What do the UK General Medical Council fitness to practice cases tell us about reducing misconduct through trainee development?

Misconduct is a pervasive issue in workplaces that can affect wellbeing, productivity and organisational reputation. It becomes even more devastating when it can impact on clients or patients. In the United Kingdom (UK), clinicians who fail to adhere to the standards set by the General Medical Council (GMC) are subjected to fitness to practice proceedings to determine if misconduct has occurred, and an appropriate sanction. There has been little research into the underlying themes behind the fitness to practice cases. Aim Analyse Fitness to Practise case transcripts in the public domain to understand what the key ethical compromises were. Method Framework analysis of a sample of fitness to practice transcripts was conducted using ‘Good Medical Practice’ (GMP), a competency-based framework, and Swick’s sociological framework. Results Analysis of 45 randomly selected fitness to practice cases from 2020–2021 shows three distinct groups of cases (dishonesty, performance issues, and sexual misconduct), each presenting unique themes. The dishonesty and sexual misconduct cases involved ethical compromises that were not fully reflected through a competency-based framework such as GMP, suggesting educational opportunities should place more emphasis on personal values and its development as well as character based ethics such as virtue ethics. Future directions Even though there are lessons from the medical education literature on person development, ethics and law education requires increased emphasis on how to effectively influence character development. This may have implications for training in other professional settings beyond medicine.