Virginia Jibowu. Kings College London Under Fire

Multiple concerns about Kings College London Medical School have been raised. The General Medical Council and every other authority have refused to investigate the evidence presented. The social experiment and EMDP should be banned by the General Medical Council. Those of us who are aware of the lax attitude of the GMC will be aware that the GMC never acts unless it has to. Kings College London Medical School appears to be institutionally racist yet everyone has turned a blind eye to the legitimate and evidence based concerns raised by Virginia Jibowu.

Samar Singh Discusses " Student Fitness to Practise"

Bare Bones of Student's Fitness to Practise.

For information regarding the manner in which the GMC treats medical students who raise valid concerns about inequality - see www.examfraud.co.uk . Following the piece regarding Professor Timothy David's role in Student Fitness to Practise issues, we present the following as a historical snapshot of how matters have developed. Essentially, Student FtP is a pointless concept that only serves the establishment and not the public.

We refer to the article below first published in the Times Higher Educational Supplement on the 21st July 2006. Following the furore regarding medical student regulation, we felt it was important to turn back the time clock and analyze a number of issues.

"Medics riled by training reforms" Claire Sanders
Published: 21 July 2006 [THES]

Medical schools reacted with alarm this week to news that the General Medical Council could lose its regulatory role for undergraduate education, writes Claire Sanders.

In what is being seen as the biggest shake-up in medical regulation in 150 years, Sir Liam Donaldson, the Chief Medical Officer, has proposed radical changes to how doctors are assessed and disciplined, many of which will mean a reduced role for the GMC.

The move is in response to criticisms of the GMC by Dame Janet Smith, chair of the inquiry into the Harold Shipman murders.

Katie Petty-Saphon, executive director of the Council of Heads of Medical Schools, said: "The GMC has an outstanding track record in safeguarding the standards of undergraduate medical education and stimulating curriculum reform. This success has been recognised internationally."

Sir Liam is proposing transferring these roles to the newly established Postgraduate Medical Education and Training Board. "This will enable the approach to curriculums, standards and inspection in medical education from undergraduate through to postgraduate to be addressed more seamlessly than at present," says his report, Good Doctors, Safer Patients.

Dr Petty-Saphon said: "The training board is a fledgling organisation that is only just getting to grips with major reform of specialty training. It simply lacks the experience and infrastructure to take on regulating undergraduate education, a task the GMC does extremely well."

Medical schools are calling for the role of the GMC to be extended to cover postgraduate training, rather than see a transfer in the other direction. While many of the reforms were widely anticipated, the decision to remove undergraduate education from the GMC took medics by surprise. Sir Graeme Catto, president of the GMC, said: "We had no idea this was on the cards. I have asked Sir Liam if he was dissatisfied in any way with our work and he said 'no'." But what he wrote in his report is in public domain and it makes sense! (Kindly read ‘archive’ on “GMC and medical education (‘Meducation’)” below).

Dr Petty-Saphon added: "The proposed transfer would erode the essential autonomy provided by the current reporting structure." Under the proposals, the GMC will report to Parliament, whereas the board reports to the Department of Health.

The board was set up last year to oversee postgraduate medical education, including the second year of the foundation programme that all medical students undertake in hospitals.

The British Medical Association was also concerned about the proposals, which are out for consultation until November 2006.

Archive on “GMC and medical education (‘Meducation’)”:

Further to the news item in 18th May 2006 issue of Hospital Doctor [‘GMC to advise on ‘student-FTP (Fitness-to-Practise)’] here are , some common-sense observations on GMC’s bungling of medical education in particular & medical regulation in general.

1. Student FTP is a silly misnomer. As everybody except the arrogant clerks at GMC would understand, one doesn’t get ‘license to practise’ until after passing their basic medical qualification examination MB BS or MB ChB, etc., and naturally isn’t fit to practise’ as a medical student. A qualified doctor gets ‘full registration’ only after completion of a year’s supervised practise as PRHO [nowF1]

2. Fitness-to-learn’ (FTL), perhaps? If the GMC (clerks or Catto) meant ‘fitness-to-learn’ (FTL) then this must be the most crackpot concept by GMC to date! Ivory-tower-vultures are wrong again as assessing prospective ‘wannabe’ doctors’ ‘fitness to learn’ is the remit of the universities at the admission stage through UCAS and GMC rightly should have no say in it.

3.Medical Curriculum and educational standards: But of course, under the Medical ‘Act’ the GMC was responsible to set medical curriculum, to supervise and maintain standards of medical education (‘Meducation’) in UK. GMC’s greedy fiasco of exporting PLAB to the third-world over past 10 years resulted in draining young medics from these countries and effectively putting them out of circulation and out of pocket. The GMC were filling their coffers in the style of the colonialist 21st Century East India Company! Sir Liam must be right and seamless regulation of all stages of medical education by one single body makes obvious sense.

4. Back to GMC’s brain-storm of ‘student-FTP’. Students qualify to enter medical schools on their academic grades, then they are like a lump-of-clay in the Meducators’ hands! If the universities couldn’t impart that education to adequate standard, it can be the fault of the system, not the individual and the buck would stop with the University-schools, or again the GMC. It can not be the fault of a student’s ‘fitness to practise’… “studying”; precisely.

