No, not if they can show they have insight and there are no other concerns.

Mr N was a consultant ophthalmologist.  His case has a long regulatory history spanning 6 years which involved 8 hearings, two GMC Performance Assessments and includes a successful appeal by Mr N regarding one of the decisions.  It serves no purpose reciting the entire history except to note that one of the problems caused by one of the suspensions to Mr N was that he was out of clinical practice for so long it added to the burden he faced returning to practice.

The primary allegations of deficient professional performance in Mr N’s case related to ‘maintaining professional performance’ and ‘assessment and clinical management’ which were initially deemed unacceptable, the other areas of ‘operative/technical skills’, ‘record keeping’ and ‘relationships with patients’ were deemed as cause for concern.

After practicing with conditions for more than 12 months the final Performance Assessment Team found Mr N’s performance unacceptable in the areas of ‘Assessment of Patient Condition’ and ‘Clinical Management’.  Their opinion rested on Mr N not considering potential TIA’s in two cases and other possible diagnoses in three other cases.  They stated he lacked insight regarding the opportunity to develop his skills in other areas of ophthalmology outside his areas of interest. They concluded Mr N was fit to practice but on a limited basis.

Mr N’s workplace reporters and clinical supervisors painted a very different picture of Mr N’s clinical practice.  Mr C and Ms A were both Consultant Ophthalmic Surgeons and worked with Mr N in their practice for 15 months.  They gave evidence that Mr N was clinically very knowledgeable, kept detailed and accurate records and was well liked by his patients.  They stated they were happy for him to continue working in their departments.

The GMC argued that the Tribunal should not look in isolation at the cataract surgeries Mr N undertook and that to be able to practice safely unrestricted he should be competent in all areas of Ophthalmology surgeries.  On behalf of Mr N it was argued that he well understood his limitations, knows what surgery he can and cannot undertake competently, and there would be no point restricting him on surgeries he will not perform.

The Tribunal agreed with the practitioner.  They determined that “it is not practical for the GMC to ask that a doctor demonstrate competence in each and every area of surgical practice, but rather it is for the doctor to demonstrate insight into their own limitations and capabilities”.   The conditions on the doctor’s registration were revoked with immediate effect.