Prominent obstretrician Professor Wendy Savage gained only 26 votes, to General Medical Council president Sir Donald Irvine's 56 in an election held on Tuesday.

Prof Savage was the first person to challenge an incumbent president of the General Medical Council (GMC).

She has led criticism that Sir Donald has been over zealous in his attempts to reform the profession following the Bristol case.

Last year, the GMC struck off two doctors, surgeon James Wisheart and manager John Roylance, following an investigation into the deaths of 29 children after heart surgery at the Bristol Royal Infirmary. A third doctor, surgeon Janardan Dhasmana, was barred from operating on children for three years.

All three doctors were found guilty of serious professional misconduct.

The GMC found that two surgeons had continued to operate on babies and young children despite the fact that they knew too many were dying, and that Dr Roylance had failed to intervene despite the high death rates.

A public inquiry ordered by Health Secretary Frank Dobson is under way into the Bristol case.

Fitness to practise

Janardan Dhasmana was barred from operating on children

The most controversial of Sir Donald's reforms are his plans to make doctors demonstrate their competence at regular intervals - a process known as revalidation.

Some parts of the medical profession have felt that Sir Donald's radical reforms after the Bristol scandal have unfairly pilloried doctors.

In her election address, Professor Savage said: "I have decided to stand for the presidency because I have concerns about the manner and direction in which Sir Donald is leading us.

"As an elected member, I believe it is my duty to openly express the disquiet that other doctors have voiced privately."

She added: "Many doctors are critical of the way the President acted following the Bristol case and the haste with which 'revalidation' was pushed through without adequate consultation.

"I consider that the decision to embark on this case was a major political error and has caused untold damage to the parents of the children and the profession."

Sir Donald, who has been president of the GMC since 1995, is defending his position.

He told the Council: "The unpredicted, high profile cases at Bristol and elsewhere have shaken public and Government confidence in the profession and caused dismay amongst those who care about the profession's self respect.

"The GMC has been thrust into the public gaze. Against this background the present Council has been vigorously proactive, reaching out across the country to build new and more effective relationships with our key constituencies - the medical profession, government and patients."