I wanted to write anonymously about my experience of being referred to the GMC and calling the Doctor Support Service because, when I received the letter I genuinely thought my life would completely fall apart and that I would never be able to cope with this, but although it is a bit of a challenge, I am definitely ok.
A bit of background – I am an SHO and I was an SHO at the time of the incident.
Receiving the letter
I recently received a letter from the GMC. The letter related to a clinical incident that occurred over a year ago in which a patient died. I had given a statement more than a year ago to the trust I worked in at the time and heard nothing since. The letter therefore came as a shock.
On receiving the letter I worried about being suspended or never getting a job once I had finished my training. The fact that I had been using work as an escape from personal problems did not help things. I did not know how I would deal with this as well as my personal problems.
Doctor Support Service
I had been thinking about suicide but had been fighting those thoughts for a long time. Being referred to the GMC did not help, because I was convinced that now I had failed as a doctor as well as in my personal life. I felt too ashamed to confide in friends or family.
I had in the past been told about the Doctor Support Service. I called the number because it meant I could talk to someone I did not have to ever meet face-to-face, so I felt it would not matter as much if they judged me.
It was very helpful for several reasons. Firstly, I could not face looking through the letter from the GMC again; however – the doctor at the end of the phone asked me to read through the first page, after going through it over the phone, I realised this was a preliminary investigation. The doctor explained that this case may well be closed by the GMC without even progressing to a full investigation.
Secondly, I really couldn’t think clearly; the person I spoke to convinced me that speaking to my defence union would help me feel calmer because I would start to feel in control. Finally I didn’t feel judged when I spoke about the complaint – this was really helpful because when I went to work the next day, it was difficult to concentrate; but I felt able to tell a nursing colleague and request them to double-check prescriptions and other things with me, meaning I was safe at work.
Two days later, I spoke to my defence organisation. They said that it may progress to a full investigation. This was difficult to hear. Again, because I was made to feel like this is not something to be ashamed of, I was able to speak to a colleague; this time a doctor who was senior to me; being able to vent my emotions again allowed me to work safely.
Avoiding becoming over-defensive
With regards to the clinical incident, I had believed my actions to be appropriate at the time. Now that the GMC was involved, I started to question all my clinical decisions. I felt like I was over investigating patients and causing them and myself unnecessary anxiety. I spoke to the doctor about this and it was useful to know that this is quite normal and that it was OK to ask for a second opinion.
After speaking about this, I felt able to speak to my educational supervisor very openly and also to my clinical supervisors because I realised it was best to ask for help with this issue. Again, people were much nicer than I expected.
I still feel embarrassed when asking about simple clinical scenarios because I worry the doctor I am phoning must think I don’t know anything; but I phrase it as: ‘Sorry to bother you, it’s been one of those days, I apologise for this.’ I still don’t like that I am not as decisive as I was, but I am hoping this will come back with time.
As a trainee, I have always disliked writing formal reflections. My reflections were usually something like: ‘I was nice to the patient. The patient was therefore happy. Learning point: Be nice. The end.’
My educational supervisor asked me to write a formal reflection on how I would ensure I would not allow this and the personal issues to affect my fitness to practise. This was useful for two reasons, firstly, the GMC can see that I am self-aware; secondly, writing quite openly about how I would deal with this has helped me remain calm.
I also really want to highlight two other amazing sources of support I had. There is a forum on Facebook called ‘Butterfly’, it’s a closed group for NHS staff who have been faced with an investigation. Talking to people on there also calmed me down as I was reassured that being investigated is unlikely to stop me getting a job (as it has not stopped others) and I was reassured that no one would judge me.
There is also a forum called ‘Tea and empathy’. It has 2,000-plus members who are mainly doctors but also other health care professionals. It’s a great source of support for work related issues, life issues and health issues. You can post anonymously or ask someone and also message other people in similar situations.
Both these forums made me feel less alone. Also, my current supervisors felt unable to comment on the clinical issues as this was not their area of expertise; using the Tea and Empathy forum, I was able to talk to a senior doctor working in the specialty where the incident occurred and ask her to critically review my reflections on the incident (my thinking was – better people criticise me now so that I am self-aware and show insight if I have to talk to the GMC).
Having talked through the GMC referral with my defence organisation and the Doctor Support Service and also receiving support from colleagues and the Facebook forums: I had realised all that was required was that I was self-aware and showed insight into what I had learnt from the investigation.
Of course I have not heard from the GMC yet – but I am thinking, if I do not appear defensive, if I state what I have learned (even if you do not feel it is your ‘fault’, there is always something to learn) and if I state that I had have this in detail with people responsible for my training and taken all relevant advice from them – what could the GMC actually do? Hopefully very little.
