We use cookies to help provide you with the best possible online experience.
By using this site, you agree that we may store and access cookies on your device. Cookie policy.
Cookie settings.
Functional Cookies
Functional Cookies are enabled by default at all times so that we can save your preferences for cookie settings and ensure site works and delivers best experience.
3rd Party Cookies
This website uses Google Analytics to collect anonymous information such as the number of visitors to the site, and the most popular pages.
Keeping this cookie enabled helps us to improve our website.
Disability, Training, Education, Appraisal and Revalidation
The General Medical Council (GMC) has a pivotal role and responsibility in local and national disability education and training.
The GMC has updated its “Good Medical Practice” standards for 2024, which will impact how appraisals are structured going forward. The updated standards have an increased emphasis on promoting patient-centered care, tackling discrimination, and creating respectful, fair and compassionate workplaces.
Read the guidance - Welcomed and valued: Supporting disabled learners in medical education and training - is the key document from GMC.
Local education providers need to read the GMC guidance to understand their rôle in supporting postgraduate training organisations to meet their obligations to students and doctors-in-training while in the work environment. They should also be aware of the options available for supporting doctors-in-training.
Having a health condition or disability alone does not constitute itself a fitness-to-practise concern.
The GMC looks at the impact a health condition is having on the person’s ability to practise medicine safely, and determines this on a unique case-by-case basis. Direct contact with patients with disabilities had a specific impact on trainees' levels of anxiety and empathy. It is considered good practise that accreditation standards for postgraduate medical programmes can require the inclusion of disability education.
The importance of the Educational Supervisor
The first time the clinical educator meets a student, it is appropriate that the student’s past experiences be considered prior to entering into a dialogue about disability. Requiring students to justify their entry into the particular educational programme, or having them explain their 'inability' rather than ability, can be detrimental.
Considering the GMC guidance, it is worth noting the following:
It is a matter for postgraduate educators and employers to assess how they approach each individual case. One approach which the GMC encourages is to consider the case management model as good practise.
The educational review process can help monitor the support a doctor in training is receiving, record any relevant conversations in the educational portfolio or escalate concerns to the support network as needed.
The preparation and evidence submitted by disabled doctors in training for the Annual Review of Competence Progression (ARCP) can be an opportunity to raise something about the support they are receiving and the environment in which they are training. The ARCP process is also a way to decide whether a doctor-in-training can be supported to meet the competence standards at their stage of training.
Trainers should remove or revise any redundant aspects of the curriculum, not crucial to meeting the required standard that may disadvantage disabled doctors.
Organisations designing assessments have a duty to anticipate the needs of disabled candidates.
All doctors-in-training must have an educational supervisor who should provide, through constructive and regular dialogue, feedback on performance and assistance in career progression.
The Medical Act [1983]
This act has enabled under statute law the GMC to tailor training to enable disabled students to become qualified. More recent moves to competency-based assessment will also help with this approach. The focus of training can change from an individual being required to carry out particular tasks/ procedures in order to progress. Instead, the underlying competencies can be identified and demonstrated in alternative ways, where it is safe to do so.
The Educational Supervisor is therefore a crucial rôle when considering the support and progression of a doctor-in-training with a health condition or disability.
Taking time to ensure that the approach taken by an educational supervisor is appropriate to build a good rapport with the doctor-in-training is crucial for effective provision of this support.
The educational supervisor is ideally placed to identify a doctor who is becoming unwell, a doctor who is struggling without adequate reasonable adjustments and a doctor who may pose a risk to patient safety. If appropriately educated and supported in their support role, the supervisor may be able to identify such problems early on and take steps to address them, thereby helping to avoid a deterioration in the doctor’s health, a clinical error or near miss or the loss of a valuable doctor from training.
To find out more, contact us to obtain our full disability factsheets.