Does a Narrow Definition of Medical Professionalism lead to Systemic Bias and Differential Outcomes? A Narrative Commentary

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Ananta Dave MD FRCPsych
Naureen Bhatti FRCGP
Joydeep Grover MBBS FRCEM
Rosanna Geddes
Triya A Chakravorty BA(Oxon)
Satheesh Mathew MD FRCPCH
Shivani Sharma, MBPsS, PGCert, FHEA, CPsychol 
Indranil Chakravorty MBBS PhD FRCP


The concept of medical professionalism is enshrined in the principles of Good Medical Practice (GMP), upheld by the General Medical Council (GMC), and is applicable to all doctors as well as undergraduate students in the United Kingdom. The principles were conceived, developed and implemented to ensure that the highest standards of medical practice are adhered to for the safety of the public and to retain trust in the medical profession. The GMC has a statutory duty to ensure that professional standards are maintained. Approximately 1% of doctors on the medical register are subject to investigation by the GMC, based on referrals made by employing organisations or the public.

While appropriate GMC investigation is essential to maintain standards, patient safety and public confidence, there are inherent inequalities in the process resulting in widely different outcomes for certain groups of students or doctors based on Black and minority ethnicity, male gender and non-UK primary medical qualification often leading to devastating consequences.

This narrative review considers the contributors to differential attainment (DA) and the impact on the health service, patients and individual wellbeing. It explores the tenets of a current narrow definition of professionalism which, while representing the unidimensional White majority view, ignores the huge diversity of the workforce and the public, thus exposing significant tensions for groups of professionals.  The Covid-19 pandemic has exposed the inherent systemic bias in the health service for both professionals and the public. This review recommends root and branch reform of the definition of professionalism, by engagement with the public and the workforce, to incorporate principles of equality, diversity and inclusion, which the authors believe will create the environment for a just and equitable professional experience. 1 

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How to Cite
Dave, A., Bhatti, N., Grover, J., Geddes, R., Chakravorty, T., Mathew, S., Sharma, S., Bamrah, J., & Chakravorty, I. (2021). Does a Narrow Definition of Medical Professionalism lead to Systemic Bias and Differential Outcomes? : A Narrative Commentary. Sushruta Journal of Health Policy & Opinion, 14(1), 1-12.
Author Biographies

Ananta Dave MD FRCPsych, Lincolnshire Partnership NHS Foundation Trust, Lincoln, UK

Medical Director 

Consultant Child & Adolescent Psychiatrist


Naureen Bhatti FRCGP, Health Education England, London, UK

Head of School, Primary Care, N E London

Joydeep Grover MBBS FRCEM, Southmead Hospital, Bristol, UK

Consultant in Emergency Medicine

Rosanna Geddes, Medical Defence Shield, UK

Legal Assistant

Triya A Chakravorty BA(Oxon), University of Oxford, UK

Medical Student

Satheesh Mathew MD FRCPCH, British Association of Physicians of Indian Origin, Bedford, UK

Retd Consultant Paediatrician


Shivani Sharma, MBPsS, PGCert, FHEA, CPsychol , University of Hertfordshire, UK

Executive Lead: Equality, Diversity and Widening Participation, Head of Psychology Group

School of Life and Medical Sciences


JS Bamrah MD FRCPsych FIIOPM, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK

Consultant Psychiatrist

Indranil Chakravorty MBBS PhD FRCP, St Georges University Hospitals Foundation Trust, London, UK

Consultant Physician & Director of Medical Education

Chair, BAPIO Institute for Health Research, Bedford, UK


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