General Medical Council's Recommendations Research Articles

COVID-19: opportunities for professional development and disruptive innovation.

As a group of medical students from the United Kingdom (UK), we currently find ourselves in a period of uncertainty as the continuing coronavirus disease 2019 (COVID-19) pandemic has caused widespread disruption to medical education. Our medical schools, like many others, have cancelled clinical placements, formal teaching, examinations and international elective programmes. Despite these challenges, we believe that the unprecedented COVID-19 pandemic is generating opportunities for both professional development and innovation in medical education. Social distancing is the most effective preventative strategy for COVID-19, but for many medical students this creates a gap where previously there were clinical attachments, a seemingly infinite syllabus and looming examinations. This unplanned interruption offers a unique opportunity for professional development, which may otherwise be missed, with the chance to consolidate learning, reflect on personal career plans and engage in academic research. Reflection helps us to process experiences and is a powerful way to facilitate learning. With over 60 specialties, and often limited exposure during medical school, choosing a career path in medicine can be daunting. There are many advantages in having a specialty interest when at medical school, and during this period it may be useful for those still unsure to reflect on past experiences and to consider their academic interests and what factors they value most in their careers. This unplanned interruption offers a unique opportunity for professional development, which may otherwise be missed, … Learning to critically evaluate research to inform future evidence-based practice is an essential skill that medical students must develop and, unsurprisingly, time constraints are often the greatest barrier to involvement in research.1 The General Medical Council recommends keeping up to date with current research in an individual's area of interest through independent study and by conducting literature searches and reviews. During the COVID-19 pandemic there will be barriers to engaging in laboratory- and hospital-based research; however, there is great value in performing systematic reviews of the literature and in taking part in qualitative research projects that may be conducted remotely, all of which will improve skills and strengthen applications to future training posts. We already know many fellow medical students engaging in reviews, video teaching, app development and even online language courses during self-isolation. Medical schools are rapidly trying to adapt their methods of teaching and assessment to accommodate the nationwide lockdown. During the severe acute respiratory syndrome (SARS) epidemic of 2003, Chinese medical schools cancelled clinical teaching and examinations. This led to the implementation of novel online problem-based learning that was so successful it was subsequently integrated into the curriculum.2 Similar to then, online teaching will play a key role in the continuation of the curriculum during the COVID-19 pandemic, with highly reproducible content accessible to students at home. During this rapid restructuring there are opportunities to strengthen engagement by involving students in the planning and execution of learning resources. Evidence shows that involving students as stakeholders in their education adds value and fosters intrinsic motivation, which strongly correlates with self-efficacy and academic performance.3 We encourage medical schools to actively engage with students to call on their ingenuity and to develop these resources, which may benefit medical education in the long term and motivate future educators. … there are opportunities to strengthen engagement by involving students in the planning and execution of learning resources The COVID-19 pandemic is catalysing an enduring transformation in medicine, with advances in telemedicine, disease surveillance and artificial intelligence, which have already been used to triage infected patients. We are experiencing an unparalleled boom in cross-industry cooperation to combat this virus, bringing together pharmaceutical, biomedical, data analytic and computational drug discovery companies with a singular goal. In the UK, we have seen airplane manufacturers, carmakers and Formula One teams repurpose their production lines to build ventilators to cope with rising demand. Johns Hopkins University has developed an interactive web-based dashboard to track COVID-19 in real time, and researchers at King's College London have created a COVID-19 symptom tracker app with more than 1.5 million downloads.4 Disruptive events, such as economic recessions and pandemics, can advance innovation, and there are opportunities here for resourceful initiatives in medical education. Students at Harvard Medical School have already created a rapidly updating COVID-19 curriculum, with the latest research and developments, that is benefiting many clinicians.5 In summary, as medical students affected by this global disruption, we see a rare opportunity for professional development in an otherwise heavily structured degree. In addition, innovation driven by medical students during this viral pandemic may accelerate the continuing transformation away from traditional teaching methods in medical education. Analysing the effects of this change, and professional development during the COVID-19 pandemic will have a lasting benefit for medical and scientific communities, and a long-lasting impact on future clinicians’ practice.

The gift of sight: normalising discussions and referral for corneal donation in the inpatient setting.

For patients with a life-limiting diagnosis, guidance by the General Medical Council recommends exploring patients' beliefs and values about tissue donation with the patient and family towards the end of life. This article gives guidance to healthcare professionals on the process of giving patients the opportunity to donate their corneas, including eligibility, communication and practicalities.

