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

Post date: 17/05/2022 | Time to read article: 3 mins

The information within this article was correct at the time of publishing. Last updated 17/05/2022

Nearly two in five doctors (37%) who graduated overseas did not have legal representation when facing a Medical Practitioners Tribunal Service (MPTS) hearing, according to figures obtained by Medical Protection covering 2018-21.

The figures, obtained by Medical Protection through an FOI request to the General Medical Council (GMC), also showed that those overseas medical graduates without legal representation were more likely to receive a harsher sanction. 83% were either suspended or erased from the medical register, and only 8% received a ‘no impairment’ judgment.

In comparison, 55% of overseas medical graduates with legal representation were either suspended or erased from the medical register, and 27% received a no impairment judgment.  A more lenient ‘warning’ - indicating when a doctor's behaviour or performance is below the standards expected and should not be repeated – was also a more common outcome for those overseas graduates with legal representation.

Medical Protection is calling for it to be mandatory for NHS Trusts to provide overseas graduates with a tailored induction programme, which strongly recommends membership with a medical defence organisation (MDO). It said the GMC also has a role to play in ensuring the induction is comprehensive and encouraging doctors to join an MDO when they arrive in the UK to start work, so they do not risk facing a fitness to practise hearing alone. The state indemnity schemes only assist with NHS clinical negligence claims.

Professor Dame Jane Dacre, Medical Protection President, said: “We have been talking with doctors who qualified overseas to gauge their understanding of the healthcare system and indemnity arrangements when they arrived in the UK. Only 52% said they joined an MDO when they arrived and started work. The GMC figures serve as a powerful reminder of how important it is for these doctors to ensure they have support with GMC investigations as soon as they start work.

“Medical Protection supports doctors from the moment a GMC complaint is received, to its conclusion at a tribunal. We see how a GMC investigation impacts on the doctors’ mental health and reputation. GMC 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 though, 37% of doctors who graduated overseas do, compared to 25% of doctors who trained in the UK. And the majority of that 37% 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 UK healthcare can be bewildering for any doctor. But it can be even more difficult for those who did not train in the UK. Indeed, professional protection requirements in the UK are different to those in other countries and many coming to work in the NHS may assume that the state indemnity schemes provide blanket protection.

“In fact, the state schemes only assist with NHS clinical negligence claims. Support with GMC investigations, complaints, inquests and disciplinary proceedings is also vital and most doctors obtain this though membership with an MDO.

“We believe NHS Trusts and the GMC could do more to help those new to the UK to understand the importance of registering with an MDO, and we look forward to working with them on this.”

The first in Medical Protection’s series of tailored live virtual events for overseas graduates will take place on 19 May. Those who have recently moved to the UK, or are planning to move to the UK soon, can hear from speakers who are medical experts and have experienced the process themselves, and take part in a Q&A. Register at:


For further information contact Kate Tullett, Media Manager at MPS: E:  T:+44 (0)7515 298791.

About MPS

The Medical Protection Society Limited (“MPS”) is the world’s leading protection organisation for doctors, dentists and healthcare professionals. We protect and support the professional interests of almost 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.

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