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Our standards for medical education and training

We have a statutory role to promote high standards and co-ordinate all aspects of medical education and training. This includes undergraduate and postgraduate education and training, and doctors' continuing professional development.

All doctors must be familiar with and follow Good medical practice. Principles about equality and diversity, such as treating patients fairly, and with dignity and respect, is an important part of this guidance and, therefore, these principles feed across into the standards that we set for medical education and training.

We publish guidance and advisory guidance across all stages of medical education and training. The below summarises where equality and diversity is included in the key pieces of our medical education and training guidance, and advisory guidance. It is not an exhaustive list.

Equality and diversity guidance for medical royal colleges

We expect the bodies we regulate to actively consider equality and diversity issues in all of their work. We are committed to fair and non-discriminatory treatment of all patients, doctors in training, employers and educators affected by the education programmes we approve. When colleges and faculties are seeking our approval for changes to curricula, examinations and assessments, they should respond proportionately to equality and diversity issues raised by the changes. Our new guidance sets out the principles for providing evidence on equality and diversity when submitting changes for approval.

Standards for delivering medical education and training

In Promoting excellence: standards for medical education and training we set standards for the delivery of medical education and training at both the undergraduate and postgraduate levels.

One of the ten high level standards (under Theme 2: Educational governance and leadership) relates to principles of fairness, equality and diversity, and this is reflected in requirements under several themes.

Theme 2: Educational governance and leadership

S2.3 The educational governance system makes sure that education and training is fair and is based on principles of equality and diversity.

R2.5 Organisations must evaluate information about learners’ performance, progression and outcomes – such as the results of exams and assessments – by collecting, analysing and using data on quality and on equality and diversity.

R2.19 Organisations must have systems to make sure that education and training comply with all relevant legislation.

R2.20 Organisations must make sure that recruitment, selection and appointment of learners and educators are open, fair and transparent.

Theme 3: Supporting learners

R3.2 Learners must have access to resources to support their health and wellbeing, and to educational and pastoral support, including:

a confidential counselling services

b careers advice and support

c occupational health services.

Learners must be encouraged to take responsibility for looking after their own health and wellbeing.

R3.4 Organisations must make reasonable adjustments for disabled learners, in line with the Equality Act 2010.* Organisations must make sure learners have access to information about reasonable adjustments, with named contacts.

R3.5 Learners must receive information and support to help them move between different stages of education and training. The needs of disabled learners must be considered, especially when they are moving from medical school to postgraduate training, and on clinical placements.

R3.10 Doctors in training must have access to systems and information to support less than full-time training.

R3.11 Doctors in training must have appropriate support on returning to a programme following a career break.

Theme 5: Developing and implementing curricula and assessments

R5.3 Medical school curricula must give medical students:

b experience in a range of specialties, in different settings, with the diversity of patient groups that they would see when working as a doctor

d the opportunity to gain knowledge and understanding of the needs of patients from diverse social, cultural and ethnic backgrounds, with a range of illnesses or conditions and with protected characteristics

R5.5 Medical schools must assess medical students against the learning outcomes required for graduates at appropriate points. Medical schools must be sure that medical students can meet all the outcomes before graduation. Medical schools must not grant dispensation to students from meeting the standards of competence required for graduates.

R5.6 Medical schools must set fair, reliable and valid assessments that allow them to decide whether medical students have achieved the learning outcomes required for graduates.

R5.12 Organisations must make reasonable adjustments to help disabled learners meet the standards of competence in line with the Equality Act 2010, although the standards of competence themselves cannot be changed. Reasonable adjustments may be made to the way that the standards are assessed or performed (except where the method of performance is part of the competence to be attained), and to how curricula and clinical placements are delivered.

 

Equality and diversity in the medical curricula

We set standards in Promoting excellence: standards for medical education and training  in line with which medical schools must deliver medical education. We do not specify a list of conditions which medical students must learn about. Their curricula and assessments are developed and implemented so that medical students are able to achieve the learning outcomes required for graduates. (PE S5.1). We say that medical school curricula must give medical students the opportunity to gain knowledge and understanding of the needs of patients from diverse social, cultural and ethnic backgrounds, with a range of illnesses or conditions and with protected characteristics (PE R5.3)

In Developing teachers and trainers in undergraduate medical education supplementary advice, paragraph 49 supplementary to Promoting excellence and Outcomes for graduates (Tomorrow’s Doctors), one of the broad themes for a development programme for someone with a role in teaching and training medical students could include principles of equality and diversity.