5. Even thinking of “judging on any medical student’s fitness-to-practise” is preposterous; and can be compared to diagnosing a newborn baby with ‘feco-urinary (stool-urine) incontinence’, ‘learning disability’, ‘autism’, ‘dyslexia’, ‘ADHD’, etc.’ all at once and then declaring it "unfit to become an adult" in its bare infancy!

We have stalwarts like Count Peter Rubin as the then Chairman of GMC’s Education Committee who mistakes ‘campus-conduct and disciplinary procedures’ as the impossible “medical schools’ current FTP proceedings” for students. Who can blame the GMC clerks for their incompetence?

Perhaps Prof Rubin needs a Frankenstein designed 440 volt to make him understand that a ‘yet-to-be-licensed-to-practise’ medical student can not be ‘danger to public’ any more than any other uni-student ‘trashing the student-bar’!

Mr Irfan Halim was stating the obvious that GMC is unfit for the purpose (see attachment Dame Janet Smith’s lecture before RSM in May 2005, published 2006). There is over 23 years of catalogue of blunders and gaffes in opaque, inconsistent and patently incompetent medical regulation by the GMC since the Medical Act of 1983; to cap with the recent indictment of Prof James Drife, a GMC member, medical screener & Catto’s rival who was found guilty of ‘serious professional misconduct’ of being directly instrumental to Richard Neale’s spate of maiming mayhem up and down England for 14 years.

What did GMC do to Prof James Owen Drife, who gave 2 references to Richard Neale [even without knowing him professionally] and 'screened out' a complaint about the same Neale while sitting as medical screener on the GMC!

Nothing much! They just ousted him from the GMC [to Catto’s relief] which stopped him ‘being a medical screener’! “Protecting patients, or protecting Drife-Neale?”

It goes to prove that subjective professional regulation by the GMC (GentleMen’s Club) in UK-NHS has been strategically protective of the GMC, for the GMC (GentleMen’s Club): people in grey suits with English birth, who fit into the club; including people like Shipman, Neale, Ledward, Kerr, Haslam, Drife, etc.

Time and again, the GMC has failed public and doctors alike. Most of GMC’s significant decisions are overturned by High Court on referral by CHRE, or on appeal; trampling the doctor under multiple jeopardy in the process, funded by doctors alone!

The Shipman Inquiry has found GMC unfit for the purpose of medical regulation [as well as revalidation] and recommended that this should be conducted by ‘anybody but GMC’. Dame Janet Smith has recommended that GMC should be removed from the FTP function which is unconstitutional by its nature, as it breaches doctors’ Human Rights.

This is because the GMC has all 4 functions converged into one body.

These are

(1) the legislative (“Rules on Good Medical Practice”),
(2) the administrative (conducting investigations on doctors in response to complaints from public, NHS-employers and other bodies ---but not from other doctors of junior grade and/or or alien-origin!),
(3) the judicial (subjecting doctors to inquiries on their professional conduct or performance and making findings of ‘serious professional misconduct’-SPM or ‘seriously deficient performance’-SDP; both without any objective definitions or thresholds) and
(4) the executive (suspension or erasure of the doctors from the medical register). In other words, GMC is the kangaroo-court of ‘MP-police- jury- judge-executioner all rolled in one’. This is just like how Saddam Hussain’s rule was in Iraq.

If a shop or a business provided substandard service, consumers could complain to the Trading Standards. With the GMC, they are vastly incompetent but there is no recourse in the law to the wronged. This state of affairs is untenable. The best way forward to end this ‘double jeopardy’ against doctors seems to be by ‘removing the incompetent body GMC --the ‘weakest link’-- from the process of medical regulation. GMC should be abolished.An organisation who cannot get its own house in order is in no position to judge medical students.

As Prof Richard Baker once put it, ‘a fantastic opportunity for the government to make medical regulation more accountable to public’.

All ‘complaints against doctors’ should be processed by CHRE and heard by court judges, so that fairness and transparency are maintained and doctors victimised wrongly could obtain due redress for malicious or unsustained complaints. This could also mean that 100 good testimonials would (as they should) be considered in ruling on an honest mistake or a clinical error, and findings of SPM could be considered ‘spent’ after, say - 5 years.

This would also diffuse the “blame culture” prevalent in medical practice [which could never be entirely free of a certain small amount of unaccountable risk].

Samar Singh

So you want to be a doctor.

Professor Rubin is desperately trying to be a man of the people. The problem is he isn't being very successful. He recently did a interview for the Guardian on encouraging doctors from the lower socioecomic classes. Strangely, the lower socioeconomic class hardly read the Guardian. They have more exciting papers to read. To having targeted the affluent intellectuals in the form of Guardianistas, Rubin expects to encourage poverty stricken teenagers into medicine. Rubin is dubbed The Count for obvious reasons. Having destroyed good doctors through the GMC, he seeks to find more new blood. His fangs are certainly out for the next innocent desperate poverty stricken teenager who is desperate enough to sacrifice themselves to the world of the GMC.

