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back to article Doctors face tribunal over claims of plagiarism in iPhone app

Three doctors face the withdrawal or suspension of their licences to practise medicine after being accused of releasing an iPhone app which allegedly plagiarised material from an award-winning medical textbook. One of the three stands further accused of writing a "misleading" review praising the app on the App Store. The trio …

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Medics are always plagiarising each other

The operation that my dad had on his knee this year was IDENTICAL to the one I had performed by a completely different surgeon several years ago. The scar even had rounded corners.

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Re: Medics are always plagiarising each other

Who are you to call plagiarism? Your knee seems to be a shameless ripoff of your dad's. It has even required the same surgery.

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Re: Medics are always plagiarising each other

Hypocrite. Your knee seems to be a shameless ripoff of your dad's. It has even required the same surgery.

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Anonymous Coward

@ Evil Graham

Are you plagiarizing yourself there? I don't know if that can properly be called plagiarism.

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Re: Medics are always plagiarising each other

Hypocrite. Your knee appears to be a shameless knockoff of your fathers. It has even required the same procedure.

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Re: @ Evil Graham

Just a clumsy accidental double-posting. I should go and see a doctor (or three).

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Anonymous Coward

Who cares

So long as they don't kill you...

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h3
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Surely when it comes to anything to do with health there is one way considered to be the best current practice and there is one place that has the best definition. Using a worse explanation is not something that should be done.

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There isn't anything wrong with copying with attribution an explanation.

There is a problem with copying without attribution or your whole work being copied with attribution and sold. The former is unethical which is frowned on in doctors, the second falls under copyright laws I believe and is probably less of interest to the GMC.

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Mushroom

Nothing to lose a license over...

Things to lose your license to practice over are things like causing real harm to people through fraud or incompetence. A guy that performs an unnecessary procedure on you and then mutilates you should lose his license. Nonsense like this doesn't even come close.

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Re: Nothing to lose a license over...

It's dishonest. Anyone who's trained in a science will have had this drilled into them at uni and will be well aware. Dishonesty in a position of high responsibility is heavily frowned upon by the GMC, and rightly so.

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Re: Nothing to lose a license over...

As a lawyer and medical ethicist, I'm very much on the side of those who wonder what the hell the GMC is wasting time on this for. If, and only if, they are found guilty of something in a court should this become a Fitness to Practice hearing. With all the piss-poor care that seems to be being reported, one would hope that the GMC has more than enough actual, genuine cases in which fitness to practice should be questioned.

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So why are doctors tried in secret for plagiarism, yet, everyone else is tried in open court? If they were plagiarising patients medical notes, I could understand it, but a text book?

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I'm guessing it's because it's a professional tribunal, not a court of law. Thus, they can do whatever the rules of the appropriate professional body allow.

These doctors aren't facing jail-time, at worst they're going to be un-doctored.

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Headmaster

These doctors are not being "tried" in a "court", they are appearing before their organisations governing body. This body controls who is licensed to practise medicine.

I believe that doctors are held to a high standard of honesty and integrity and the actions they are accused of bring those qualities into question, even though what they did might not be illegal.

As an aside it was only when I got to the bottom of this article I realised that these were British doctors: a hint nearer the top might have been useful!

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Re: British

The article doesn't say that they were British; just that the BMI is involved. I would have thought however that the names of the three gentlemen were a dead giveaway: Dr Afroze Khan, Dr Zishan Sheikh and Dr Shahnawaz Khan? Definitely British.

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But...

It is not best practice to rip off someone else's work and pass it off as your own to make a commercial gain.

Most scientific papers are supported by quotes and texts by other authors and researchers but tend to be properly referenced.

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Struck off and die?

Seems a bit heavy-handed - it may well be that they have indulged in a bit of unprofessional plagiarism, but how does that affect their medical skills? Personally I don't give a damn if my GP is regularly downloading 'pirate' music, or parks his car on a double yellow line, so long as he's medically competent.

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Anonymous Coward

Re: Struck off and die?

While working in an Acute Hospital I have been constantly asked to 'Turn (X) into a word document so we can use it' - where (X) is normally a book, leaflet or PDF.