Do we need a core curriculum for medical students? A scoping review

ObjectiveThe General Medical Council (GMC) recommends medical schools to develop and implement curricula enabling students to achieve the required learning outcomes. UK medical schools follow the GMC’s Outcomes for graduates,...

Should Undergraduate Lectures be Compulsory? The Views of Dental and Medical Students from a UK University.

Formal lectures have been a traditional part of medical and dental education, but there is debate as to their compulsory status. This study was designed to explore dental and medical students’ views on compulsory lectures and the use of Video-Recorded Lectures (VRL). A cross-sectional study of University of Bristol students in Years 2 to 4 was conducted using an online questionnaire. The majority of both dental (76%) and medical (66%) students felt lectures should be non-compulsory. The most common learning resources used by both dental and medical students were live lectures, lecture handouts and VRL. The majority of both dental (84%) and medical (88%) students used VRL. Most students attended lectures all of the time both before and after the introduction of VRL, even though most dental and medical students believe lectures should be non-compulsory. VRL is a popular learning resource. These findings tie-in with General Dental Council and General Medical Council recommendations that encourage self-directed learning. Dental and Medical schools should offer a range of learning resources and make use of current technology, including the use of VRL.

Health informatics in UK Medical Education: an online survey of current practice.

ObjectiveHealth informatics has growing importance in clinical practice with successive General Medical Council recommendations. However, prior data suggest that undergraduate medical education largely neglects this area. An up-to-date, UK-wide view of health informatics training in medical schools is required.DesignAn online survey was developed using current guidance and recommendations of UK professional bodies.Participants and SettingSenior academic staff and health informatics educators at all 34 UK medical schools were invited to complete the survey.Main outcome measuresQuantitative and qualitative data regarding health informatics in the undergraduate medical curriculum.ResultsA total of 26/34 (76%) of UK medical schools responded and 23 provided full information. Aspects most frequently mentioned were literature searching and research governance. Seventeen per cent of respondents felt there was little or no HI training, although clinical record keeping was addressed by all medical schools. Pedagogies used to teach health informatics were self-directed learning (78%) to lecture based (70%), seminars (70%), informal teaching in clinical settings (57%) and problem-based learning (22%). Health informatics was usually integrated vertically and horizontally across the curriculum (76%). Assessment and updates of the health informatics curriculum are limited (57 and 41%, respectively). Thirty-two per cent of respondents reported a low level of confidence among students to use health informatics as doctors. In the most up-to-date survey of health informatics teaching in UK medical schools, there are three major findings. First, the proportion of health informatics in the medical undergraduate curriculum is low. Second, there was variation in content, pedagogy and timing across medical schools. Third, health informatics is rarely assessed and course content is not regularly updated.ConclusionsThere is a role for national guidelines and further research in this area of the curriculum which is rapidly gaining in prominence.

PWE-429 Development of a gastroenterology handbook for junior doctors

<h3>Introduction</h3> Every 4–6 months new junior doctors rotate through Gastroenterology departments across the UK. The General Medical Council recommends that induction and support mechanisms are in place so that junior doctors are able to deliver “safe, effective and efficient care to patients as soon as they start a new job.”¹We developed a Gastroenterology handbook containing relevant and important clinical information to be used nationally as part of the induction process for junior doctors. <h3>Method</h3> In order to establish the need for such a resource we surveyed consultants and junior doctors from across the UK, and solicited advice on its content. We developed a first draft and sought the endorsement of the Trainees Section of the British Society of Gastroenterology (BSG), who agreed to support the production of the handbook and verify its content. The content included resources for management of acute Gastroenterology conditions based on up-to-date consensus guidelines, and sections on procedural skills. Feedback from a focus group of junior doctors attending the BSG Gastroenterology Taster Conference was extremely positive. A second draft has been piloted on six junior doctors in the Gastroenterology department at Aintree University Hospital Liverpool. <h3>Results</h3> Prior to developing the handbook, 22 Gastroenterology consultants from 16 NHS trusts were surveyed as to the perceived ‘need’ for such a resource as well as suggested content. 73% of departments had an induction meeting for new junior doctors, with 32% having pre-existing written induction material. A significant proportion (18%) had no induction for junior doctors. 68% of consultants felt that a national Gastroenterology handbook would improve the induction process at their trust. 12 junior doctors (FY1-CT2 level) in several trusts were also surveyed. 41% had no induction on starting their Gastroenterology rotation, and 75% were apprehensive about managing acutely unwell patients. All of the trainees believed that the Gastroenterology handbook would be a valuable resource. Survey responses suggested that the most important clinical scenarios to include were acute GI bleed, decompensated liver disease, and acute colitis. <h3>Conclusion</h3> A standardised national clinical induction handbook for junior Doctors working in Gastroenterology does not already exist, and there is considerable appetite amongst junior doctors and Gastroenterology consultants for such a resource. We created a handbook with the aim of easing the transition of junior doctors joining Gastroenterology departments, and improving patient care. We intend to introduce the handbook nationally for the intake of doctors in August 2015. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> GMC guidance, Induction and Mentoring; http://www.gmc-uk.org/guidance/ethical_guidance/11825.asp; accessed on 25.02.2015

