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General Medical Council refusal to grant provisional registration - reasons, prevention and what to do if it happens


Timothy David ,

University of Manchester, GB
About Timothy

Academic Lead for Student Fitness to Practise

Faculty of Medical and Human Sciences, University of Manchester

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Sarah Ellson

Fieldfisher LLP, Manchester, GB
About Sarah

Sarah is a partner at Fieldfisher LLP.

She is a recognised expert in public and regulatory law and she heads the firm's market leading public and regulatory law team.

She takes a particular interest in health and social care and bioscience regulation, but she also works in education, surveying, sport, security and psychotherapy. As well as overseeing the investigation of complaints and attending disciplinary hearings as an advocate or legal adviser to Panels, she advises on audit, policy and strategy matters in the design and implementation of regulatory frameworks.

Her work involves working with start-up regulators as well as obtaining new legislation and interpreting it for established clients. She regularly advises on judicial review cases and appeals. She very much enjoys the work she does training and mentoring those involved in regulation. She has had personal involvement, often through her work with the General Medical Council, in a number of leading cases in this field.

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Summary: The General Medical Council has refused provisional registration to UK medical graduates 30 times between 2010 and 2016. The reasons given for refusal were lack of insight (29/30, 97%), lack of remediation (29/30, 97%), probity concerns (18/30, 60%), and health (11/30, 37%). In the only case that did not involve both lack of insight and lack of remediation, there were serious concerns about the applicant’s health. This article explains the processes that lead to registration refusal, and offers advice about how to prevent refusal and how to respond to refusal. Thus far, 16 of the 30 have re-applied, and 13 were successful in gaining provisional registration.

Relevance: Medical students need to be aware that even if their medical school has permitted graduation, and even if a student has been found to be fit to practise by a university committee, the GMC may decide that the student has failed to demonstrate fitness to practise. This will lead to a refusal to grant provisional registration, which at the very least will set back an individual’s career by 12 months.

Take Home Messages: Lack of insight and the resulting failure to change behaviour and demonstrate remediation risk loss of a career. It is imperative that students respond to advice and warnings. Students may not realise that it is not just the seriousness of problem behaviours but their response to advice that determines how a medical school will decide what action to take.

How to Cite: David T, Ellson S. General Medical Council refusal to grant provisional registration - reasons, prevention and what to do if it happens. The British Student Doctor Journal. 2017;1(2):36–40. DOI:
Published on 29 Jun 2017.
Peer Reviewed


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