BMA wins ‘landmark’ judgement in support of disabled doctors

The case concerned the lawfulness of the RCGP’s attempts policy, in which it would allow only four (exceptionally five) attempts at exams known as the ‘ AKT/RCA tests.’

These are required to complete GP training. According to the RCGP’s attempts policy, no additional attempts would be granted, even in circumstances where a candidate discovers, after sitting a test, that they have a disability which, if known at the time, would have entitled them to “reasonable adjustments”, including additional time for the taking of the test.

The court found that the RCGP’s decision regarding Dr. Karmakar was irrational due to the lack of coherent justification for the policy. However, it ruled that the RCGP did not breach the Public Sector Equality Duty, nor did it fail to make reasonable adjustments, and was not guilty of indirect discrimination.

Dr. Karmakar’s arguments in the case centered around several key points:

1. Discrimination: She argued that the RCGP’s policy of limiting candidates to four attempts at the AKT and RCA was discriminatory, particularly against those with disabilities. She highlighted that her late diagnosis of a disability meant she was not able to access reasonable adjustments during her earlier attempts.
2. Reasonable Adjustments: Dr. Karmakar contended that the RCGP failed to make reasonable adjustments for her disability, which would have allowed her to perform on a level playing field with other candidates.
3. Public Sector Equality Duty: She claimed that the RCGP did not comply with its Public Sector Equality Duty, which requires public bodies to consider how their policies and decisions affect people with protected characteristics, such as disabilities.
4. Irrationality: Dr. Karmakar argued that the RCGP’s decision to enforce the four-attempt limit was irrational, as it lacked a coherent justification, especially in light of her circumstances.

The court’s response to Dr. Karmakar’s arguments was multifaceted:

1. Discrimination: The court acknowledged the challenges faced by Dr. Karmakar due to her late diagnosis but ultimately found that the RCGP’s policy was not discriminatory. The court noted that the policy applied equally to all candidates and was not specifically targeted at those with disabilities.

2. Reasonable Adjustments: While the court recognized the importance of reasonable adjustments, it concluded that the RCGP had not failed in its duty to provide them. The court found that the RCGP had procedures in place to consider and implement reasonable adjustments for candidates with disabilities.

3. Public Sector Equality Duty: The court determined that the RCGP had complied with its Public Sector Equality Duty. It found that the RCGP had considered the impact of its policies on individuals with protected characteristics and had taken steps to mitigate any adverse effects.

4. Irrationality: The court agreed with Dr. Karmakar that the RCGP’s decision lacked a coherent justification, deeming it irrational. This was a significant point in Dr. Karmakar’s favor, as it highlighted the need for the RCGP to provide clear and logical reasons for its policies.

Commenting on today’s judgement, the Chair of the BMA Council, Professor Phil Banfield said:

“The BMA is delighted the court has vindicated our efforts to stand up for disabled doctors who have been treated unfairly by the Royal College of GPs. The BMA supported a GP candidate in bringing legal action, challenging the College’s policy of not allowing trainee GPs re-sits or additional exam attempts where they received a late diagnosis of a disability and had failed previous exam attempts without the benefit of reasonable adjustments. The GP candidate has successfully argued that the College was acting unlawfully and putting its disabled trainees at a significant disadvantage.

​”Today’s landmark judgment not only confirms that the RCGP’s treatment of the disabled candidate in this case was unlawful, but also that the RCGP’s policy in relation to the Applied Knowledge Test, applying to all disabled candidates, is quashed and must be replaced. The Court ruled that “the College has failed entirely to provide a coherent justification for its policy” and that the legal grounds underpinning the decision are “applicable in principle to the generality of candidates for membership of the College”. This plainly supports the BMA’s long-standing conviction that the RCGP’s relevant policy on exam attempts was unlawful and unfair to disabled trainees.

“Over a year ago, following our calls, the Association of Medical Royal Colleges produced principles for Royal Colleges on how to provide a consistent and fair approach for all trainee doctors, across medical examinations.

“As a result, the BMA then urged medical royal colleges, faculties and exam bodies to implement policies which provided fair opportunities for all candidates, in line with that guidance. Despite protracted engagement by the BMA with the Royal College of GPs, the College continually refused to change its stance.

“Whilst today’s judgment is welcome, and will pave the way for disabled trainee GPs to receive much fairer treatment over examinations, it is hugely disappointing that legal action was necessary to achieve this outcome. The College’s intransigence towards change that would promote fairness for disabled trainee GPs in the UK, left us and the candidate in this case with little alternative. We are proud to support our disabled colleagues and sincerely hope this judgment serves as a warning to other Royal medical colleges to ensure they treat all their trainee doctors fairly and make suitable adjustments for those who need it.”

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