General Medical Council Survey Research Articles

Hospital Mortality and Trainee Experiences: How General Medical Council Survey Findings Correlate With Summary Hospital-Level Mortality Indicator.

This study aimed to investigate whether components of junior doctor satisfaction are associated with patient mortality within the United Kingdom. We conducted a cross-sectional study of publicly available data (the General Medical Council [GMC] National Survey and the Summary Hospital-level Mortality Indicator [SHMI]) pertaining to subjective physician trainee satisfaction and patient mortality within 80 United Kingdom-based healthcare institutions. The direction and strength of correlation between components of the GMC National Survey and relative patient mortality as described by the SHMI were calculated. Additional outcomes included mean GMC survey scores for reported domains and mean SHMI by healthcare institution. SHMI for included healthcare institutions ranged from 0.69 to 1.21 (mean [SD], 1.01 [0.1]). Mean GMC domain scores ranged between 44.61 and 88.62 (mean [SD], 71.16 [10.84]). Statistically significant correlations were observed for clinical supervision, clinical supervision out of hours, rota design, overall satisfaction, and teamwork. After application of Bonferroni correction, statistically significant correlations remained for both clinical supervision and clinical supervision out of hours. There is a significant association between components of subjective trainee satisfaction and patient mortality within the United Kingdom. Further investigation to examine these relationships, perhaps to target intervention, may prevent avoidable patient harm.

Quality in postgraduate medical education: hearing the trainee voice and beyond

Most doctors in training will have completed the annual General Medical Council training survey, but what happens to the results and how do they lead to improvement in the quality of training? This article discusses the General Medical Council survey and potential ways in which the assessment of quality in postgraduate medical training could be improved.

A model for improving postgraduate medical education using the GMC survey

AimsTo investigate whether the General Medical Council (GMC) National Training Surveys (NTS) can be analysed to develop a plan of action that improves postgraduate training.BackgroundAs part of its role in quality assurance of medical training, the GMC conducts an annual survey of trainers and trainees. The Doctors in training survey, part of the NTS, consists of 70 questions which are grouped into 18 indicators of quality. At Surrey and Borders Partnership NHS Foundation Trust, we were keen to use the comprehensive data in the NTS to improve training. We analysed each question to create a plan of action to improve the quality of training.MethodWe used data from the online reporting tool to calculate the scores for each question in the 2018 NTS. Taking into account the impact of year-on-year changes in the content of the survey, we examined the score, change from 2017 to 2018, and difference between the score and indicator mean to identify poorly-performing questions. Other questions with clear potential for further improvement were also highlighted. A plan of action was produced by the Leadership and Education Fellow and Director of Medical Education.Result29 actions were identified. The most common were to ensure that information (e.g. job descriptions, professional opportunities) was accessible to trainees (8 actions); liaise with other teams (e.g. Human Resources, Safety team) (6); discuss issues with or provide information to trainers (5); discuss with trainees to contextualise survey results within their experiences (4); and ensure that information was delivered at induction (3).To implement these actions, we conducted a workshop for trainers and held feedback meetings with trainees. 76.5% of trainers (13/17) and 88.5% of trainees (23/26) surveyed following these respective events agreed or strongly agreed that the NTS can be used to improve the training experience. A presentation on making the most of the placement was added to trainee induction and was rated excellent or good by all respondents (28/28). Posters were also produced to disseminate information. In the subsequent NTS, there was an improvement in SABP's performance in 12/18 indicators in the Doctors in training survey, with one green flag denoting performance in the top quartile of trusts nationally.ConclusionThe NTS can be analysed to create a plan of action with elements that trainers and trainees feel can improve their experience. Our model demonstrates the potential for using NTS data to plan quality improvement in training.

Enhanced faculty development: using the GMC survey to run a trainer development workshop

