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Junior doctors and fitness to practice procedures in the UK: analysis of factors prompting tribunal referrals and outcomes
  1. Helen Grote1,
  2. Flora Greig2
  1. 1 Department of Neurology, Chelsea and Westminster Healthcare NHS Trust, London, UK
  2. 2 Department of Psychological Medicine, King's College Hospital, London, UK
  1. Correspondence to Dr Helen Grote, Chelsea and Westminster Healthcare NHS Trust, London, UK; helen.grote{at}


Purpose of the study To ascertain factors influencing referral to, and outcomes from medical tribunals for junior doctors with less than 7 years of postgraduate training.

Study design A mixed methods analysis of 49 publicly available determinations from the UK Medical Practitioner Tribunal Service (MPTS) between 2014 and 2020 was undertaken. Data on demographics, training grade, type of case and outcomes from the tribunal were recorded. A qualitative thematic analysis of the determinations was also undertaken, with themes being identified based on frequency and pertinence to the process of determination.

Results The largest group of junior doctors referred to an MPTS tribunal (38%) was those on the foundation programme; in their first 2 years postgraduation. Fifty-three per cent of all junior doctors referred to a tribunal were erased from the medical register. Erasure from the register was significantly associated with male gender, less than 4 years postqualification, non-attendance at the tribunal hearing, lack of legal representation and lack of insight or remorse at the tribunal hearing. Several cases involved dishonesty in relation to academic achievements and workplace-based assessments.

Conclusion Consideration should be given as to how best to support the transition in professional identity from student to doctor. Teaching medical professionalism should be a priority in undergraduate and early postgraduate education, with lessons from fitness to practice tribunals shared for educational purposes.

  • education & training (see medical education & training)
  • law (see medical law)
  • medical law

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  • Contributors The concept for the paper was devised by HG. HG submitted the original FOI request. Data were analysed by both authors independently; joint consensus was reached where discrepancies were observed. The paper was written jointly. Figure 1 was prepared by HG, with other figures and statistics prepared by FG. The final paper for publication was prepared by HG, who is signing on behalf of both authors as guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests HG is a medical tribunal member for the MPTS.

  • Provenance and peer review Not commissioned; externally peer reviewed.