THE General Medical Council (GMC) is the body that regulates doctors in the UK – from overseeing medical education and training, to deciding when concerns about a doctor’s practice should be investigated. When those systems are fair and consistent, they protect patients and support doctors to practise safely. When they are not, the consequences can be life-changing for individual doctors and damaging for the health service as a whole.
Ethnic minority doctors, and those who have graduated outside the UK, experience disadvantages that increase the likelihood of contact with regulatory processes and create barriers throughout education and training. These disadvantages are rarely the result of a single incident. More often, they reflect patterns that build over time – shaped by workplace culture, access to support, and how concerns are raised and handled. As the regulator, the GMC has both the responsibility and the legitimacy to lead efforts to level the playing field – but lasting change depends on collective action across the system. Without it, we risk driving talented doctors out of our health services altogether.
Fairness is not an abstract ideal. Equity in professional experiences translates directly into better results for patients. Fairness in how doctors are trained, supported and regulated helps create the conditions for safer care.
Our work and goals
In 2021, we committed to a focused, evidence-driven programme to address long-standing inequalities where they are most entrenched. That meant tackling disproportionate employer referrals to the regulator – which can expose some doctors to lengthy, stressful investigations at higher rates than their peers.
Why does this matter? Because referral to a professional regulator is not a neutral administrative step. Even when no action is ultimately taken, the process itself can be deeply distressing, disruptive to careers, and damaging to wellbeing. If some doctors are more likely to be referred despite similar circumstances, fairness is compromised long before any regulatory decision is made.
The latest data show that change is possible. Sustained collective action across the system is beginning to make a difference, with a consistent narrowing of gaps over time.
We are also working with others to address unfair differences in medical education and training outcomes. Progress here is slower, reflecting how deeply embedded these inequalities are and the time it takes for interventions to translate into outcomes. Early disadvantage can be difficult to overcome and, if left unaddressed, can shape career-long opportunities. There are early signs of improvement in some areas, particularly for internationally qualified doctors, but this is work that requires patience, persistence and scale.
Why fairness matters more under pressure
The NHS is under intense and sustained pressure. When systems are stretched, efforts to address fairness can be pushed aside by immediate operational demands. But we know that when pressure rises, inequalities often deepen.
Left unaddressed, inequality distorts opportunity and weakens healthcare culture. It erodes trust, undermines cohesion, and damages the very foundations that services under strain rely on most. In pressured environments, inconsistency and bias – whether conscious or not – are more likely to take hold, with lasting consequences.
Ethnic minority doctors – whether UK-qualified or internationally qualified – now make up a larger share of the medical workforce than white doctors. In a workforce under immense pressure, the system cannot afford to lose talent because of poor culture or avoidable unfairness. The cost of inequality is one it simply cannot carry.
In these conditions, fairness matters more, not less. When doctors feel valued and treated equitably, morale improves, teams are more stable, and retention is stronger – all of which benefit patient care.
Looking ahead
Change is possible, but it does not happen by accident. Fairness cannot be treated as optional or postponed until pressures ease. If we want patients to receive safe care from a confident and supported medical workforce, equality and fairness must be built into how doctors are trained, supported and regulated. The alternative is to accept the human and clinical cost of inaction.