AimsTo investigate whether the General Medical Council (GMC) National Training Surveys (NTS) can be analysed to create a trainer development workshop that improves postgraduate training.BackgroundAs part of its role in quality assurance of medical training, the GMC conducts an annual survey of trainers and trainees. The Trainer survey, part of the NTS, consists of 47 questions which are grouped into 11 indicators of quality. At Surrey and Borders Partnership NHS Foundation Trust, we were keen to use the comprehensive data in the NTS to improve training. We analysed each question to create a workshop to engage trainers in discussion about improving the experiences of trainers and trainees.MethodOur analysis of the NTS used data from the online reporting tool to calculate the scores that were obtained for each question in the 2018 NTS. A question was discussed at the workshop if it performed poorly relative to other questions in the indicator; to provide useful information; or to clarify ambiguity. Indicators where interesting comparisons can be drawn between the views of trainers and trainees were also discussed. The 90-minute workshop was led by the Leadership and Education Fellow and Director of Medical Education. Attendees were subsequently sent an online survey.ResultThe workshop consisted of an introduction to the NTS; group discussion on which indicators were felt to be important, good- or poor-performing; discussion of specific questions; and a review of feedback from trainees.12 questions and 3 indicators (Handover, Supportive environment, Rota design) were discussed. 11 questions were chosen for poor performance, which sought to contextualise the results within the experience of attendees. 8 questions were chosen to provide information, such as resources and current initiatives. 3 were chosen to clarify ambiguity. Many questions met several criteria.17 attendees responded to the online survey. 64.7% agreed or strongly agreed that the NTS asks questions that are important for them. 76.5% agreed or strongly agreed that the NTS can be used to improve the trainer experience.In the subsequent NTS, there was an improvement in 9/11 indicators in the Trainer Survey, with four green flags denoting performance in the top quartile of trusts nationally.ConclusionThe NTS can be used to structure a workshop that trainers feel can improve their experience. Our strategy demonstrates the value of analysing the NTS dataset intelligently to engage trainers in improving training.

The GMC national training survey: Does it have an impact?

The General Medical Council (GMC) national trainee survey (NTS) monitors junior doctor training experience annually, which is then used by organisations such as Health Education England to inform quality management. Its validity as an assessment of the learning environment to drive improvement is frequently questioned; currently there are no published evidence-based studies to demonstrate its impact. To explore the effects of the GMC survey, we carried out a retrospective cohort study using publicly available GMC NTS survey data. We compared 2018 and 2019 scores in paediatrics in London across all 18 survey indicators, to identify any relationship between these 2 consecutive years of data. Our findings demonstrate that results of the GMC NTS in 1 year are associated with a change in the NTS the following year, with both an improvement in below average departments and deterioration in above average units. These findings suggest that annual GMC NTS results may have an impact on the quality of learning environments as measured in subsequent surveys - therefore they act as both a measure and a potential modifier of outcome.

The key features of highly effective training units in obstetrics and gynaecology

Key content High‐quality training environments may increase job satisfaction, reduce attrition and promote excellence in education and training. Data on training are collected through the General Medical Council Survey, Training Evaluation Form and Workforce Survey. Attrition rates in obstetrics and gynaecology are high (30%) – among the highest across all specialties – and reasons for this include morale and undermining, training processes and paperwork, support and supervision, work–life balance, National Health Service environment and job satisfaction. High attrition rates affect the remaining workforce and can have a negative impact on the working environment. Learning from excellence may be more helpful than focusing on negative aspects of poor training. Learning objectives To understand the fundamental features of highly performing units. To identify contributors to poor training performance. To implement a simple structure for analysing training performance. To learn simple interventions that can improve training.

Handover among junior doctors: a quality improvement study

Background/Aims Handover is a procedure that ensures efficient transfer of clinical information across teams. It is also an opportunity for junior doctors to develop clinical competencies, communications skills and leadership. Poor handovers can result in delays, clinical errors, duplication of work, poor morale, increased length of hospital stay, and risk of harm to patients. Poor handovers were identified as an area of concern for two successive years in the General Medical Council's survey. Methods Measures were undertaken to address this by updating their handover policy, developing a new handover protocol and instigating rota monitoring by involving junior doctors and consultants through focus groups. A survey was conducted among the same cohort of junior doctors before and after the interventions. Findings There was a remarkable improvement in junior doctors' attitudes towards safety, frequency of face-to-face handover, use of a handover book, and overall positive experiences of the handover procedure. Conclusions It is worth examining the approach to handover among other health professionals and perhaps between professions regarding the same patients.

A model for embedding high-fidelity simulation training within core medical training (soon to be internal medicine training)

Feedback obtained from the General Medical Council survey of trainees within Oxford Deanery, now Health Education Thames Valley (HETV), from 2014 to 2016, supplemented by local surveys of Frimley Health’s outgoing cohorts of core medical trainees (CMTs), highlighted a dire lack of procedural exposure across CMT programmes both locally and nationwide. We aimed to develop and embed a sustainable simulation training programme tailored to the ‘essential and desirable procedures’ and ‘emergency presentations’ outlined in the Royal College of Physicians / Joint Royal Colleges of Physicians Training Board curriculum for core medical trainees which provided them with the necessary skill set to develop as …

Higher specialty training in genitourinary medicine: A curriculum competencies-based approach.

