Intended for healthcare professionals


Editor’s Choice: Entering a hall of mirrors

BMJ 2016; 353 doi: (Published 20 June 2016) Cite this as: BMJ 2016;353:i3412
  1. Tom Moberly, editor
  1. BMJ Careers
  1. tmoberly{at}

Amid the frustration, anger, and concern about proposed changes to the junior doctor contract, another issue has been provoking disquiet among trainees in recent months.

This is the revelation that the process of reflection on individual fears and failings that doctors are required to undertake as part of their training can be used against them in court. Trainees in London were informed of the danger that they had created for themselves through their own reflections in a letter sent by four of Health Education England’s postgraduate deans in April.

The letter explained that a doctor in training had been asked to release a reflective log from a portfolio in a court case against the doctor. As Daniel Furmedge comments in BMJ Careers this week, “This development has caused a wave of anxiety among trainees and concern among trainers.”

Furmedge argues that this new development marks the end for meaningful written reflection. “So it should be,” he says. “It is time we used a more personalised face-to-face educational process for medical education.”

Given that written reflection is now a requirement of many areas of medical training and practice, its use is unlikely to be abandoned overnight. With that in mind Marika Davies and Dan Kremer set out to explain what doctors may want to know about the potential medicolegal pitfalls in this area and how to avoid them.


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