The General Medical Council (GMC) has produced guidance outlining the requirements and expectations for clinical attachments (also known as observerships). Such a clinical attachment is primarily intended for international medical graduates (IMGs) and doctors who are suspended or who have undertakings/conditions on their registration.
Here we summarise the provisions, but do ensure that you read the linked fuller guidance.
Clinical Attachments for International Medical Graduates:
IMGs can observe medical processes in the UK, particularly in the NHS, under the supervision of a consultant. Initially, IMGs cannot make clinical decisions or give advice. After observation, they may take on limited duties, such as:
➽ Observing consultations
➽ Clerking (patient administration)
➽ Taking patient histories
➽ Physical examinations (under direct supervision)
➽ Observing surgery
Clinical Attachments for Doctors with Undertakings/Conditions:
Used as a way to reintroduce clinical duties after being out of practice. Supervised by a named clinical supervisor, with duties aligned to restrictions or requirements. There is to be an initial observation phase, followed by limited duties after a risk assessment, including:
➽ Observing consultations
➽ Clerking
➽ Taking patient histories
➽ Physical examinations (under direct supervision)
➽ Observing or assisting surgery (under direct supervision)
Clinical Attachments for Suspended Doctors:
Duties must align with those of a final-year medical student (unregistered and unqualified). Direct supervision is required, and no clinical decisions or advice can be given. Suspended doctors must:
➽ Inform their supervisor and patients about their suspension and the reasons for it.
➽ Obtain informed consent from patients before taking histories or conducting examinations.
Role of Clinical Supervisors:
➽ Supervisors are responsible for the actions of suspended doctors, who lack indemnity insurance.
➽ Supervisors must ensure patient safety and avoid reputational risks, especially in cases of suspension due to misconduct.
➽ Regular progress reports and task confirmations must be provided to the GMC.
This guidance ensures clinical attachments are conducted safely and ethically while supporting professional development.
See the GMC Document: Guidance on Clinical Attachments
See also the GMC document (for those who have had a break from practice): Clinical Attachment Report Form (GEN4) and further guidance on the types of evidence that may assist: GMC – Breaks in Practice Guidance
If you seek legal advice on the above guidance, contact Doctors Defence Service on 0800 10 88 739
(Article 5/1/26)