Medical education and professionalism

Abstract

Since Hippocrates, a dozen precepts have provided guidance for medical education and professionalism. Not so any more. The UK's General Medical Council (GMC) has specified 300 standards for undergraduate education and behaviour in two reports. The first, Medical students: professional values and fitness to practise was published on March 11. The second—an update of Tomorrow's Doctors—is available for consultation until March 27 and will be published in the summer. Standards for professionalism, safety, and diversity are important. However, with so many requirements, the relative merit of each point is lost, as is the broader goal of education. Medicine and education have changed since the GMC's last edition of Tomorrow's Doctors in 2003. Medical school intake has expanded, often students are older at entry, and they graduate with larger debts. More teaching is devolved to non-physicians. Medical practice is increasingly influenced by economics and global health. Graduates work shorter hours with less on-the-job training, but care for people who live longer, experience more comorbidity, and receive polypharmacy. Doctors make greater use of electronic resources, not only for information and learning, but also for consultations, records, diagnosis, treatment, and follow-up. Yet the skills to meet rapidly evolving contemporary practice are barely acknowledged in the GMC's reports, let alone developed imaginatively for future practice. To address the needs of medical students, more educational research of high quality is needed, not more regulation. The burden of bureaucracy on clinician-educators, whose contributions as teachers and role models are so often undervalued, is already immense. Tomorrow's doctors will retire around 2055, so action is needed now to future-proof their skills. To enable students to provide best practice throughout their careers, medical schools should prioritise the teaching of skills for self-directed, lifelong learning: particularly evidence-based practice and computer literacy. Students are medicine's greatest asset. Their full potential is only realised if education nurtures enthusiasm and ideals, fosters compassion, and kindles a spirit of scientific inquiry. The GMC should concentrate on promoting these qualities.