A doctor’s registration with the GMC might be erased for a number of reasons.  In this article, we will look at how a doctor can apply to restore their GMC registration.

GMC Registration

Doctors who practise medicine in the UK need to hold a licence to practise along with the suitable type of registration for the work that they do. It is the licence to practise which allows doctors to carry out certain activities such as prescribing medicines and treating patients.

Doctors who hold registration without a licence cannot practise medicine in the UK.

Restoration to the GMC Register

Doctors can be removed from the register for a number of reasons:

Due to an administration error and lapse (“administrative erasure”)

This could happen when a doctor failed to pay the annual registration fee or provide an up-to-date residential address.  Restoration to the GMC register under these circumstances is normally straightforward.  Under exceptional circumstances, restoration due to administrative erasure could result in a formal investigation where, for example, the error was caused by an allegation of deception or another form of misconduct.

GMC Guidance

• GMC guidance on making decisions on voluntary erasure applications and advising on administrative erasure
• GMC guidance for case examiners on making restoration decisions following voluntary or administrative erasure

Voluntary erasure

A doctor can apply for voluntary erasure at anytime during their registration including at anytime during a fitness to practise investigation.  The GMC has an adopted process for considering applications for voluntary erasure during a fitness to practise investigation.

Doctors who have had an application for voluntary erasure approved, can apply to re-join the register.  The process is set out in The General Medical Council (Voluntary Erasure and Restoration following Voluntary Erasure) Regulations Order of Council 2004.

Restoration decisions are referred to GMC case examiners (one lay and one medical) and the accompanying GMC guidance states that granting restoration:

“will be appropriate if the case examiners are satisfied, based on reliable evidence, that the doctor is fit to practise without restriction. Restoration should normally be granted if the concerns are not serious enough to raise an issue of impaired fitness to practise or are not capable of proof to the civil standard.”

The alternative to granting the application is refusal or a referral to the MPTS.

Doctors considering applying for restoration following a voluntary erasure should seek legal advice to discuss the individual circumstances that lead to the voluntary erasure and the best way to approach the restoration application

GMC Guidance

• GMC guidance on making decisions on voluntary erasure applications and advising on administrative erasure
• GMC guidance for case examiners on making restoration decisions following voluntary or administrative erasure

Erasure due to impaired fitness to practise

In circumstances where a doctor’s registration has been erased by the Medical Practitioners Tribunal Service (MPTS) due to impaired fitness to practise (or “disciplinary erasure”), an application for registration is much more complicated.

Generally speaking, the GMC will not consider restoration applications until at least 5 years have elapsed from the date of the disciplinary erasure and applications for restoration following a disciplinary erasure will be referred to the MPTS.

The GMC stipulates that the MPTS will consider a “number of factors”, including:

• the circumstances that led to erasure including the reasons given by the previous tribunal (or panel) for the decision to direct erasure
• whether you have demonstrated insight into the matters that led to erasure and taken responsibility for your actions
• whether you have remediated the previous findings about your behaviour, skills, performance or health and if there is a risk of repetition
• what you have done since your name was erased from the register
• the steps you have taken to keep your medical knowledge and skills up to date

Regarding the “circumstances that led to erasure” and the “reasons given”, these are matters of fact.  Doctors cannot ask, or argue, before the MPTS that the facts proved against them that led to their erasure should be reconsidered.

Please refer to our article “Fitness to Practise – Reflection, Insight & Remediation for Doctors” for further guidance on demonstrating insight and remediation.

The issue of evidence of maintaining “medical knowledge and skills” needs careful planning and consideration.  The evidence of maintaining “medical knowledge and skills” will largely depend on the circumstances of each case.  It is highly advisable that doctors seek expert legal advice on the most appropriate course of action when considering a restoration application.  A number of things could be considered:

1. Strong and clear evidence of remediation and insight
2. A personal development plan showing how you will, or have, maintained your medical knowledge and skills
3. PLAB training notwithstanding the fact that you might not take the exam
4. In some cases, clinical attachments could be appropriate

Ultimately the burden of proof rests on the doctor making the restoration application to convince the MPTS that they are fitness to practise.  If you are considering an application for restoration, contact Kings View Chambers at the earliest opportunity for GMC fitness to practise advice, guidance and representation.

GMC Guidance

• GMC Guidance for doctors on restoration following disciplinary erasure
• MPTS Guidance for medical practitioners tribunals on restoration following disciplinary erasure