Risk factors at medical school for subsequent professional misconduct: multicentre retrospective case-control study.
OBJECTIVE
To determine whether there are risk factors in a doctor's time at medical school that are associated with subsequent professional misconduct.


METHODS
Matched case-control study. Setting Records from medical schools and the General Medical Council (GMC).


METHODS
59 doctors who had graduated from any one of eight medical schools in the United Kingdom in 1958-97 and had a proved finding of serious professional misconduct in GMC proceedings in 1999-2004 (cases); 236 controls (four for each case) were selected by systematic sampling from matching graduation cohorts. Case-control status was revealed by the GMC after completion of data entry.


METHODS
Odds ratios for being a "case," with multivariable conditional logistic regression of potential risk factors including pre-admission characteristics and progress during the course. These data were obtained from anonymised copies of the students' progress files held by their original medical schools.


RESULTS
Univariate conditional logistic regression analysis found that cases were more likely to be men, to be of lower estimated social class, and to have had academic difficulties during their medical course, especially in the early years. Multivariable analysis showed that male sex (odds ratio 9.80, 95% confidence interval 2.43 to 39.44, P=0.001), lower social class (4.28, 1.52 to 12.09, P=0.006), and failure of early or preclinical examinations (5.47, 2.17 to 13.79, P<0.001) were independently associated with being a case.


CONCLUSIONS
This small study suggests that male sex, a lower socioeconomic background, and early academic difficulties at medical school could be risk factors for subsequent professional misconduct. The findings are preliminary and should be interpreted with caution. Most doctors with risk factors will not come before the GMC's disciplinary panels.
Yates
Janet
J
Medical Education Unit, University of Nottingham Medical School, Queen's Medical Centre, Nottingham NG7 2UH. janet.yates@nottingham.ac.uk
James
David
D
D000328:Adult; D016022:Case-Control Studies; D004503:Education, Medical, Graduate / Q000706:statistics & numerical data*; D004504:Education, Medical, Undergraduate / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D028743:Professional Misconduct / Q000706:statistics & numerical data*; D012307:Risk Factors; D012577:Schools, Medical; D012959:Socioeconomic Factors; D013337:Students, Medical / Q000706:statistics & numerical data*; D006113:United Kingdom; D055815:Young Adult