GMC wants to be fairer to doctors

The GMC is taking concrete steps to identify and mitigate bias wherever it appears in its regulation.

Prof Dame Carrie MacEwen

In a letter to the profession, the council’s chairwoman Prof Dame Carrie MacEwen says building in robust controls to the way it works can assure doctors, the public and itself that its approach is fair at all times and in all circumstances. 

Her letter says:

‘The ethnic make-up of the UK medical profession is becoming increasingly diverse. In 2021, more international medical graduates joined the medical register than UK graduates and just under half of all trainees were from an ethnic minority background. 

‘While we are seeing the demography of doctors evolve, indicators of inclusion and equality remain stubbornly fixed.

We recently published data that show that ethnic minority doctors continue to experience significant disparities in exam pass rates, despite increasing efforts to reverse this trend. In specialty exams, Asian trainees have a pass rate of 68%, compared to 79% for white trainees. 

‘For UK graduates of black and black-British heritage, the figure is even lower at 62%. These disparities are compounded by socio-economic status, with pass rates of 67% for the most affluent UK black trainees, compared to 59% for the least affluent. 

‘This imbalance persists through­­out a doctor’s career, baking in disadvantage across the years. When it comes to the selection of F2 doctors into specialty training, we found that a higher proportion of white trainees were offered posts than those from ethnic minority groups. 

‘While those on the receiving end of discrimination may not be surprised by these findings, it is shocking, and salutary, to see this state of affairs documented so starkly.


Quantifying inequalities 

‘Accurately quantifying these inequalities is crucial if we’re to tackle them definitively. Every year, the national training survey (NTS) of doctors in training and trainers helps us pinpoint where action needs to be taken to ensure that every doctor has the fair, supportive and inclusive working environment they deserve. 

‘This year, we’re including new questions specifically on discrimination, from micro-aggressions and stereotyping, to the availability of mentorship and support.

‘The results of the NTS, which we will get in the summer, will provide detailed, granular data. 

‘This will help those responsible for education and training to target initiatives that improve all aspects of doctors’ workplace and training experiences, no matter who they are or where they work. These efforts are a critical part of helping us achieve our target to eliminate differential attainment in medical education by 2031.

‘Tackling deep-seated disadvantage in medicine requires a concerted, sustained effort from all involved in the health system. For us at the GMC, that means working with our partners to effect change, but also looking inward at our own work.

Fairness of procedures

‘Confidence in the fairness of our processes is at the heart of being an effective and compassionate regulator. Without it, trust is eroded and fear festers. 

‘That’s why we’re taking concrete steps to proactively identify and mitigate bias wherever it may appear in our regulation. By building in robust controls to the way we work, we can assure the profession, the public and ourselves that our approach is fair at all times, and in all circumstances. 

‘I believe that supportive cultures and inclusive leadership are the most important drivers of compassionate care. Making sure every clinician has a fair chance to reach their full potential is therefore not just vital for them, but also for their patients. 

‘We are committed to playing our part, so that every doctor, from every background, has the opportunity to thrive.’