As a black doctor, am I more likely to be referred to the GMC by my employer?

Referrals are more likely

Udvitha Nandasoma, MDU head of advisory services, says, “The General Medical Council’s State of Medical Education and Practice1 revealed in 2023 that the number of doctors from ethnic minorities was higher than that of white doctors for the first time. The number of black or black British doctors and those with ‘other’ ethnicity increased by two thirds (67%) between 2019 and 2023.

“As a doctor from an ethnic minority you are twice as likely to be referred to the GMC2 by your employer as a white colleague. And doctors who graduated outside the UK are three times more likely to be referred to a fitness to practise process by their employer than UK graduates.

“Despite this disparity it’s important to remember that the overall risk of being referred to the GMC remains relatively low. The latest figures show that between 2018 and 2022 0.22% of white doctors were referred to the GMC by their employer compared with 0.41% of doctors from an ethnic minority. The GMC has pledged to eliminate this disparity by 2026.

“Changes at the GMC are only part of the solution. Employers must also improve their support for doctors, especially those new to UK practice, with better induction and supportive interventions when things go wrong. This is key, given the growth of the UK medical workforce will mostly be driven by international medical graduates over the next 10 years.

“For MDU members involved in GMC provisional inquiries, the proportion of cases discontinued without any sanction being imposed on the doctor was similar for both UK graduates and international medical graduates at 82%. Being referred to the GMC is stressful, regardless of the outcome, and not all doctors benefit from medical defence organisation membership.

“Work must continue to ensure the process by which employers consider whether to refer, and how the GMC considers those referrals, is fair and transparent. The MDU website has an information hub for international medical graduates.3”

Seek out support

Patricia Ogunmakin, anaesthetics core trainee and education and training officer at Melanin Medics, says, “The possibility of a GMC referral can be daunting for any doctor, but for black doctors this concern is amplified by the evidence. As a black doctor, I am acutely aware of the challenges I might face.

“Data show that black doctors are more than twice as likely to be referred by their employers compared with their white colleagues, with those trained overseas at even greater risk. These disparities reflect complex personal and institutional factors that require thoughtful navigation and systemic change.

“To mitigate this, it is crucial to familiarise yourself with your work environment. It is fundamental to attend inductions, engage with and complete mandatory training, and seek shadowing opportunities. Don’t hesitate to ask for support from clinical supervisors and colleagues. Organisations like Melanin Medics can be an invaluable source of peer support, offering a safe space to discuss concerns and develop strategies to thrive. Having a support system of peers, buddies, or mentors not only aids personal development but is also vital for your wellbeing.

“Complaints are an inevitable part of medical practice and can arise long after an event has occurred. Keeping accurate, thorough, and timely documentation is essential. It’s a safeguard for both you and your patients. Joining a medical defence organisation early in your career is also vital—they can provide expert advice and support if you’re ever referred.

“For those working with black doctors, particularly those who are new to the NHS, advocacy is essential. I encourage colleagues to offer guidance during their transition, and employers to ensure transparency and inclusivity in their systems. A welcoming and supportive environment can make a profound difference. By taking proactive steps, we can collectively work to reduce the disparity in referrals of black doctors to the GMC.”

We have robust checks in place

Sondra Roberto, assistant director of outreach at the GMC, says, “The GMC receives over 7000 complaints a year, but the vast majority do not meet the threshold for investigation and are closed with no action being taken.

“Doctors from ethnic minorities are, however, disproportionately referred to us by their employer, as are doctors who trained outside the UK. Racism and prejudice remain part of the reality of our health system, and this is just one example of where some doctors from ethnic minorities are treated differently from their white colleagues.

“In 2021 we set an ambition to eliminate this disproportionality by 2026 and we are on track to meet that target. One area of focus has been the training delivered to responsible officers and employers to help them build supportive and inclusive cultures. For example, the professional behaviours patient safety training programme focuses on the delivery of constructive feedback at an early stage to prevent escalation to more serious problems.

“Responsible officers must now answer more questions before they make a referral to us. They must tell us how they’ve considered systemic problems, and any action they’ve taken locally to tackle them. They must also confirm they’ve undertaken impartial checks to ensure the referral is fair.

“But knowing that there is progress may not allay fears you have now. It’s important to understand that if you’re ever the subject of an employer referral we have robust checks and balances in place to make sure you’re treated fairly in the GMC process. The decision making principles that we published last year help our decision makers to be aware of bias, to challenge assumptions, and to avoid taking evidence at face value.

“There is information on our website about the support you can access if you’re facing an investigation. And if you’re experiencing racism at work and need support now, please visit our speaking up hub for further advice.”