When I explain about copyright and the requirement for reasonable use and attribution, I am met with blank stares - usually followed by 'We don't have the time/budget for that'.

I'd be happier if they just stated the truth - 'But then I'd have to do the work myself and understand it, rather than just use this and take the credit'

Nice to see at least an attempt to enforce professional standards. If someone is willing to cheat and rip off another's work in the publication of material then it's reasonable to conclude that they may well have done this elsewhere too.... in their medical exams, for example.

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Anonymous Coward

Re: Struck off and die?

Doctors occupy a position of the highest trust, you must be literally able to trust them with your life. Will a doctor who is prepared to lie and cheat for money be also willing to prescribe drugs based on whether he is being given a kickback to prescribe them, instead of what might be the best drugs to heal you?

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Re: Struck off and die?

I'm guessing that that's the maximum penalty that this tribunal can impose for any cause, and very unlikely to happen in this case. Unless the copyright owner is very influential - which they may be.

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Rol
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Re: Struck off and die?

"......but how does that affect their medical skills?"

Doctors are far more than flesh mechanics!

A doctor must behave like the wife of Caesar, anything that might bring their reputation into question, their judgement or their professionalism is sufficient to have them considered unsuitable to occupy that position of trust.

And trust is pivotal when considering they have the power of life or death in their hands.

No, if they have committed an offence, they have crossed the Rubicon and no longer can they be trusted to make value judgements when their own values have been proved flawed.

I hope they are innocent, but I hope more that the high standards are maintained, standards which they were fully aware of when they joined the highly paid profession.

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Rol
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Re: Struck off and die?

and let's not forget, while they were busy putting this app together, they were most probably getting paid to look after their patients, a role that is supposed to be very demanding of your time and energy.

Maybe, if the money made from the app, was given to their employer, the NHS, all could be forgiven.

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WTF?

@Rol Re: Struck off and die?

"and let's not forget, while they were busy putting this app together, they were most probably getting paid to look after their patients"

So you're saying that doctors never have free time? Never an evening or a weekend off, never go on vacation?

Maybe, just maybe, (and I'm spitballing here), they put the app together outside working hours?

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Re: Struck off and die?

Its more than that.

People are also looking at the amount that a doctor can make and wondering why they feel the need to lie to make more money.

Trust is hard to gain and very very easy to loose.

Shameless greed has the power to tar the industry with a big big brush, especially when you look at all the sound bites that a lazy media can copy and paste (ironic hey?) apps iDoc fake reviews on iStore etc

Throw the greedy fuckers to the wolves

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Re: Struck off and die?

Don't forget - this is about their ethics and fitness to practice medicine. The copyright holder can hit them for infringement and such as well, separately.

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Re: Struck off and die?

Well that sounds amazing, but in reality there are bound to be lots of doctors of mediocre or less character, just as with every profession. It took twelve years to get Andrew Wakefield struck off the Medical Register, and parents all over the world still question whether the MMR vaccine is a good idea based on what he told the press. Think how many doctors there are who didn't do anything that obviously and publicly bad.

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Mushroom

Re: Struck off and die?

> A doctor must behave like the wife of Caesar,

Good luck actually holding up that kind of absurd standard.

The problem of course is that while you are busy creating a standard that no honest man can satisfy, the rest of us will have to suffer for it while all of the competent people that care about their profession are cast out. The only people left will be the really hard core sleazebags that can game this kind of system.

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WTF?

if the money was given to the NHS, all could be forgiven.

Er, why? Are you in favour of dishonesty when the state does it?

Terrible the way AT&T slurped all that data. If only they'd given it to the NSA, all could be forgiven.

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They should have copied from more than one place.

Copying from a single place is PLAGIARISM

Copy from many places is RESEARCH

but only if you attribute it :¬)

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What does plagiarism have to do with Fitness to Practice?

Not that I'm saying what they did is ok, but plagiarism has nothing to do with fitness to practice medicine.

Would a doctor who receives a speeding ticket also be struck off? Both are offenses, but not crimes, and neither should have an impact on a doctor's fitness to practice medicine.

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Re: What does plagiarism have to do with Fitness to Practice?

Breach of patient trust

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Thumb Up

Re: What does plagiarism have to do with Fitness to Practice?