Undergraduate teaching in geriatric medicine: mapping the British Geriatrics Society undergraduate curriculum to Tomorrow's Doctors 2009

in 2008, the British Geriatrics Society (BGS) developed the Recommended Undergraduate Curriculum in Geriatric Medicine. This was subsequently mapped to the second edition of Tomorrows' Doctors (TD2, 2003). Following the publication of the third edition of Tomorrow's Doctors in 2009 (TD3), the mapping exercise was repeated to verify the extent to which the updated General Medical Council recommendations supported teaching in ageing and geriatric medicine. we analysed TD3 and identified 48 aspects of its general guidance that were relevant to the teaching of medicine for older people. We then mapped these to the 2009 BGS curriculum. the BGS curriculum was supported in full by TD3. However, learning outcomes relating to the interpretation and conduct of research in TD3 had no corresponding outcomes in the BGS curriculum. the BGS curriculum for medical undergraduates continues to provide a specific and complete list of learning objectives, all of which could help to operationalise the general statements made in TD3 with relation to ageing and geriatric medicine. Learning outcomes in research in frail older patients have been added following this mapping exercise.

Role of accrediting bodies in providing education leadership in medical education

Introduction: Accreditation is necessary to maintain the quality of medical education. It requires official bodies to authorize the accreditation; recognized standards against which the medical school can be judged; and a robust process. Effects of accreditation: Accreditation may have positive effects on medical education. The impact of the publication of the General Medical Council recommendations in Tomorrow's Doctors provides a good example. In contrast, out-of-date requirements may inhibit developments in medical schools. Role of accreditation authorities: If accreditation authorities are to provide leadership in medical education they must undertake regular review of their standards. This should be informed by all stakeholders and include experts in medical education. The format of the standards must provide clear direction to medical schools. Accreditation should take place regularly and should result in the production of a publicly accessible report.

Are medical educators following General Medical Council guidelines on obesity education: if not why not?

BackgroundAlthough the United Kingdom’s (UK’s) General Medical Council (GMC) recommends that graduating medical students are competent to discuss obesity and behaviour change with patients, it is difficult to integrate this education into existing curricula, and clinicians report being unprepared to support patients needing obesity management in practice. We therefore aimed to identify factors influencing the integration of obesity management education within medical schools.MethodsTwenty-seven UK and Irish medical school educators participated in semi-structured interviews. Grounded theory principles informed data collection and analysis. Themes emerging directly from the dataset illustrated key challenges for educators and informed several suggested solutions.ResultsFactors influencing obesity management education included: 1) Diverse and opportunistic learning and teaching, 2) Variable support for including obesity education within undergraduate medical programmes, and 3) Student engagement in obesity management education. Findings suggest several practical solutions to identified challenges including clarifying recommended educational agendas; improving access to content-specific guidelines; and implementing student engagement strategies.ConclusionsStudents’ educational experiences differ due to diverse interpretations of GMC guidelines, educators’ perceptions of available support for, and student interest in obesity management education. Findings inform the development of potential solutions to these challenges which may be tested further empirically.