Of course if they do take action, at least I won’t be dealing with it on my own.
The most important thing I have learnt is a GMC referral is nothing to be ashamed of. You cannot stop someone complaining. If I am not judging myself it makes it very difficult for friends, colleagues and potential employers to start judging me.
I hope the GMC continues to fund the Doctor Support Service. Speaking to someone helped me stay safe at work, reflect on the incident and show insight – which are all the things they want doctors to do to protect the public.
Marianne Poirier is a junior doctor. She writes under a pseudonym
This article was submitted in response to a request by the BMA’s Doctors for Doctors unit, which asked members for examples on the emotional impact of practising medicine. It aims to reduce the stigma around doctors’ health issues, and help increase understanding that doctors are not alone in having to cope with the unique pressures that their vocation brings them.
See more of the articles, and for further information, see: bma.org.uk/doctorsfordoctors
The Doctor Support Service is available on 020 7383 6707 or at [email protected]. You can read more here, or see our feature on the services.
Very articulate indeed and shows strength under adversity :)
A very good article and I loved the "As a trainee, I have always disliked writing formal reflections. My reflections were usually something like: ‘I was nice to the patient. The patient was therefore happy. Learning point: Be nice. The end."........
Thank you for sharing your experiences in your eloquent and honest account. We doctors tend to be overly critical of ourselves and take on blame even when the fault doesn't lie with us - I suppose medicine attracts self-critical high-achievers with an over developed sense of responsibility, and the NHS culture reinforces the idea that the buck stops with the doctor. Your article is really insightful and I particularly liked your comment that we can't stop patients making complaints but we can be less judgemental of ourselves and try and take the positive learning from the experience. Over a long career, it will happen, whether a GMC referral or a PALS complaint, and it helps to know that we're not alone, as well as the practical advice you share.
The article writing whether a true story or fiction for advertisement is less important than the fact that it represented a far too simplistic and false impression of what a deadly life destroying phenomenon the GMC involvement is. In the given article the core matter is nothing and the person involved was fully protected in a full time secured work place with full of supporting people all over in work place and outside.
The true real scenario with GMC in most cases is the person involved will be thrown out of work place and will remain isolated and barred from any contacts with anyone at the source and not even allowed to collect any evidence to self defence. That is already same as life imprisonment even before the case trial began, let alone getting another job or even sympathy – “you are guilty, until proven otherwise”.
Even in the given simplistic article the name of GMC itself is enough to ruin the person’s life with a permanent black spot to damage the self confidence forever no matter how the words of wisdom expressed in writing.
Once involved with GMC (not as in article) life is stained forever – for competent innocent doctors.
I hope to see proper real case scenarios published so that people can see how many doctors committed suicide and how many lost their lives just like that, being living dead, that’s the reality, hardly known.
It is about time the BMA challenge the organisation that is the GMC. The GMC are an organisation which has become so pwerful, yet without any apparent accountability. Who are they? In days gone by the profession was represented, now they set standards without any apparent understanding and are bullying the profession.
I would strongly encourage the BMA to ask its members if they have any faith or confidence in the GMC.
You have my full sympathy and i am sure all will be well in the end.
I am sure many would agree we as doctors are very self critical when things go "wrong", and that should be enough punishment -in most but not all cases of course- the unnecessary havoc of having to undergo FTP proceedings is not recognising that we are indeed second victims , after the patient.
Well done for airing this.
The online support is a new area of support that most will never have heard of.
One of the comments below questions if this is fictitious - I think that is highly disengenuous - this account rings true. However it is incomplete and it's looks as if case examiners have yet to decide if it goes to an MPTS hearing.
My question is can we not have a less draconian system given that apparently 80% do not lead to serious outcomes? This is a very destructive process and sadly the adverse effects do last e.g. GMC put an entry on your record for 7 years even if a case is not found. The personal damage I'm afraid lasts for the rest of your career.
I am going through similar experience with all the emational upheaval, including sense of gulit, worthlessness and judging myself being clinically incompetent.
Suicide did come to my mind but just for a fraction of a second.
It is the length of time all the process takes that has a very bad and negative effect on ones daily life
Weel done by publishing this article
Whoever you are, you have my heart felt sympathy having been through the "GMC process" due to a vexatious complaint myself. Please ignore the comment that starts "The article writing whether a true story or fiction...". A troll by any other name is still a troll. I had a similar reaction to you in the immediate aftermath of the complaint's arrival. However, after a year, with the support of the defence union, I was completely exonerated by the GMC's expert and now 3 yrs later, I am content at work and looking forward to taking early retirement in a couple of years
This is a moving and thoughtful account from an evidently sensitive - highly sensitive - young doctor. It is impossible not to feel some of that pain when reading it.
