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This chapter outlines the aims and objectives of the book and its focus on regulatory reform of the General Medical Council and how it investigates complaints against a doctor’s fitness to practise alongside the introduction of medical revalidation to periodically test professional competence. To set the scene to this analysis in subsequent chapters, the emergence of risk-based approaches to professional regulation are outlined as well as how these have transformed traditional ‘doctors only’ approaches to medical governance.

The chapter provides a historical policy account of the introduction of medical revalidation in the UK and outlines the limiting structural and cultural factors at play and how these might well hinder its ability to identify poorly performing doctors.

This chapter outlines recent developments in the fitness to practice hearings where complaints are made against doctors. It traces the introduction of the medical practitioner tribunal service as a separate arm of the general medical council. It outlines how the tribunal service works and discusses its performance over the last decade. As a result, it questions whether recent reforms made have secured the public interest.

In light of previous chapters, the final chapter outlines how recent developments in the regulation of doctors are a result of the fluctuating social conditions associated with the emergence of the risk society. It discusses the possible future of risk-based forms of medical regulation and sets out a conceptual and policy-focused research agenda for ascertaining the impact of regulatory reform on both the public and the medical profession.

Improving your emotional resilience is a key task for you as a medical student. As a future doctor, your health and well- being are vital to that of your patients: if you are not functioning reliably, you will not be able to help your pa­tients as much as you otherwise would. It is therefore vital that you look after your body and mind and, by implica­tion, adopt a lifestyle that is both healthy and sustainable. It is often said that doctors make bad patients. There is some evidence that doctors are slow to seek help for health problems, and comply poorly with advice given by other healthcare professionals. In addition, doctors’ lives may be unhealthy, with high levels of stress, low levels of exercise, and excessive consumption of alcohol. The mental health of doctors is a particular con­cern. Doctors are at relatively high risk of mental dis­order, and female doctors appear to be at higher risk of suicide than women in the general population. The reasons are several, and include the following: … ● The nature of doctors. Doctors are driven to succeed, and do not tolerate failure well. It is inevitable that some of our patients will die, some treatments will not be successful, and that, in a professional lifetime, some mistakes will be made. Our aim should be to reflect on and learn from these events, and then to move on positively. ● The nature of doctors’ work. Doctors tend to work hard, work for long hours, and work in challenging, resource- constrained environments. ● Poor help- seeking. Doctors may be reluctant to seek help for their medical problems, and this is particularly likely when the problem is psychiatric. ● Unsupportive and unsustainable lifestyle. Many doctors have challenging careers and challenging home lives, and allow themselves little time to recharge their batteries away from these ever-present stressors. They may not prioritize the maintenance of important resilience factors, such as the relationship with their partner, or interests outside medicine. ● Knowledge of and access to the means of suicide. Doctors (and vets, farmers, and pharmacists, to whom the above- mentioned factors also apply) have special expertise in the use of chemicals which are toxic in overdose.