GMC bans doctors from signing contracts containing “gagging” clauses

Doctors should boycott “gagging” clauses in agreements with employers or contracting bodies that try to stop them raising concerns about patients’ safety or quality of care, new guidance from the General Medical Council recommends. Mirror guidance for doctors in management roles will put them under a corresponding duty not to propose or condone contracts or agreements containing such clauses. Gagging clauses still appear, despite NHS guidance as far back as 1999 that all trusts should “prohibit confidentiality ‘gagging’ clauses in contracts of employment and compromise agreements which seek to prevent the disclosure of information in the public interest.” The House of Commons health select committee …

Shadowing a foundation-year doctor: a third-year medical student’s perspective

This paper considers the advantages of shadowing foundation-year doctors (FY1) in the third year of medical school, an opportunity the UK's General Medical Council (UKGMC) recommends to be given to final-year students only. Eighteen students spent 1 day each shadowing an FY1, holding their pager and carrying out their duties under direct supervision. Questionnaires, based on UKGMC expectations of an FY1, were completed assessing students' confidence and experience before and after the shifts. The doctors were interviewed. The questionnaire response rate was 72 per cent (13/18). The overall increase in student experiences in good clinical care (p<0.001), maintaining good medical practice--teaching and learning (p=0.002), and recognition and management of the acutely ill (p<0.001), were statistically significant. The increase in student confidence in answering the pager (p<0.001), prioritising jobs (p=0.002), venepuncture (p=0.008), writing drug charts (p=0.031), writing in patient notes (p=0.002) and developing management plans (p=0.002) were statistically significant. Qualitative results yielded an overwhelming opinion from students and doctors that it should be made a compulsory part of the third-year curriculum. The doctors found it increased their knowledge and teaching skills. This study has implications for the future of medical training. If incorporated into the third-year curriculum, compulsory shadowing would give students a structured one-to-one learning experience during which to learn clinically relevant skills. By shadowing a doctor so closely, they will also learn first-hand how to interact professionally with patients and other health care workers, a skill difficult to teach at medical school.

Teaching medical undergraduates: the psychiatrist as medical teacher

SummaryThis article is a brief review of the teaching role of psychiatrists and is directed at psychiatrists in the UK National Health Service who teach medical undergraduates. It reviews the responsibility of delivering teaching, the delineation of teaching duties, and the teaching roles of the psychiatrist in the changing environment of medical education. Application of good principles of clinical teaching and delivery of tomorrow's doctors in line with the General Medical Council's recommendations are discussed. The article also describes a recommended core curriculum in psychiatry for undergraduates, which lays out what should be taught.

Public health education for medical students: rising to the professional challenge

Public health competencies, especially as they relate to the management of chronic disease, will be of increasing importance to the global health-care workforce. The General Medical Council's recommendations on basic medical education have helped to entrench the position of public health and related disciplines. Tomorrow's Doctors has recently been updated. This article describes the indicative goals that should underpin the development of undergraduate medical education in public health, presented in a national statement. The statement was originally produced on behalf of academic departments of public health and related disciplines in UK medical schools. The dearth of evidence in this field leaves many questions for future educational research.

The General Medical Council's Recommendations as to Basic Medical Education 1967

Medical EducationVolume 1, Issue 4 p. 237-238 The General Medical Council's Recommendations as to Basic Medical Education 1967 First published: September 1967 https://doi.org/10.1111/j.1365-2923.1967.tb01708.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume1, Issue4September 1967Pages 237-238 RelatedInformation

The General Medical Council's recommendations as to basic medical education 1967. II. The views of a teacher of physiology.

The General Medical Council's recommendations as to basic medical education 1967. II. The views of a teacher of physiology.

The General Medical Council's recommendations as to basic medical education 1967. 3. The views of a teacher of medicine.

The General Medical Council's recommendations as to basic medical education 1967. 3. The views of a teacher of medicine.

Student Selected Components (SSCs): AMEE Guide No 46

Student Selected Components (SSCs) are one of the more innovative recent developments in medical education. Initially established in the UK in the 1990s in response to the General Medical Council's recommendations in Tomorrow's Doctors (1993), they provide students with a significant element of choice and depth of study in the curriculum. SSCs have become an integral part of medical curricula throughout the UK, and to a limited extent the rest of the world. In most cases they contribute to the delivery of learning outcomes broadly encompassing personal, professional and research skills, whilst creating opportunities for students to explore future career options. This AMEE Guide is written for developers of new medical curricula, where SSC-like initiatives offering choice and depth of study, in conjunction with core learning, are being considered. Its aim is to provide insight into the structure of an SSC programme and its various important component parts. It is also relevant for those already involved in SSC development by offering insight into effectively managing, assessing and improving existing programmes, to deliver effective, coherent and core-integrated teaching valued by students and faculty alike.

