Advice for Doctors Under GMC Investigation: A Complete UK Guide (2026)

The most important thing to understand is this: how you respond in the early stages can define the entire outcome. This guide covers everything doctors under GMC investigation need to know — from understanding the process to taking proactive steps that protect your career.

What Is a GMC Fitness to Practise Investigation?

The GMC's fitness to practise process is designed to protect patients and maintain public trust in the medical profession. It is triggered when concerns are raised about a doctor's conduct, performance, or health — whether from a patient complaint, a workplace referral, a whistleblowing disclosure, or a criminal conviction.

Since the updated Good Medical Practice guidance came into force in January 2024, the GMC has effectively lowered the threshold at which it can take action. The previous "serious or persistent failure" standard has been removed, meaning a broader range of concerns can now trigger a formal investigation. Medical defence organisations have flagged this as a significant change — one that makes early, proactive engagement more important than ever.

The investigation process typically moves through the following stages:

1. Initial Triage and Assessment — The GMC reviews the concern to decide whether it meets the threshold for a formal investigation.
2. Formal Investigation — Evidence is gathered, and the doctor is invited to respond. This is a critical stage where your written representations carry significant weight.
3. Case Examiners Review — Two case examiners (one medical, one lay) review the evidence and decide whether to close the case, issue a warning, agree undertakings, or refer the doctor to a tribunal.
4. Medical Practitioners Tribunal Service (MPTS) — If the case is referred, an independent tribunal considers the evidence and can impose conditions, suspend, or erase a doctor from the register.
5. Interim Orders Tribunal (IOT) — At any point, if the GMC considers there is an immediate risk to patients or public confidence, it can refer the case to the IOT, which can impose interim conditions or suspension while the investigation continues.

Why Acting Early Makes All the Difference

Many doctors make the mistake of waiting — waiting for more information, waiting for legal advice to crystallise, or simply hoping the concern will go away. This is one of the most costly errors in a GMC investigation.

The GMC and MPTS are not only assessing what happened — they are assessing your insight, your accountability, and your commitment to improvement. Doctors who demonstrate these qualities early consistently achieve better outcomes than those who respond defensively or too late.

Developing Insight: What the GMC Is Really Looking For

"Insight" is a word used constantly in fitness to practise proceedings — and for good reason. It is one of the primary indicators the GMC and MPTS use to determine whether a doctor remains fit to practise.

Strong, credible insight involves:

• Acknowledging the concern honestly — without minimising, deflecting blame, or being defensive
• Understanding the impact — recognising how your actions (or inactions) affected patients, colleagues, and public confidence in doctors
• Identifying root causes — reflecting on why the issue occurred, whether situational, systemic, or personal
• Demonstrating remediation — showing concrete steps taken to ensure the issue does not recur

A well-crafted reflective statement, supported by evidence of learning, is one of the most powerful tools a doctor can present at any stage of a GMC investigation. It tells the regulator: I understand what happened, I take responsibility, and I have changed.

Proactive Remediation: Start Before You're Asked

Remediation is the process of addressing identified concerns through targeted learning and development. Many doctors only begin remediation once formally required to — but starting early is significantly more effective.

Proactive remediation demonstrates genuine motivation rather than compliance. It gives you documented evidence of improvement that can be referenced in written representations, at case examiner stage, and at MPTS hearings.

Effective Early Remediation Activities

• Completing CPD-accredited Ethics and Ethical Standards for Doctors courses aligned to GMC standards
• Engaging with a clinical supervisor or mentor
• Undertaking reflective writing exercises structured around the specific concerns raised
• Addressing specific skill gaps — whether in communication, record-keeping, professional boundaries, consent, or clinical decision-making
• Participating in multi-source feedback (MSF) or appraisal

CPD Courses Specifically Designed for Doctors Under GMC Investigation

Choosing the right CPD course matters. Generic continuing education will not carry the same weight as structured, regulator-aligned learning specifically designed to address fitness to practise concerns.

At Probity & Ethics, our CPD-accredited online courses are built for exactly this purpose. They help doctors demonstrate insight, reflection, and remediation in a format that is recognised by legal representatives, responsible officers, and medical defence organisations.

Courses Particularly Relevant to Doctors Under Investigation

• Fitness to Practise for Healthcare Professionals — understand the GMC process in depth, what panels look for, and how to present remediation effectively
• Ethics and Ethical Standards for Doctors — strengthen ethical decision-making, explore professional boundaries, and evidence integrity in your practice
• Professionalism and Professional Standards for Doctors — rebuild professional values, explore accountability, and address conduct-related concerns
• Probity and Honesty for Healthcare Professionals — demonstrate transparency, truthfulness, and trustworthiness — qualities the GMC places at the core of fitness to practise

Legal Advice: Why You Need a Specialist, Not Just a Solicitor

A GMC investigation is not a standard legal matter. It requires representation from professionals who understand both medical regulation and the specific procedures of the MPTS and Interim Orders Tribunal. Specialist knowledge here is not optional — it is the difference between an amateur and a professional performance at a tribunal.

When Seeking Legal Support, Doctors Should

• Contact their medical defence organisation first. The Medical Defence Union (MDU), Medical Protection Society (MPS), and similar organisations offer legal support as part of their membership benefits. If you are already a member, contact them immediately upon receiving GMC correspondence.
• Seek a solicitor with specific GMC and MPTS experience. Look for a firm or individual with a demonstrable track record in fitness to practise proceedings — not just general medical law.
• Engage legal support as early as possible. Your lawyer can manage all communications with the GMC, help craft a compelling written response, gather evidence, and ensure your rights are protected throughout.

Understanding the Interim Orders Tribunal (IOT)

The IOT is one of the most urgent and high-stakes elements of the GMC process. If the GMC believes a doctor poses an immediate risk to patient safety or public confidence, they can refer the case to the IOT at any point — even before the main investigation concludes.

The IOT can impose interim conditions (restricting the scope of a doctor's practice) or interim suspension (removing them from practice entirely) while the investigation continues. These orders are reviewed at regular intervals and can be challenged.

Legal representation at IOT hearings is critical. An experienced advocate can argue against disproportionate restrictions, propose workable alternative conditions, and present evidence — including completed CPD courses and supervisor reports — to demonstrate that interim measures are unnecessary or overly restrictive.

Possible Outcomes of a GMC Investigation

Understanding the range of potential outcomes helps doctors and their legal teams set realistic goals and plan their response accordingly:

• No further action — The concern is closed at triage or initial assessment, with no formal action taken.
• Advice — The case examiners provide informal advice without any formal sanction.
• Warning — A formal warning is placed on the doctor's record, publicly visible on the GMC register for five years.
• Undertakings — The doctor agrees to specific conditions on their practice, such as supervision, retraining, or restrictions on certain procedures. Undertakings avoid a tribunal but remain on the public register.
• Referral to MPTS — The case proceeds to a formal tribunal. Possible sanctions include conditions, suspension, or erasure from the medical register.

Proactive remediation, strong written representations, and early legal engagement consistently improve outcomes — and can mean the difference between undertakings and a full tribunal hearing.

Frequently Asked Questions: GMC Investigations

Take Action Now — Protect Your Career and Reputation

A GMC investigation is serious. But it does not have to define you or end your career. The doctors who navigate the process most successfully are those who respond with clarity, accountability, and evidence of genuine learning — not those who wait, minimise, or disengage.