Standards for curricula and assessment systems sets out the standards and requirements that medical Royal Colleges, Faculties and specialty associations must apply when developing and monitoring curricula and assessment systems. Section 17.1-17.3 includes mandatory requirements for local education providers, deaneries and Colleges / Faculties on equality and diversity.

In Patient and public involvement in undergraduate medical education supplementary guidance, paragraphs 28-42 we explain that medical schools should try to ensure diversity among those involved in medical education across the protected characteristics, and / or economic status.  This should be through direct patient contact and, exposure to and experience of, dealing with a variety of individuals including those with disabilities or from vulnerable groups.

Responsibilities of medical students and doctors to patients and colleagues

Medical students

  • Graduates from medical school must be able to communicate sensitively and effectively and respect disabled people (Outcomes for graduates, paragraph 15b and Outcomes for graduates, paragraph 20d). They must also understand the legal, moral, and ethical responsibilities involved in protecting and promoting the health of patients with learning disabilities or mental illnesses (paragraph 20f). They must respect all patients, colleagues and others regardless of their age, colour, culture, disability, ethnic or national origin, gender, lifestyle, marital or parental status, race, religion or beliefs, sex, sexual orientation, or social or economic status (paragraph 20d).
  • Medical students - professional values and fitness to practise supplementary advisory guidance supplementary to Promoting excellence and Outcomes for graduates (Tomorrow’s Doctors) expands further on some of these principles. For example, in order to demonstrate that they are fit to practise, students should respect patients and treat them with dignity throughout their time at medical school (paragraph 28a).

Doctors in training

  • Good medical practice requires doctors to seek and follow advice from a suitably qualified professional about their health. This is particularly important if they have, or suspect they have, a serious condition that could be passed on to patients, or if they are receiving treatment that could affect their judgment or performance. Medical students - professional values and fitness to practise, paragraphs 35-38explains what medical students need to do to ensure that their health does not put patients or colleagues at risk.
  • Continuing professional development: guidance for all doctors, paragraphs 34-35, sets out guidance about what doctors are expected to do to maintain and improve their practice through continuing professional development (CPD). In relation to equality and diversity, this includes information about what doctors should do to keep up to date and return to practice, if they are considering taking a career break.

Responsibilities to students and doctors in training

Medical schools and local education and training boards (LETBs) and postgraduate deaneries must meet a number of equality and diversity obligations towards their students and doctors in training.  Some examples are provided below:

  • Students, doctors in training and applicants to medical schools and postgraduate deaneries must be treated fairly. Medical schools and postgraduate deaneries must meet the requirements of equality and human rights legislation. This includes making reasonable adjustments for disabled students or doctors in training. The Gateways advisory guidance, aimed primarily at medical schools, provides practical suggestions on making reasonable adjustments to help schools ensure that disabled students do not face unnecessary barriers to successful medical careers. Supporting medical students with mental health conditions is also is designed to help medical schools support students who have mental health conditions. It gives examples of good practice and advice for medical schools on how to provide the best possible help to students.
  • Medical students - professional values and fitness to practise, supplementary advisory guidance supplementary to Promoting excellence and Outcomes for graduates (Tomorrow’s Doctors) provides additional advice on areas such as making reasonable adjustments and providing pastoral or remedial support for medical students, and information on occupational health support services (paragraphs 46-54).
  • Following our review of health and disability, and a survey conducted by the Medical Schools Council, we found out that there are a small number of disabled students who are expected to graduate from medical school, but who might have difficulties at the later stages of training with cardiopulmonary resuscitation (CPR). As a result of the work we undertook to look at this issue in more detail, we have developed a position statement on the requirements for medical students and doctors in training gaining competence in cardiopulmonary resuscitation (pdf). This document explains how we have built flexibility for disabled students into the provisions for CPR in our education outcomes and standards. You may also be interested to read the statement on health and disability in medical education and training (pdf), which provides information about the position of disabled medical students and doctors with disabilities who are in medical education and training.
  • The make-up of the medical profession is changing, and there is now more demand for flexibility and choice in work-life balance. This means that opportunities for less than full time training (LTFT) have increased. LTFT has become the preferred term, rather than flexible, part-time, or other expressions. We have developed a range of advisory guidance in this area, which includes: 
  1. 1. GMC position statement on less than full time training (pdf). This sets out our revised requirements on the arrangements for specialty trainees in less than full-time training who are working towards a Certificate of Completion of Training (CCT).
  2. 2. GMC additional statement on academic training in a less than full time setting (pdf). This clarifies the position of academic trainees in less than full time training.
  3. 3. GMC additional position statement: workplace based assessments and annual review of competency progression (pdf). This clarifies the position of doctors in less time than full training, and the requirements for the number of workplace based assessments.