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Professional competence and retired registered medical practitioners

With commencement of Part 11 of the Medical Practitioners Act – Maintenance of Professional Competence on the first of May 2010, the Medical Council is making progress with the establishment of professional competence schemes in time for May 2011. It has recently published draft rules and standards, which will underpin the new system, and has sought views of all interested parties through a public consultation process. One of the issues under consideration is how the new statutory requirement to maintain competence should be applied to retired medical practitioners. The Medical Council is aware that this is a matter of concern to many of its registrants and this article discusses some of the issues.

The Medical Practitioners Act 2007 and retired doctors

The Medical Practitioners Act 2007 underpins the Medical Council’s regulation of the medical profession in Ireland. It makes no specific reference to the issue of retirement and has no provision for the establishment of a specific registration status for retired doctors. Part 11 of the Act, which concerns the maintenance of professional competence, makes no distinction in its requirements for retired doctors.

The Medical Council is also aware of the challenges in arriving at a clear, consistent and workable definition of a retired doctor, since many doctors who retired from their substantive career post continue to practise medicine as periodic locums or in a private capacity. Thus, being retired is often not synonymous with being out of the practise of medicine. The role of the Medical Council is to protect the public by regulating everyone engaged in the practise of medicine in Ireland.

Retired medical practitioners – clarifying some causes of concern

It is worth clarifying some causes of concern for retired doctors who may consider voluntarily withdrawing from the register as a consequence of the new requirements to maintain professional competence.

Firstly, voluntary withdrawal from the Medical Council’s register does not mean that an individual must cease to use the title of “Dr” before their name. The individual’s use of this appellation arises from their holding of a medical degree and is not linked to their registration with the Medical Council. While Part 6 of the Medical Practitioners Act 2007 precludes an unregistered medical practitioner from the practise of medicine and the advertising of their services, it does not preclude an individual who withdraws from the Medical Council’s register from continuing to use the title Dr.

Secondly, voluntary withdrawal from the Medical Council’s register does not mean that an individual may not provide first aid in the event of an emergency. Part 6 of the Medical Practitioners Act 2007 clearly states that a circumstance in which an unregistered medical practitioner may practise medicine is in the course of rendering first aid to a person (Section 38(e)).

Finally, retired medical practitioners wishing to retain registration with the Medical Council for the purpose of treating relatives should take note of the Section 52 of the “Guide to Ethical Conduct and Behaviour for Registered Medical Practitioners” which states that “it is not advisable for you to treat members of your own family or issue prescriptions, sick certificates or reports for them”.

The practice of other medical regulatory authorities

The Medical Council has reviewed the practice of other medical regulatory authorities with regard to the application of requirements to maintain competence to retired doctors. Internationally, most medical regulatory authorities take the position that maintenance of professional competence is required for registrants engaged in any clinical practice. For example, the General Medical Council in the UK is implementing a system of licensing and revalidation which requires retired doctors who wish to engage in any clinical practise to hold a license and to periodically revalidate this license. Notably systems which had specific provisions for retired doctors previously, for example some Australian medical regulatory authorities, have since removed these provisions on the grounds that they do not adequately protect the public and that any doctor who wishes to engage in any clinical practice, no matter how infrequently, must maintain their competence in the same way as someone practicing full-time.

Options under consideration

There are two options under consideration by Council for managing the application of the new requirements to maintain competence to retired registered medical practitioners:

Option 1: All non-trainee doctors engaged in any clinical practise participate in the Medical Council’s system for regulation of the maintenance of professional competence, regardless of whether they identify themselves as retired or not. Any doctor unable to or unwilling to engage in professional competence schemes would be advised to voluntarily withdraw from the register.

Option 2: The Medical Council use rules made under Section 11 in support of Section 94 of the Medical Practitioners Act to make specific provisions for retired doctors. The duty to maintain professional competence for retired registered medical practitioners is then supported through a specifically designed scheme and a report to verify participation in such a scheme could then be sought by Medical Council at renewal of registration.

Next steps

The Medical Council has sought the views of the profession, the public and other stakeholders on both these options as part of its recent consultation on draft rules and standards. This consultation closed on the 30th of November 2010 and the feedback is currently being collated. It will be considered by the Medical Council in early 2011 and direction on this matter will be issued to all registrants.