Doctors who graduated overseas face harsher sanctions when unrepresented at medical tribunals

25 July 2022

Over half of doctors (55%) who graduated overseas did not have legal representation when facing a fitness-to-practice hearing with the Medical Council, according to figures obtained by Medical Protection covering 2018-21.

The figures, obtained by Medical Protection through an FOI request to the Medical Council, also showed that those overseas medical graduates without legal representation were more likely to receive a harsher sanction – 30% either had their registration suspended or cancelled from the medical register. In comparison, merely 6% of overseas medical graduates with legal representation either had their registration suspended or cancelled.

A higher proportion (14%) of overseas medical graduates with legal representation had a ‘no findings’ outcome – the most lenient outcome – at their fitness-to-practice hearings, while only 3% of those without legal representation received that outcome.

The Medical Practitioners (Amendment) Act 2017 makes it mandatory for all doctors to provide evidence to the Medical Council that they have adequate indemnity which protects them from clinical negligence claims. Medical Protection says this legal requirement is reassuring for both doctors and patients, but may not be sufficient given doctors require support with other matters such as fitness-to-practice hearings, complaints, or disciplinary proceedings arising from their clinical work.

Legal representation at fitness to practice hearings can be extremely stressful and costly, and many doctors will be unable to self-fund their defence if they do not have protection in place. Medical Protection said more could be done to help doctors who are new to the country, understand the need for comprehensive professional protection.

Dr Rob Hendry, Medical Director at Medical Protection said:

“Medical Protection supports doctors from the moment a Medical Council complaint is received, to its conclusion at a tribunal. We see how a Medical Council investigation impacts on the doctors’ mental health and reputation. Medical Council investigations often take several months – and sometimes years – to conclude and the hearings can last weeks. For some, fitness to practise proceedings have career ending implications.

“I cannot imagine facing this process alone, without someone fighting my corner. Sadly, 55% of doctors who graduated overseas do, compared to 32% of doctors who trained in Ireland. And the majority of that 55% go on to face tougher sanctions at their hearing when compared to those with legal representation.

“The various guidelines and requirements that come with working in Irish healthcare can be bewildering for any doctor. But it can be even more difficult for those who did not train in Ireland. Indeed, professional protection requirements in Ireland are different to those in other countries and many coming to work with the HSE may assume that the state Clinical Indemnity Scheme (CIS) provides blanket protection when it only protects against clinical negligence claims in the public sector.

“It is vital that doctors who are new to Ireland receive a better induction, including clear information about professional protection arrangements. We will also work with the Medical Council to see what more could be done at the point of registration to improve the information that new doctors from overseas receive.

“We believe the Medical Council, employers and locum agencies all have a role to play in making improvements in this area and we look forward to working with them on this.”


For further information contact:

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About Medical Protection

Medical Protection is a trading name of The Medical Protection Society Limited (“MPS”). MPS is the world’s leading protection organisation for doctors, dentists and healthcare professionals. We protect and support the professional interests of more than 300,000 members around the world. Membership provides access to expert advice and support and can also provide, depending on the type of membership required, the right to request indemnity for any complaints or claims arising

from professional practice.

Our in-house experts assist with the wide range of legal and ethical problems that arise from professional practice. This can include clinical negligence claims, complaints, medical and dental council inquiries, legal and ethical dilemmas, disciplinary procedures, inquests and fatal accident inquiries.

Our philosophy is to support safe practice in medicine and dentistry by helping to avert problems in the first place. We do this by promoting risk management through our workshops, E-learning, clinical risk assessments, publications, conferences, lectures and presentations.

MPS is not an insurance company. All the benefits of membership of MPS are discretionary as set out in the Memorandum and Articles of Association.