of all research defined as ‘world-leading’ or ‘internationally excellent’. Research Fortnight analysis of RAE 2008 ranks the University 7th in the UK by research power. In 27 subject areas, the University features in the UK Top Ten, with 14 of those in the Top Five.
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