The dearth of training in equal opportunities for GPs could leave them open to complaint and must be addressed swiftly, argue James Gerrard and Jamie Bahrami, who carried out a survey of the issue

As professionals with independent contractor status within the NHS, GPs need to be aware of legislation governing equal opportunities, especially as they do not usually have the advantages of a personnel department to guide them.

It may not be adequate, in practice, to rely on a perceived innate sense of 'fair play' in demonstrating the delivery of equal opportunity.

Nor is this enough to reduce the risk of an industrial tribunal case.

1To determine the amount of training in equal opportunities available to GP training scheme course organisers, trainers and registrars, a postal survey was sent to course organisers via departments of postgraduate general practice.

Anonymity was assured in a letter explaining the study. The survey initially took place in March last year, with a further batch of questionnaires sent to non-responders in May.

The questionnaire consisted of four questions with yes/no responses and space for free text.

The first three questions asked course organisers whether equal opportunities training had been received by themselves, general practice trainers in their area and registrars on their training scheme.

The final question asked whether it was the policy of the local region/deanery that those appointing registrars, trainers and course organisers had received recent training in equal opportunities.

Completed questionnaires were returned by 250 (49. 6 per cent) course organisers in the UK. The table shows their responses to the four questions.

Course organisers were most likely to have received equal opportunities training. GP trainers were less likely to receive such training, and it was unlikely to be undertaken by GP registrars during their general practice training.

Eighty-two respondents (32. 9 per cent) were not aware of any policy in their region or deanery concerning the recent training in equal opportunities of those on appointment committees.

In other words, the number of GPs at all levels who undergo any formal training in equal opportunities is low, and this is particularly the case for GP registrars.

There are likely to be several reasons for this - one may be low priority given to this subject in a busy educational timetable. The lack of importance accorded to the subject is perhaps reflected in the low response rate to our questionnaire.

This is in contrast to the emphasis that the Royal College of General Practitioners has placed on trying to ensure that all candidates sitting its membership examination are treated fairly.

It is notable that in answer to the question regarding regional/deanery policy on equal opportunities training, a third of respondents did not know of the existence of any such policy, or felt that there was none.

This may suggest that existing policies are not being effectively implemented.

In addition, some GPs may believe the concept of equal opportunities is not relevant to them.

4However, if GPs retain their independent contractor status an awareness of the law in this area will remain an essential consideration.

The British Medical Association last year updated its policy by issuing Recruitment and Selection of Doctors: good practice guidelines.

Following changes introduced last year to the selection process for GP registrars, spelled out in the registrar GP scheme's UK guide, all those involved in such appointments must have had recent training in all relevant aspects of equal opportunities and employment law.

In the light of our findings this may mean that some regions need to consider setting up training courses for their trainers and course organisers who are the key players in these appointments.

Finally, GP registrars who qualify and then work in partnership without any appropriate training may expose themselves to a risk of industrial tribunal or formal complaint if they are unable to demonstrate the delivery of equal opportunities when appointing staff or treating patients.

It seems reasonable to us, therefore, that any core syllabus for GP training should include modules in this important area.


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2 Wakeford R, Farooqi A, Rashid A, Southgate L. Does the MRCGP discriminate against Asian doctors? BMJ 1992; 305 (6845): 92-94.

3 Roberts C, Sarangi S, Southgate L, Wakeford R, Wass V. Oral examinationsequal opportunities, ethnicity, and fairness in the MRCGP. BMJ 2000; 320 (7231): 370-374.

4Boulos G. Language, fairness, and the MRCGP examination. BMJ 2000; 320 (7244): 1278.