Seems there are too many doctors in that country, keep up the excellent work! </sarcasm>

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Mushroom

Re: What does plagiarism have to do with Fitness to Practice?

> Breach of patient trust

Due to lying or cheating someone else? Really.

No. "Breach of patient trust" is something like falling asleep on duty or prescribing something to a patient when they are allergic to it. Nonsense that happens out of the operating theater really doesn't matter.

You know: the "do no harm thing".

Even a pervassive inability to get your bills right doesn't qualify as "breach of patient trust".

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Devil

Re: What does plagiarism have to do with Fitness to Practice?

Personally, I don't want to be treated by a doctor who has been proven to think, "Rules for doctors? Ha! They don't apply to me!" Call me picky.

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FAIL

@Squander Two

"Personally, I don't want to be treated by a doctor who has been proven to think, "Rules for doctors? Ha! They don't apply to me!""

Doctors are fallible like everybody else; they get speeding tickets, shout at their kids, smoke, and don't always recycle properly.

If the next time you're ill enough to need a doctor you decide to wait for one who's never ever broken a rule, even one totally unrelated to their profession, then you're going to be in for a long painful illness.

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Re: What does plagiarism have to do with Fitness to Practice?

>Would a doctor who receives a speeding ticket also be struck off?

Honesty offences are treated differently than violence offences, are treated differently than traffic offences. This is not just medicine: there are a lot of jobs you can't get (storeman, shop assistant, lawyer, etc) if you have a dishonesty offence record.

I don't know if they will be struck off for this offence, but falsely claiming that you wrote a "Guide to Critical Appraisal" seems to me to be very close to falsely claiming that you know something about medicine.

I think I would be very worried about being treated by a surgeon who had a record of lying about his qualifications. Or a critical-care doctor who I knew had lied about how much he knows about critical-care.

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"never ever broken a rule, even one totally unrelated to their profession"

Well, there's the rub. What's related to their profession and what isn't?

Do you think Roy Meadow should have been struck off? Genuine question; reasonable people can disagree on this one. After all, his infraction amounted to misinterpreting some statistics and being mistaken -- not the same as lying -- when testifying in court, neither of which had much to do with treating patients per se. He certainly committed no crime. But the GMC thought he should be struck off, and I agree with them.

I have actually been in the position of needing doctors pretty damn urgently, and have a lot of experience of dealing with them. That experience has taught me quite a bit about the differences between the good ones and the bad ones. Contrary to what a lot of people commenting here think, it's not medical knowledge that's the clincher. A doctor who doesn't understand what's wrong with you can still be brilliant if they acknowledge that they don't know and so defer to another doctor. The big problem you run into with doctors -- the problem that can kill you all too quickly -- is arrogance. When they're not sure what's wrong with you but would never admit that, when they're sure that their years of experience mean they can just tell what's wrong with you and so they don't need no stinking tests, when they don't listen to their patients because they know better than some unqualified hypochondriac pleb, when, in short, they are convinced of their own brilliance: that's when you need to get the hell out and find another doctor, urgently. Not that you always have that option. Read the headlines: this is what a large proportion of malpractice and wrongful death cases boil down to. "My husband had brain cancer but his doctor told him to take an aspirin." We've all seent hat one, far too many times. My own wife's life was saved when a doctor overruled the arrogant idiot who was treating her, thank God. I met an old freind a couple of weeks ago who I'm pretty sure is going to die soon, largely due to his misplaced trust in his arrogant moron of a GP.

Trust is a big deal. When misplaced, it can kill. But, even when it doesn't, breach of trust has a knock-on effect: if a patient has plenty of experience of untrustworthy doctors, they will cease to trust the medical profession as a whole, and so will avoid perfectly good doctors in future. Thus, having a run-in with an untrustworthy doctor in 1980 can lead to your death in 2020. This happens. Speak to people who go see alternative quacks instead of doctors: they're not all just delusional; plenty of them avoid conventional medicine because they've learnt the hard way that its practitioners are not to be trusted. Which is why crowing at them that it's "evidence-based" has no effect. This being the case, it is obviously in the interests of the medical profession to purge themselves of anyone untrustworthy.