The GMC Register once had 300,000 doctors. It has now dwindled down to 185,000 practicing doctors. So a mere 185,000 doctors now try and help a population of 61.4 million. Doctors are unhappy with the General Medical Council. The option of revalidation otherwise dubbed the "harassment" of doctors isn't going down well. Given this shortage of doctors in general, Rubin is trying to persuade the lower social classes into entering the esteemed medical profession. Is it esteemed anymore? Or is it an imprisonment of genuine people who would otherwise be free? Rubin tells the world that he was from a atypical background. He flaunts his father's personal history to tell us all " if I can do it, you can". The point here is this :- do we really want to be like Prof Rubin? Does any spotty teenager want to be a bald man with large ears who knows nothing about the real world.

"Research by the British Medical Association (BMA), the doctors' trade union, shows that just one in ten medical students comes from the three lowest socio-economic groups, far less than the 30% from such backgrounds in higher education overall. It estimates that by next year the average debt incurred by a graduate of a five or six-year medical degrees will rise to an average of £37,000 by next year, with those in London paying as much as £67,000"

So instead of campaigning for a change in culture ie less judgmental medical school staff, Prof Rubin asks that richer students pay more tuition than poorer students. Rubin assumes this to be "equal opportunities". Rubin makes the assumption that all rich students are funded well by their parents. In reality, not every parent funds their child. This view will create discord and resentment between the two groups. Rubin fails to understand that the entire system of university education should be changed. The whole system is encouraging those from a higher social class into education. We are becoming a generation where education is only given to those who can afford it - a system that was in place in the 18th Century. It isn't just medicine that is in trouble, all students are in dire straits. There is no such thing as equal opportunities. It is time to scrap tuition fees, reinstate the full grants and ensure students from their GCSE years are provided with support and additional funding [ topped up EMAs] in order to work towards their aspirations. Each student should be judged equally - grades should not be lowered for poorer students nor should they be funded by their richer counterparts. The system in the UK used to believe in education for all. It certainly doesn't anymore. Rubin therefore fails to understand the that this issue is a global problem in UK education. The solution isn't to insult poorer students by offering them beggar funds. The solution is to equalise opportunity by ensuring all students are able to study - whether they are rich or poor. If the basic grants were of a decent amount, no one would need extra funds.

One of the GMC blessed programmes encouraging those from a so called "lower social class" is the Extended Medical Degree Programme. This extended medical degree programme has recently been criticised by its students. The programme has been accused of being insulting to minority students by implying they are in some way a special needs section of medical school. Students were given psychometric tests to show if the experiments in social mobility were working.

Medical Students were subjected to the draconian processes as implemented by the General Medical Council. Again, Prof Rubin believes that any person in their right mind would opt to choose a profession where every segment of you is scrutinised.

What to expect from the GMC.

This is what he says about Revalidation

"Rubin will certainly leave a major footprint in the sand of UK healthcare. His top priority is implementing the revalidation of all those 185,000 doctors. Although he describes it as "the biggest change to medical regulation since the GMC was established in 1858", revalidation has so far generated little controversy outside specialist medical publications – despite significant suspicion towards it among doctors. It will involve every doctor undergoing an annual 360-degree appraisal – with input from colleagues and patients – to prove their skills are up to scratch, and having to acquire, every five years, a fresh licence proving that they are fit to practice"

This is what the Telegraph said about GMC Style hearings for medical students.

The issue was highlighted at the British Medical Association's annual representatives meeting after student Drew Kinmond said the numbers graduating with black marks against their name has increased from three per cent in 2006/7 to one in ten last year.

He told the conference in Liverpool: "Students are not doctors, we are still in training. There has to be a period of time where students can be students and learn what it takes to be a doctor. There has to be a period of time where we can make some mistakes.

"That is why students are not in charge of patient safety."

He said he supported disciplinary action in serious cases such as assaulting a patient or dealing drugs, but urged the rules to remain in proportion.

The General Medical Council has issued guidance on disciplinary matters at medical school in an attempt to standardise rules that apply to behaviour before graduation.

The guidance states: "Students must be aware that unprofessional behaviour during their medical course, or serious health issues that affect their fitness to practise, may result in the GMC refusing provisional registration.This is the case even if the circumstance in question occurred before or early on in medical school."

The medical schools can set their own rules and hold hearings when they are breached.

Students have been warned they face action for skipping bus fares, setting off fire alarms, damaging carpets and floors, playing loud music, being impolite, not filling out forms on teacher feedback, parking violations, and attendance.

Of course, Rubin fails to inform the general public about the oppression that exists in medicine.You could successfully get into medicine and one night out may end your career. There are very few good things to say about medicine. Rubin implies that doctors earn a great deal. For the hours they do, they earn practically nothing. By the time you pay your student loans off and living expenses, MPS fees, GMC fees etc you will probably have as much in your pocket per week as someone working at the checkout in ASDA.

Professor Rubin also misses out the fact that hundreds of doctors are prevented from working due to the GMC's draconian Interim Order Panel. Having got rid of the usual good doctors in the NHS, Rubin wants to get in new blood. Well, one cannot expect any less from the man referred to as Count Rubin.