GMC Guidance on Medical References

Whether you are a locum doctor looking to collect references for your CV, a junior doctor signing off a medical student, or a senior consultant acting as a referee for your supervisees, you should know and understand the GMC guidance and expectations on medical and professional references. 

In this article we break down the GMC’s guidance on medical references so you know what you can expect from your referees, and what is expected of you should you ever be asked to provide a reference for a colleague. 

The GMC’s Good Medical Practice lists the following statements for qualities and standards that all doctors should abide by and demonstrate at their annual appraisals and ARCP’s.  

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✅  ‘You must be honest and objective...’

The GMC states that references must be honest and objective. That means that you must not allow your personal feelings towards the person you are providing the reference for to influence your review of their abilities. This works two ways; you can’t rate someone higher than they deserve simply because you like them, and you also can’t rate someone lower than they deserve because you dislike them. 

This applies to all situations involving any type of reference, assessment, or appraisal of a colleague or student’s competence, performance, or conduct. 

✅  ‘You must be honest and trustworthy…and make sure that any documents you write or sign are not false or misleading.’

This means that any signed documents request or provide to others must be accurate and cannot deliberately mislead or leave out information that is relevant. If you are uncertain about the accuracy of the document you are signing, you must ‘take reasonable steps to ensure that the information is correct’, but if you are still uncertain the best policy is to refuse to sign rather than risk authenticating a false document. 

✅  ‘You must keep to the principles of equality and diversity…’

This statement refers to the appraisers moral and ethical duty to remain free of judgement and prejudice when assessing their colleagues performance. Doctors should not experience career barriers on the basis of their fixed characteristics, nor should those characteristics influence in any way a doctors ability to professionally progress.  

The GMC goes on to state that ‘the safety of patients and the public could be put at risk if you make false, exaggerated or incomplete comments about another professional’s competence or experience.’ This could be interpreted as a warning against appraisers being over-generous in their assessments of doctors on the basis of equality and diversity, resulting in unsafe practitioners being allowed to work, or an appraiser being over-critical and depriving the public of a qualified healthcare professional from being allowed to provide care when they have the required skills and knowledge to practice safely and effectively. 

✅  ‘You should include all information you are aware of that is relevant…’

Referees are obliged to share all information about a candidates professional competence and overall suitability that is relevant to a potential employer. This information must be things that the referee can substantiate, and must be presented in an objective, fair, and unambiguous way. 

This is usually about information relating to ongoing, unresolved, or past complaints about the candidate but only if they relate to the suitability of the candidate to perform their professional duties. 

It does not include information about personal or health circumstances unless these ‘have a direct bearing on their suitability for the particular post in question.’ Even so, the referee should get consent from the person they are providing the reference for, before sharing this information.

In the event that the candidate refuses to disclose information which could result in patient harm, the GMC has guidance about releasing information in the public interest, under the heading of Confidentiality. 

✅  ‘You must be prepared to explain and justify your decisions and actions.’

The GMC states that your inability to justify your decision to provide a particular reference or appraisal can result in your registration being put at risk. 

As a referee, it is important to remain objective and factual in your references wherever possible so you can justify any reviews or ratings you provide. Your reference needs to be fair to both the candidate and the prospective employer, meaning that you cannot simply provide a neutral or positive reference if you do not feel that it is an accurate reflection of the skills and abilities demonstrated by the candidate while they worked with you. 

If you are someone receiving a reference, you have the right to challenge or appeal any reference that you feel is unfair or inaccurate knowing that the referee has to be able to justify their report. If you ask for a copy of a reference from your referee, they should provide it to you though they are not legally required to. 

✅  ‘You should state the basis upon which you are making your assessment of the candidate, such as how long you have known them and in what capacity.’

This is do to with full disclosure and providing context. If you are the best person to provide a reference for someone, then you should do it even if you don’t particularly want to. However, providing context for how long you’ve known the referee for and in what capacity can help establish context for your reference. 

For example, if you worked with a student for a day, your reference will carry different weight than if you worked with them for the duration of their three month placement. 

‍We hope you found this information helpful. If you want to read more about the GMC guidance, you can find it here. Or, check out our Ultimate Guide to your Medical Portfolio where we link all of our articles about medical references, portfolios and appraisals.