Intended for healthcare professionals


Deprofessionalising doctors?

BMJ 2002; 324 doi: (Published 16 March 2002) Cite this as: BMJ 2002;324:627

The independence of the British medical profession is under unprecedented attack

  1. Denis Pereira Gray (, chairman of the Academy of Medical Royal Colleges and emeritus professor of general practice
  1. University of Exeter, Institute of General Practice, Barrack Road, Exeter EX2 5DW

    A patient seeing a doctor professionally in the United Kingdom has expectations of professional conduct that far exceed what is expected of citizens generally or employees of most institutions. This sense of professionalism is important to patients as it motivates doctors. The underpinnings of that professionalism, established over 150 years, have in the last 150 days all been questioned.

    The medical profession in the United Kingdom first emerged through the medical royal colleges in 1505. The 1858 Medical Act united the medical profession and, almost 150 years ago, created the General Medical Council—a structure through which the profession could develop an ethical code,1 systematise education, and punish erring members. The council derives its authority from parliament; its membership includes 25% of lay members, soon to increase to 40%; it elects its own president; and it has been a model for other professions, such as the General Teaching Council.

    Postgraduate education developed later, and the profession entered into a partnership with the State to regulate it. The Joint Committee on Postgraduate Training for General Practice (JCPTGP) and the Specialist Training Authority (STA) between them control postgraduate training for doctors. Both bodies have …

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