There are some limited circumstances where this occurs without too great a regulatory problem. For example, a doctor may be extremely advanced in their successful specialist training and for one reason or another the final stages training were derailed – they should still tell their employer what has happened and how this well be remedied.
The Gold Guide includes guidance and references the rules on applying for consultant positions. It includes the fact that postgraduate doctors in training must not be interviewed more than 6 months prior to their anticipated Certificate of Completion of Training (“CCT”) date.
Dr T’s case is a warning about a precipitate application and a doctor not fully disclosing all of their experience. Dr T completed his first ARCP review and moved to ST2 level. He did not progress any further having failed several times to pass the relevant Royal College exams. Unfortunately given those results and the time that elapsed, he received an Outcome 3 and then an Outcome 4 in the final ARCP review, he was then released from the training programme.
Despite this, later in time, Dr T decided to apply for a locum consultant position at a different Trust. On his CV Dr T gave the impression that he had competency beyond the ST2 level. This was by way of omission and a vaguely worded description of his experience than any explicit outright positive assertions.
The Clinical Lead involved in recruiting Dr T admitted there was no formal interview and they needed the post filled. She spoke with Dr T about his experience and he did not correct her assumptions about his training. She also spoke with her consultant colleagues and they had no concerns about his performance and clinical skills. Dr T had a consultant referee and another doctor involved with Dr T at the Trust found him clinically knowledgeable. Dr T was offered and took the position and was later offered and took a second position at the Trust as a locum consultant. It was only when he applied for another Trust role that the concerns came to light and he was dismissed.
The evidence was that Dr T was an “excellent clinician”. Testimonial evidence provided that he was a “very safe and reliable doctor” who was “an excellent example of a doctor that you can trust and rely on to take care of patients at a senior level”. Dr T admitted he should not have proceeded as he did and apologised for his dishonesty.
A doctor involved in recruitment in the case suggested that if Dr T had been honest and upfront about his experience he would likely still have offered him a mid-grade position. Dr T believed the Outcome 4 did not apply to him because he had resigned by that point, he had done so for personal reasons and another doctor had informed him it was possible to apply for a consultant locum position even without the Royal College entry.
The Tribunal held that Dr T’s fitness to practise was impaired, and owing to his insight and remediation, he should be sanctioned with a 6 month suspension.
There are clear risks in prematurely applying for advanced roles. Numerous paragraphs in Domain 1 of GMP cite the need to be competent, work within your limits and keeping up with guidelines. Paragraph 82 in Domain 4 refers to being honest about your experience qualifications and current role, and, in all professional communications, paragraph 89 states that you must not deliberately leave out relevant information.
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