Specialty trainees in genitourinary medicine (GUM) are required to attain competencies described in the GUM higher specialty training curriculum by the end of their training, but learning opportunities available may conflict with service delivery needs. In response to poor feedback on trainee satisfaction surveys, a four-year modular training programme was developed to achieve a curriculum competencies-based approach to training. We evaluated the clinical opportunities of the new programme to determine: (1) Whether opportunity cost of training to service delivery is justifiable; (2) Which competencies are inadequately addressed by direct clinical opportunities alone and (3) Trainee satisfaction. Local faculty and trainees assessed the 'usefulness' of the new modular programme to meet each curriculum competence. The annual General Medical Council (GMC) national training survey assessed trainee satisfaction. The clinical opportunities provided by the modular training programme were sufficiently useful for attaining many competencies. Trainee satisfaction as captured by the GMC survey improved from two reds pre- to nine greens post-intervention on a background of rising clinical activity in the department. The curriculum competencies-based approach to training offers an objective way to balance training with service provision and led to an improvement in GMC survey satisfaction.

More junior doctors report heavy workloads, GMC survey finds

Over two fifths of junior doctors reported that their workload was heavy or very heavy, a General Medical Council survey has found. On Thursday 14 July the GMC published the preliminary results of its national training survey in medical education and training in the United Kingdom. Of the junior doctors who responded to the survey, 43% described the rate of intensity of their work as heavy or very heavy, an increase of 2% from the 2015 survey. In 2014, 42% gave the same response. Of the 54 563 doctors training in the UK who were surveyed by the GMC, 53 835 responded—a 99% response rate. The survey was open from 22 March to …

Evaluation of the educational climate for specialty trainees in dermatology.

Dermatology specialty trainees (STs) in the United Kingdom (UK) are few in number and will join a thinly spread national consultant body. It is of paramount importance to deliver training programmes of the highest quality for these doctors, central to which is the establishment and maintenance of an educational climate conducive to learning. To conduct a pilot study to evaluate the educational climate for dermatology STs in one UK deanery (West Midlands). Secondary analysis of published data was performed, from the UK's General Medical Council (GMC) national training survey, and the Job Evaluation Survey Tool (JEST) administered by the West Midlands deanery. A modified online version of the Postgraduate Hospital Educational Environment Measure (PHEEM) was circulated among dermatology STs. The GMC's survey data show that UK dermatology STs rated their training highly in comparison with undifferentiated UK postgraduate trainees. West Midlands dermatology STs (n=22) scored very similarly to UK dermatology STs. The JEST gave broadly encouraging results, with 21/22 (95%) happy to recommend their posts to colleagues. The modified PHEEM yielded a global mean score of 96.5/152, attracting the descriptor 'more positive than negative but room for improvement'. Despite inherent methodological limitations, the GMC, JEST and modified PHEEM surveys have revealed useful comparative triangulated data which allows the conclusion that West Midlands dermatology STs seem to be training in a favourable educational climate. This represents an important facet of the quality assurance process for medical education, and allows insight into areas which may require improvement.

Surgeons are less satisfied with training than other doctors, GMC survey finds

Surgeons are less satisfied with their training than doctors working in other specialties, a General Medical Council survey has found. More than 53 000 doctors in training completed the GMC’s national training survey. Overall, trainees recorded a satisfaction score of 81.2 out of 100, an increase from the 2013 score of 80.8.1 The GMC measured satisfaction by asking junior doctors about their post, including how they rated the …

MEDICAL HANDOVER IN NORTHAMPTONSHIRE HOSPICES: ROOM FOR IMPROVEMENT?

BackgroundA rigorous medical handover system in a hospice is essential to ensure patient safety as well as quality and continuity of care especially in the face of changing work patterns...

Limitations of GMC survey on overseas doctors

EDITOR—I was interested to read about the survey conducted by the GMC (General Medical Council) on career prospects for overseas doctors in the United Kingdom.1 The GMC surveyed a sample of recently passed PLAB (Professional and Linguistic Assessment Board) candidates and concluded that more than 75% of these doctors got a job within eight months of their arrival. This is completely at variance with the experience of overseas doctors on the ground. It would have been helpful if the GMC …

Basic Medical Education in the British Isles

Journal Article Basic Medical Education in the British Isles Get access Basic Medical Education in the British Isles Vol. 1. General Section & School Profiles Vol. 2. The Disciplines & Specialities. The Report of the General Medical Council Survey. Pp. xvi + 876, hard cover. London: The Nuffield Provincial Hospitals Trust, 2 Vols. £14. 1977. Postgraduate Medical Journal, Volume 54, Issue 631, May 1978, Page 364, https://doi.org/10.1136/pgmj.54.631.364-b Published: 01 May 1978

The GMC Survey

The GMC Survey