GMC: Writing references: Summary

SJT Textbook: Writing References

Writing References GMC

This writing references GMC guide explains how doctors must provide honest, objective, and evidence-based references to protect patient safety in MSRA SJT scenarios.

🎥 Video Lesson (YouTube)

🎧 Podcast Lesson (Spotify / Apple / Amazon)

🎯 THE CORE PRINCIPLE

Writing a reference is a professional responsibility with direct implications for patient safety, team functioning, and public trust. The GMC requires doctors to be honest, fair, accurate, and objective when providing references, appraisals, or assessments for colleagues.

References must contain relevant information about competence, performance, and conduct, including concerns that may affect patient safety or professional trust. Doctors must not provide false, misleading, or incomplete references, even to help a colleague.

In the MSRA SJT, high-scoring answers show transparency, evidence-based judgments, appropriate inclusion of concerns, and readiness to seek advice when uncertain, rather than avoidance, omission, or personal bias.

The writing references GMC guidance requires honesty and full disclosure of relevant concerns.

⚡ HIGH-YIELD ACTIONS (What Scores Points)

1. Be honest and objective when writing any reference.
2. State clearly your relationship to the candidate and how long you have known them.
3. Include relevant information on competence, performance, and conduct.
4. Substantiate all comments with factual evidence where possible.
5. Highlight unresolved or serious concerns that may affect patient safety.
6. Exclude personal bias or irrelevant personal views.
7. Avoid misleading reassurance through selective omission.
8. Respect confidentiality, disclosing personal details only when justified.
9. Provide a copy to the candidate if they request it (normally).
10. Seek defence body advice if unsure what to include.

MSRA SJT frequently tests breaches of writing references GMC objectivity.

These traps reflect avoidance, bias, concealment, and subjectivity, all of which score very poorly.

💬 MODEL PHRASES (Use These in SJT Logic)

* “I will include relevant concerns that may affect patient safety.”
* “I will outline my professional relationship with the candidate clearly.”
* “I will seek advice from my defence organisation if unsure.”
* “I will avoid including unsubstantiated or irrelevant information.”

F – Fair and balanced
A – Accurate and evidence-based
C – Conduct and competence included
T – Transparency about concerns
S – Safety of patients prioritised

Omitting safety concerns breaches writing references GMC duties.

📋 QUICK FAQ

Can I refuse to write a reference to avoid including concerns?
No. If you are the most appropriate person, you should provide a fair and honest reference. Do I have to include negative information?
Yes, if it is relevant, substantiated, and impacts patient safety or professional trust. Can the candidate see the reference?
They are normally entitled to a copy if they request it. Can I include personal information?
Only if it is directly relevant and justified or consented to. What if I am unsure about what to include?
Seek advice from your medical defence organisation.

Fitness to practise decisions rely on accurate writing references GMC disclosure.

📚 GMC ANCHOR POINTS

• Honesty and objectivity – Good Medical Practice
• Writing references – Writing references guidance
• Protecting patients – Good Medical Practice
• Confidentiality – Confidentiality guidance
• Raising concerns – Raising and acting on concerns guidance

Patient safety outweighs colleague loyalty under writing references GMC rules.

💡 MINI PRACTICE SCENARIO

A colleague asks you to write a reference. You are aware of unresolved conduct concerns that did not lead to formal action. Best action: Provide an honest, factual reference that includes the relevant concerns. Why: Omitting material safety concerns would be misleading and risk patient safety.

🎯 KEY TAKEAWAYS

✓ References must be honest and objective
✓ Include relevant conduct and safety concerns
✓ Avoid misleading reassurance
✓ Substantiate all comments with evidence
✓ Personal bias must be excluded
✓ Candidates can usually see references
✓ Patient safety outweighs colleague loyalty

🔗 RELATED TOPICS

* → Raising and Acting on Concerns
* → Fitness to Practise
* → Leadership and Management
* → Duty of Candour
* → Good Medical Practice

📖 FULL PRACTICE QUESTIONS

Example SJT — Best of 3 (8 options; choose three)

You are asked to write a reference for a colleague applying for a senior role. You are aware of a recent unresolved patient safety concern.

Options:
A. Provide a completely positive reference to support them
B. Include the safety concern factually
C. Seek advice from your defence organisation
D. Refuse to write any reference
E. Mention the concern without evidence
F. State your professional relationship clearly
G. Omit the concern because it was not proven
H. Add personal criticisms unrelated to work

Example SJT — Rank 5 (best → worst)

You are unsure whether to include a borderline conduct issue in a reference.

Options:
A. Seek advice from your defence body
B. Include the concern factually and proportionately
C. State only positive qualities
D. Avoid writing the reference entirely
E. Exaggerate the concern to protect yourself