For me, this plagiarism is indicative of arrogance; of contempt for rules and a readiness to lie. In the UK, for better or worse, we have a breezy laugh-it-off attitude to speeding tickets, and so you don't need to be particularly arrogant or contemptful of socety at large to get one -- which is why you bring it up as an example, of course. But it does depend. 35 in a 30 zone? Who cares? 60 in a 30 zone? Yes, strike the bastard off.

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Re: "never ever broken a rule, even one totally unrelated to their profession"

@Squander Two:

"Contrary to what a lot of people commenting here think, it's not medical knowledge that's the clincher. A doctor who doesn't understand what's wrong with you can still be brilliant if they acknowledge that they don't know and so defer to another doctor. The big problem you run into with doctors -- the problem that can kill you all too quickly -- is arrogance."

It isn't just doctors - anyone you deal with that is confident enough to say "I don't know, but I do know how to find out" is worth their weight in gold, whether it is your local shopkeeper or a professional. The problem is, as I was once seriously asked by a surgeon, "If I'm going to be cutting you open and rummaging about in your insides, do you want me to come into the room with confidence bordering on arrogance or do you want me to tell you all the times I've had things go awry?" The point is, most of us want the people with our lives in their hands to appear more godlike than human. However, a little humility helps to temper that - the surgeon that failed to act appropriately to save my father's life was retired early as a result of our complaint about his offhand manner when we praised the care but asked why he wasn't transferred to the local centre of excellence. Had he said "I made a mistake" he wouldn't have triggered he investigation that showed he had not followed best practice in his treatment ...

"When they're not sure what's wrong with you but would never admit that, when they're sure that their years of experience mean they can just tell what's wrong with you and so they don't need no stinking tests, when they don't listen to their patients because they know better than some unqualified hypochondriac pleb, when, in short, they are convinced of their own brilliance: that's when you need to get the hell out and find another doctor, urgently. Not that you always have that option. Read the headlines: this is what a large proportion of malpractice and wrongful death cases boil down to. "My husband had brain cancer but his doctor told him to take an aspirin.""

Yes, but the medical training system leads to this. The concept of the differential diagnosis, which essentially places a premium on the most probable cause for any given symptoms, means that an atypical presentation will not necessarily lead to a correct diagnosis. The only option is to send anyone that complains of e.g. recurrent headaches immediately for a brain scan (which might not pick up the problem anyway), instead of suggesting that a trip to the optician is a good idea (which is more likely to pick up the problem).

"Speak to people who go see alternative quacks instead of doctors: they're not all just delusional; plenty of them avoid conventional medicine because they've learnt the hard way that its practitioners are not to be trusted."

We have a difference of opinion about the level of delusion of people that go to unlicenced, unregulated, and/or openly fraudulent "alternative" practitioners. The only way they might be considered to be better off is that they possibly don't risk side-effects from non-active substances. What these doctors have done is make the best available information easy to access for practitioners, thus making it less, rather than more, likely that mistakes will occur. Otherwise, people believing in "woo-medicine" are totally delusional.

"For me, this plagiarism is indicative of arrogance; of contempt for rules and a readiness to lie."

To be fair, my fairly extensive experience of doctors is that they think plagiarism is restricted to cheating in exams. Copyright means as little to them as it does to the average person that downloads music from unofficial sources. You are holding them to higher level of knowledge than they have. That the authors and publisher of the book didn't think of this shows greed and untrustworthiness that concern me far more than the actions of the people that wrote the app.

"But it does depend. 35 in a 30 zone? Who cares? 60 in a 30 zone? Yes, strike the bastard off."

No, it depends on a lot more - had he taken account of all considerations? What was the time and what were the road conditions? Why was he speeding? Was there an emergency situation? 60 in a 30 zone in a heavily built up area with children crossing the road to go to school isn't ever safe (despite the way some of the plod drive when it suits them), but it might be at 4am. Context is all.

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FAIL

Re: "never ever broken a rule, even one totally unrelated to their profession"

"If a patient has plenty of experience of untrustworthy doctors, they will cease to trust the medical profession as a whole, and so will avoid perfectly good doctors in future. Thus, having a run-in with an untrustworthy doctor in 1980 can lead to your death in 2020"

Yup. My old doctor was not good. I don't have much experience with my new doctor, but since my mother had an allergic reaction to a medicine and he went and prescribed the exact same thing under a different name, I have little trust in him.

