GMC wins right to discriminate against disabled student

Anna Ellis, BMJ

A young disabled student has lost the right to take the General Medical Council to an employment tribunal, following their decision that the learning outcomes required of doctors at the point of graduation could not be modified for individual students.

In December 2000 Heidi Cox initially won the right to pursue a case against the GMC under the Disability Discrimination Act 1995. The GMC appealed that decision and won last week, on the grounds that it is not a trade organisation but a qualifying body and therefore exempt from the act.

Heidi Cox, who is 28 and a wheelchair user, won a place to study medicine at Oxford University in 1999, on a course adapted for her needs. The GMC, however, told Oxford that it could not approve a specially adapted course that would result in the achievement of a lesser degree of skill and knowledge.

Ms Cox had to leave a course in medicine at St George's in 1992 after an accident left her disabled. She has since gained a MSc and an honours degree in pathobiology. Her aim was to return to medicine and eventually become a pathologist.

Professor Peter Rubin, chairman of the GMC's education committee, explained that the GMC neither encouraged nor discouraged disabled students to become doctors. The GMC has the legal powers to set standards that must be achieved by qualifying students, and the issue was whether a student could achieve those core competencies, regardless of their abilities or disabilities. He pointed out that there are disabled students in many medical schools at the present time.

The ruling decided that the GMC was not a trade organisation; its duty lies in protecting the public and it does not exist for the advancement of its members. The judgment found that qualifying bodies are excluded from the Disability Discrimination Act 1995 to preserve the balance between individual rights and public safety.

“Selection of students is a matter for Universities, not the GMC,” said Professor Rubin. “In fact, we encourage innovative courses and have no fixed view on how outcomes are achieved.”

Professor Rubin added that it was not a question of whether a student was disabled from the outset or became disabled whilealready on the course. He predicted that trends in North America and Australasia suggest that we need to face the challenge of deciding where the boundary lies between individual aspirations and the requirements of medical practice.

The GMC has set up a working party, including representation from the BMA Medical Student Committee (MSC), to provide guidance in this area. Peter Taysum, deputy chair of the committee and chair of the welfare working group, said: “It is very unfortunate that Heidi Cox has lost the appeal case, especially when facts about her disability were not discussed at the hearing.” The MSC is hopeful that the Human Rights Act 2001 will take into account the rights of the public as well as those of disabled medical students.

“The MSC is glad to be involved with the rewriting of the GMC's guidelines on student health and conduct,” he added, “although we hope to see the GMC lead by example in improving equal access into medicine for everyone.”