KARIUKI: Inside the legal framework governing doctors, dentists

Yet, circumstances can arise where a practitioner’s or student’s fitness to practice becomes compromised—either due to health challenges, performance or skills issues, or behavioural concerns. This is where the Medical Practitioners and Dentists (Fitness to Practice) Rules, 2016 (Legal Notice No. 128 of 2016) play a vital role.

Enacted under the Medical Practitioners and Dentists Act (Cap. 253), these rules provide a structured, fair and transparent framework to assess and address impairments while prioritising patient safety and supporting rehabilitation where possible.

As CEO of the KMPDC, I have witnessed firsthand how these rules strengthen our regulatory mandate to register, license and oversee practitioners, medical and dental students and health facilities. Introduced in 2016, these rules marked a significant evolution in our approach to professional regulation by shifting focus from purely punitive measures toward proactive intervention and restoration. They apply to all registered practitioners and medical/dental students in approved training institutions, ensuring high standards from education through practice.

Centring on public protection, fitness to practice is defined as having the essential skills, knowledge and character to work safely and effectively. Impairment occurs when health or behavioural conditions risk compromising a practitioner's competence, judgment, or performance.

The rules target serious misconduct, including professional failure, reckless acts, sexual misconduct, dishonesty and substance misuse. They also address concealment of errors, violence, or any behaviour that harms safety or erodes public confidence in professional standards.

This comprehensive scope allows the KMPDC to address a wide range of issues, ranging from addiction and mental health challenges to performance deficiencies, while distinguishing fitness concerns often amenable to support and remediation from outright misconduct, which are handled under complementary disciplinary procedures.

Patients, colleagues, institutions, the public, or even the practitioner themselves can initiate proceedings by completing the prescribed Fitness to Practice Reporting Form. Submissions are received by KMPDC, triggering review by the Fitness to Practice Committee. This committee comprises council members, representatives from the Kenya Medical Association and Kenya Dental Association, the council’s legal adviser and co-opted experts, including specialists and relevant professionals which ensures a multidisciplinary and impartial assessment.

The process begins with a preliminary inquiry to determine if an investigation is warranted. Merited cases undergo formal assessment, resulting in council recommendations ranging from supervised practice to temporary or permanent license withdrawal. 

The rules prioritise medical, social, or professional interventions to correct impairments, reserving license suspension or revocation as a last resort for safety or non-compliance. Restoration is possible after successful intervention, while appeals ensure due process within 14 days.

 Since their implementation, the 2016 rules have bolstered KMPDC’s ability to handle fitness-related concerns transparently and effectively. So far 45 cases have been lodged, 38 completed and seven are currently ongoing. The nature of cases lodged range from mental health concerns (depression, substance use disorders), physical health concerns, abscondment of duty to perceived below average performance in knowledge and skills.

Some of the outcomes of the cases have been referral for medical treatment prior to licensing, clearance for licensure under supervision, examination of knowledge and skills prior to licensing and referral to disciplinary and ethics committee.

The rules promote a culture of accountability while offering pathways for recovery, reducing stigma around health-related impairments (such as substance use disorders or mental health conditions) that can affect even the most dedicated professionals. By enabling early intervention, we prevent potential harm, support practitioners’ return to safe practice and uphold the high standards expected in Kenya’s health sector.

Focused on patient safety, these rules integrate with inspections and the 2022 Inquiry and Disciplinary Proceedings Rules to form a protective regulatory framework. Increased reporting has successfully reduced unchecked risks, reinforcing trust through a balance of compassion and rigor.

Challenges persist, including ensuring timely reporting, maintaining confidentiality and addressing stigma that may deter self-referrals. The KMPDC remains committed to awareness campaigns, training and refining procedures to meet evolving needs. We encourage all stakeholders, practitioners, health facilities, patients and the public to engage proactively and report concerns responsibly, seek support early, and uphold ethical practice.

As Kenya advances its journey toward universal health coverage and higher-quality care, the Fitness to Practice Rules, 2016, exemplify our dedication to excellence. They reassure citizens that their healthcare providers are held to the highest standards and assure practitioners of a fair, supportive regulatory environment. The KMPDC will continue collaborating with government, professional associations, training institutions, and communities to safeguard the integrity of the practice of medicine and dentistry.

Together, we build a healthier Kenya one where fitness to practice is not merely a regulatory requirement, but a shared commitment to compassion, competence, and confidence in every consultation, procedure and patient interaction.

The writer is the CEO, Kenya Medical Practitioners and Dentists Council