I will visit my doctor when it is a choice between seeing him or going to emergency.

Fail icon: him, and me :-)

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Re: "never ever broken a rule, even one totally unrelated to their profession"

Intractable Potsherd,

> The problem is, as I was once seriously asked by a surgeon, "If I'm going to be cutting you open and rummaging about in your insides, do you want me to come into the room with confidence bordering on arrogance or do you want me to tell you all the times I've had things go awry?" The point is, most of us want the people with our lives in their hands to appear more godlike than human.

Agreed, but there's a difference between how they appear and what they actually do. No matter how confidently we might want our surgeon to behave, we wouldn't want them to be opening us up without first getting us X-rayed or scanned because they're so brilliant they don't need to. Of course, surgeons never do this (except on the battlefield), but there are plenty of people who never get to the surgeon in time because other doctors have such faith in their own diagnostic intuition that they don't bother with tests.

Airline pilots are trained to appear arrogant for the same reason: to give passengers confidence. The way they sound rather bored over the tannoy is something they're taught, to convey the impression that they could fly a plane in their sleep. But they don't fall for the bullshit themselves to the extent of refusing to listen to air traffic control and not looking at any of the instruments.

> Yes, but the medical training system leads to this. The concept of the differential diagnosis, which essentially places a premium on the most probable cause for any given symptoms, means that an atypical presentation will not necessarily lead to a correct diagnosis.

True, the first time. The problem with medical arrogance is that this still happens when the patient is coming back for the eighth time after being unsuccessfully treated by everyone else -- or even coming back with a previously correctly diagnosed condition, fully explained in their notes, which the doctor chooses to ignore because they're too damn brilliant to need to read other doctors' notes. I've seen that first hand more than once.

I think people who haven't been at the sharp end drastically underestimate the damage done to the reputation of the profession by arrogance. I can see why the GMC would come down like a ton of bricks on any case like this they came across, even if it might look like an overreaction to some of us outsiders.

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I do hope D.E Knuth doesnt try this

It is a little worrying that you cant have an app like this because someone wrote it in a book first.

I somehow doubt the authors of the book wrote it completely off their own backs - they have taken standard best practices used across the world and written them down but I doubt if they can be said to own them in any real sense of the word.

There may be a technical breach of copyright but then there is fair use and its not like the original authors tried to patent the methods.

The authors should put out a free app for android.

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Re: I do hope D.E Knuth doesnt try this

It is a little worrying that you cant have an app like this because someone wrote it in a book first.

It certainly would be, if that were the case. But that's clearly not what's going on here.

The allegation is that specific substantial parts were copied without permission or attribution. In other words, creating an app like this is probably fine, so long as the content is original, or proper permission is granted and credit given for copied content. That's pretty much how copyright works in every industry.

I somehow doubt the authors of the book wrote it completely off their own backs - they have taken standard best practices used across the world and written them down but I doubt if they can be said to own them in any real sense of the word.

AIUIBIANALSTWAGOS, recipes in the US are not eligible for copyright, but collections thereof are -- the creative part being considered the selection and organization of the recipes. This might be considered a reasonable parallel to a selection and organization of standard practices. If that is what was copied for the app, I can see a case.

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Anonymous Coward

All educated in the UK

and good english names to boot, do they not realise they play into the stereotypical migrant ideal that the UK biggots have?

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Joke

So I might not be in a position to complain, but if I'm in need of critical appraisal the very last thing I want to see is a doctor referring to an app on their phone!

Facebook update: "GEES, look at this guy, ha ha ha ..."

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Anonymous Coward

BM Institute

Load of crap Institute can do witchhunts but not apps.

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Anonymous Coward

Re: BM Institute

So what were you struck off for? Stealing drugs? Interfering with patients?

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Pirate

Isn't it usual in the UK that...

...when you get struck off you then open a private medical practice?

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Re: Isn't it usual in the UK that...

No, struck off means you cannot practice anywhere in the UK, public or private

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Re: Isn't it usual in the UK that...

No, struck off means you cannot legally practice anywhere in the UK, public or private

FTFY

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