Professional boundaries
These scenarios test “professional integrity”. They often ask how you can be helpful while keeping the boundaries that protect professional judgement and trust. The GMC expects you to maintain professional boundaries and not let personal interests affect your professional judgement.
Gifts
You must not ask for or accept gifts, payments or hospitality that may affect, or be seen to affect, how you treat or refer patients.
Usual starting point: a small, unsolicited token of thanks after care has finished, such as chocolates for the ward, can usually be accepted graciously, in line with local policy.
What could change it: the gift is large or money; it is offered during ongoing care, so it could be seen to influence treatment; it comes with an expectation; or local policy requires declaration. Declining politely and explaining why, or declaring the gift, is then the better option. Refusing rudely introduces a different problem.
Treating yourself, family, friends and colleagues
Wherever possible, you must avoid providing medical care to yourself or anyone with whom you have a close personal relationship, and avoid prescribing for yourself or those close to you.
Usual starting point: decline politely and direct the person to their own GP or the appropriate service. This applies to colleagues asking for an informal prescription as much as to relatives.
What could change it: a genuine emergency where no one else is available. Then do what is necessary and hand over care promptly.
A related pattern is a friend or relative admitted to your ward. Avoid accessing their records unless you are directly involved in their care. Consider asking a colleague to take over, and do not share information with mutual acquaintances.
Relationships with patients
You must not use your professional position to pursue a sexual or improper emotional relationship with a patient or someone close to them.
Usual starting point: if a patient or relative shows romantic interest, respond kindly but clearly that this is not appropriate, and consider whether their care should be transferred to a colleague. If you are worried about boundary-crossing by a colleague, seek advice from a senior; the GMC guidance covers reporting responsibilities.
Social media and private messaging
When communicating publicly, including on social media, you must keep patient confidentiality, be honest, and maintain boundaries. Messages in private groups may become public.
You may see questions such as:
- A patient sends a friend request. Usually decline politely and keep communication within professional channels.
- A colleague posts about a patient. Even without a name, details can identify someone. Usually speak to the colleague promptly and ask them to remove it. Escalate if the post is serious or they refuse.
- A ward WhatsApp group shares patient details or photographs. Raise the concern and use approved systems for clinical information.
What changes the response is how identifiable and harmful the content is. A clear confidentiality breach needs prompt action, not just a quiet word next week.
Honesty about yourself
You must always be honest about your experience, qualifications and current role, and introduce yourself to patients.
Questions may involve overstating experience on an application, letting a patient believe you are more senior than you are, or claiming a competency that has not been signed off. Look for an option that corrects the false impression clearly. Also see requests to hide or misrepresent.
References
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