Crossing the line – Learning psychiatry at the movies

Special Study Modules (SSMs) have developed in response to the General Medical Council's recommendations. St George's, University of London runs a ‘Psychiatry and Film’ SSM for medical students on the 5-year MBBS course. Many films have plots or characters that have a mental illness. Psychiatry & filmmaking share certain skills. Both seek to understand character, motivation and behaviour. Cinema therefore has the potential to be a useful tool for medical educational purposes. Specific to psychiatry, themes such as the accuracy of portrayals of different mental illness, the psychiatrist/patient relationship and living with a mental illness can be explored. General issues such as the role of the psychiatrist in society, medical ethics, professionalism and stigma can also be usefully highlighted for consideration and debate. This may encourage medical students to consider psychiatry as a potential career specialty and help reduce negative attitudes to mental illness.

The use of drotrecogin alfa (activated) in a patient with recent orthotopic liver transplant*

Drotrecogin alfa has been shown to reduce mortality in severe sepsis. However, it remains unlicensed for use in patients with previous liver transplantation. We report its use in such a case. Prior to administration a risk benefit analysis was performed in line with General Medical Council recommendations. This included being satisfied that no appropriately licensed alternative would better serve the patient's needs and that sufficient evidence existed to demonstrate the safety and efficacy of the drug. Responsibility was taken for prescription, monitoring and follow up. The process was carefully documented and the patient recovered fully with no adverse effects. To date the only published data on the use of drotrecogin alpha in transplant recipients is a case series of three patients. Further published data may encourage review of the licence.

Undergraduate training in Psychiatry: World perspective

Byline: R. Murthy, S. Khandelwal Historical Development of Mental Health Services During the last three centuries, there has been major shifts in the way mentally ill are viewed and cared for all over the world. The changes during the last 50 years are most significant. From a situation of considering the "mad" as "bad" and incarceration in jails and asylums, there is now recognition of the human rights of the mentally ill. From jails and asylums, the care of the mentally ill persons has moved to the community. Another important development is the care providers. Current approach to care in the community includes, besides psychiatrists, other mental-health professionals, primary-care doctors, family members, volunteers and the ill persons. The driving forces towards these changes have been many: the recognition of the wide range of mental disorders, the high prevalence of mental disorders in the community, the availability of a variety of interventions (pharmacological and nonpharmacological), the demonstration of the effectiveness. Human Resources for Health Care There is an international focus on human resources for health care. The theme of the World Health Report 2006 (WHR 2006) was Working Together for Health. The WHR 2006 begins with the following observation: "In this decade of the 21[sup] st century, immense advances in human well-being coexist with extreme deprivation. In global health we are witnessing the benefits of new medicines and technologies. But there are unprecedented reversals. Life expectancies have collapsed in some of the poorest countries to half the level of the richest - attributable to the ravages of HIV/AIDS in parts of sub-Saharan Africa and to more than a dozen "failed states". These setbacks have been accompanied by growing fears, in rich and poor countries alike, of new infectious threats such as SARS and avian influenza and "hidden" behavioural conditions such as mental disorders (emphasis added) and domestic violence ."(xv) (emphasis added). Further, the report states The ultimate goal of health workforce strategies is a delivery system that can guarantee universal access to health care and social protection to all citizens in every country. There is no global blueprint that describes how to get there - each nation must devise its own plan. Effective workforce strategies must be matched to a country's unique situation and based on social consensus (emphasis added). (p.119) The human resources for mental health care are grossly inadequate in the developing countries, as presented by the WHO Atlas document in 2005. In the Indian context, the development of appropriate human resources for health in general is receiving serious attention. For example, the setting up of the Public Health Foundation of India in 2006 is a good example of this concern. Both authors come from a background of community mental health and experience of training and working with primary health-care doctors. The effort is to present the "world" perspective (from the World Health Report, the World Psychiatric Association (WPA) guidelines, experiences of different countries) and identify some issues relevant to undergraduate education in India. World Health Report 2001 The World Health Report 2001 makes 10 overall recommendations. The first of this is "Provide treatment in primary care." The management and treatment of mental disorders in primary care is a fundamental step which enables the largest number of people to get easier and faster access to services. It is to be recognized that many are already seeking help at this level. This not only gives better care but also cuts wastage resulting from unnecessary investigations and inappropriate and nonspecific treatments. For this to happen, however, general health personnel need to be trained in the essential skills of mental health care. Such training ensures the best use of the available knowledge for the largest number of people and makes possible the immediate application of interventions. …