Public Policy Editor
More than 30 bogus doctors have succeeded in working for the National Health Service, a study at Bath University has revealed.
And the masquerading medics get away with it - at least for a time - because the way they learn their trade is remarkably similar to the way genuine doctors learn, the study shows. Because medicine is often collaborative rather than an individual effort, Joanne Hartland, a research fellow at the university's school of social sciences, says, "information is exchanged, decisions discussed, experience pooled and expertise passed on".
"Junior doctors develop from being weak links in a team ... A team, then, is not surprised to find weak links in its midst, and this allows bogus doctors to get away with a few mistakes," Ms Hartland says in the Health Service Journal. "A well-equipped bogus doctor can blend into the medical culture, taking up a position in the medical team, learning by apprenticeship, benefiting from the actions of colleagues and accumulating experience. In many ways, bogus doctors are uncomfortably like genuine doctors."
The study identified more than 100 bogus doctors over several years- the cases unearthed by following up press reports and rumours and advertising for known cases in medical journals. Many used their claim to be a doctor for other ends than medicine, but more than 30 set out to do the genuine job and convince other staff of their authenticity.
Several managed to practise - usually in hospital - for several years before being unmasked, although one bogus GP practised for almost 30 years.
Particularly for bogus doctors from overseas, colleagues sometimes dismiss unusual conduct as a cultural anomaly or the product of non-British training. And provided their attempts at medical practice fall somewhere within a wide "spectrum of acceptability", impostors do not draw attention to themselves, the study found.
The General Medical Council - the doctors' disciplinary and registration body - offers the best hope of halting bogus doctors. But the study says it admits "one hundred per cent security is almost impossible". Candidates for registration have to produce original certificates, not photocopies, and hospitals should check with medical schools overseas if an applicant appears particularly implausible. But "the line between sensible checks and more widespread scepticism placing the majority of new doctors under suspicion, is very narrow".
The study highlights five cases, two of whom were exposed because of medical mistakes. But the other three were exposed by bureaucratic checks unrelated to medicine - one whose immigration status was queried when returning from abroad, one who was exposed by a family member and one who made unusual insurance claims, the subsequent investigation exposing his medical qualifications as bogus.
The fake doctors' casebook
Arrived in Britain in 1961 with a medical degree and apparent hospital reference from Pakistan. Was in fact an unqualified chemist. Worked as a GP for almost 30 years until a member of his family spilled the beans. Jailed for five years in his early 60s.
Produced a medical degree certificate in 1967 from Kabul University - in fact he had failed - and worked as a locum doctor and then a casualty officer. Anonymous caller alerted the GMC after four years. Arrested, age 39, as he re-entered Britain after a holiday. Deported.
A former cadet nurse with one term's experience at medical school, worked his way up to a senior registrar post in anaesthetics on the back of a bogus 1970 Australian medical school qualification. Police investigation of an insurance fraud exposed him. Two-year imprisonment after four years' medical work.
Failed medical student from Sri Lanka who gained hospital post as dermatologist. Exposed by consultant who undertook two-person ward rounds and spotted gaps in his knowledge. Arrested, age 32, and jailed for 18 months.
Trained paramedic produced US medical degrees and references. Successfully held down junior post in geriatrics but exposed when he took a job in accident and emergency, and consultants became alarmed at his treatment and decisions. Jailed for three years.