'What others think' figures prominently in her considerations and I want to point out that one can be no less an excellent doctor for having 'what others think' matter rather less in one's thinking.
Winston Churchill, when asked by his secretaries how he slept at night with the weight of the Russians, the Germans, the Economy....on his mind, said simply: "I take off my clothes, I get into bed, I say 'Bugger everybody'....and I put out the light".
We don't all naturally have the personal armour that this remark hints at, but we can, by working at it, adopt a little of the same approach. And still practise excellent medicine.
Melanie, I just want to add to your comment when you rang your Medical Defense Organization. I am glad to hear you did mention that Medical defense organization did say you may have full hearing. And you felt distress again. Because they do not want to take the blame just in case it may go to full hearing not that this has only 1 percent chance of going to full hearing. They are so horrible both the doctor or their solicitors. In my experience I felt they didn't trust me. Also because I am Asian, only white skin supposedly has right to speak truth ( in my experience). This is the real reason of excessive high rate of suicide of doctors facing GMC hearing. They people I felt responsible are MEDICAL DEFENSE ORGANIZATION. and if you read that article written by a psychiatrist about 3 yrs ago. When my wife rang to know what percentage of doctors who committed suicide are from ethnic minority. She was declined this information. But I give you the answer, like every other things in NHS this shall be also highest rate of suicide among Ethnic minority doctors. And do you know why. All three major DEFENSE ORGANIZATION have under lying RACIST POLICY. BMA & GMC both had hearing in RACIAL COMMISSION & are behaving differently. May I request RACIAL COMMISSION, through the medium of BMJ to investigate all doctors suicide case, speak to their families, it is not the GMC hearing or Support provided by BMA not enough, its the Medical defense organization which are guilty.
Thank you for writing this- and for your honesty
most of us live in fear of a GMC referral even though we know that it is not uncommon due to the work we do.
I will remember your bravery in sharing this for a very long time . I'm sure will be very helpful to many people.
I received a letter of complaint from a patient which she copied to the GMC. Eventually the matter was investigated and I was found not to be at fault.
However I feel that I will never get back some of my life. My youngest was sitting entrance exams for secondary school and I was not able to be there for her. I found it very difficult to make decisions at work, I didn't feel I could trust anyone, I felt as though there was a continuous pain in my stomach and at times I felt I would rather have been struck down with a life threatening illness or be dead than face the complaint as I didn't want to be at fault.
I do think that intention has to come into cases... did I intend to do harm... was I deliberately careless... was it planned.. was there a motive..
I felt like a criminal even though I was not...
The person who (abusively) calls the writer of the comment about whether this is a true story or fiction for advertisement a "troll" is in fact the real troll here - just one who has a "politically correct" hat on. At least 28 doctors (it is actually more than this) have indeed committed suicide whilst under GMC investigation in recent years - figures that the GMC tried very hard to suppress. They refused many freedom of information requests and obfuscated for a very long time before that figure got into the public domain - and even then it was only because of persistent work by a dedicated investigative journalist. Any doctor who is stupid or naive enough to believe the rosy scenario portrayed in this propaganda as representative of what really happens during GMC investigations is going to get a hell of a shock, if and when that GMC letter pops through their front door one day. I work part-time as a medico-legal expert witness and I spend many hours each week studying cases in which excellent doctors have been vexatiously and maliciously accused of wrong doing. I also see some cases (far fewer) of doctors who are blatantly unfit to practice - either through woeful and unbelievable ignorance of basic medicine, or from shockingly lazy and bad practice, whom the Defence Societies will protect from any discipline. But one thing is for sure - the GMC has not a jot or scintilla of interest in treating doctors fairly - it is only interested in how the media and the public perceive it. The GMC has, on occasions involving high profile cases, even tried to distort and truncate hearings in order to fit in with the deadlines of newspapers who are running stories about these cases, to try to ensure favourable coverage for itself. It is well known in legal circles that one of the fundamental qualifications needed for working at the GMC is a deep and ingrained hatred of the medical profession. Just look at the quote from Dr Clare Gerada, who said she had spoken to doctors whose investigations had dragged on for as long as five years, while they lost their families, their homes and their livelihoods, and who described the process as “death by 1,000 arrows, as bad as getting a diagnosis of cancer”. If the GMC really cared about doctors, they would by now have shut themselves down in shame, sacked all of their toxic staff, and cooperated in a complete re-boot of our disciplinary system - starting with the acknowledgement that all doctors are "innocent until proven guilty", rather than the opposite presumption which they currently operate under. There should be a requirement, enshrined in law, for all cases to be concluded within a year of the complaint, (two at most with special dispensation). Five years to conclude proceedings which have the power to utterly destroy a professional person's life is an outrage.