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Original research
Cross-sectional exploration of the impact of the Dr Bawa-Garba case on doctors’ professional behaviours and attitudes towards the regulator
  1. Asta Medisauskaite1,
  2. Henry Potts2,
  3. Faye Gishen3,
  4. Kirsty Alexander1,
  5. Shah-Jalal Sarker4,
  6. Ann Griffin1,3
  1. 1Research Department of Medical Education, University College London, London, UK
  2. 2UCL Institute of Health Informatics, University College London, London, UK
  3. 3UCL Medical School, University College London, London, UK
  4. 4UCL Queen Square Institute of Neurology, University College London, London, UK
  1. Correspondence to Dr Asta Medisauskaite; a.medisauskaite{at}


Objective This paper examines the impact on doctors’ attitudes towards the General Medical Council (GMC) and on professional behaviours (reflective practice and raising concerns) following the Dr Bawa-Garba case.

Design A cross-sectional survey designed using the theoretical lens of the theory of planned behaviour (TPB) was administered from September 2017 to February 2019. By chance, this coincided with critical events in the Dr Bawa-Garba case.

Setting Primary and secondary care settings across a broad geographical spread in England.

Participants 474 doctors.

Outcome measures Attitudes towards the GMC and two professional behaviours in TPB dimensions.

Results Attitudes towards the GMC became more negative during the period that the Medical Practitioners Tribunal Service and GMC suspended and subsequently erased Dr Bawa-Garba from the medical register. Specifically, confidence that doctors are well regulated by the GMC and that the GMC’s disciplinary procedures produce fair outcomes was rated more negatively. After this period, overall attitudes start to recover and soon returned close to baseline; however, confidence in how the GMC regulates doctors and their disciplinary procedures improved but still remained below baseline. There was no change in doctors’ attitudes or intention to reflect or raise concerns.

Conclusions The lack of change in doctors’ attitudes towards the GMC’s guidance, the approachability of the regulator, defensive practice and professional behaviours as a response to the Dr Bawa-Garba case demonstrates the resilient and indelible nature of medical professionalism. At the time, professional bodies reported that repairing doctors’ trust and confidence would take time and a significant effort to restore. However, this study suggests that attitudes are more fluid. Despite the high-profile nature of this case and concerns articulated by medical bodies regarding its impact on trust, the actual decline in doctors’ overall attitudes towards the GMC was relatively short lived and had no measurable impact on professionalism.

  • medical education & training
  • protocols & guidelines
  • risk management
  • medical ethics

Data availability statement

No data are available. The data generated and analysed during the current study are not available, as consent for this has not been granted by participants.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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Data availability statement

No data are available. The data generated and analysed during the current study are not available, as consent for this has not been granted by participants.

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  • Twitter @astamedis, @DrAnnGriffin

  • Contributors AG was the lead for the research. AG, AM and S-JS designed the study. HP led on the quantitative data analysis. FG drafted the first version of the introduction. KA contributed writing about regulation and trust. All authors inputted into the interpretation of the data, write-up, critical revision and approved the final version for publication.

  • Funding This paper was prepared using data collected for a project supported by the General Medical Council (Evaluating the impact of the RLS Duties of a Doctor programme (GMC621)).

  • Disclaimer The researchers remained independent from the funders. The funders were not involved in the design of the study, analysis, interpretation of data or writing up.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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