Our public consultation ran from 1 July to 27 September 2015.
What did we consult on?
The draft framework set out the core professional values, knowledge, skills and behaviours that we think all doctors should know about. They should be able to apply and adapt these to a range of clinical and non-clinical contexts by the time they complete specialty training.
The aim is to embed these generic professional insights and capabilities in all postgraduate specialty training. In future, curricula should not focus solely on knowledge, tasks or procedures, but in addition describe and develop the complex, adaptive and high level professional behaviours consistent with good medical practice.
What questions did we ask?
We asked 22 questions on the structure and content of the framework, as shown in the consultation document (pdf) (for information only).
What did the respondents say?
The consultation outcome showed very strong support for the framework - 97% of respondents were in agreement that GPCs are fundamentally important to UK medical practice.
There was also good support for the framework structure, with some helpful suggestions for change. We have responded to this by incorporating ‘communication and interpersonal skills and capabilities’ and ‘dealing with complexity and uncertainty’ in the Professional Skills domain 2.
We have also established a separate domain 4 which further prioritises the importance of capabilities in health promotion and illness prevention.
Framework approved by Council
GMC Council approved the GPC framework on 25 February 2016. The Council paper (pdf) contains the updated GPC framework at Annex A and the consultation summary report at Annex B.
We know that most doctors provide a high standard of care to their patients. In addition to expertise in their specialty, they demonstrate important generic professional capabilities are essential to providing safe and effective patient care.
These broader human qualities – such as being able to communicate effectively, to work as part of or lead a team, to teach or educate and to apply a range of other professional skills or judgements in complex or difficult circumstances – are in combination the foundation of professional practice.
Making accurate, time-sensitive decisions and continuously re-assessing situations or priorities while addressing patients’ needs, often in a fast-moving and stressful environment, can be challenging. Developing an understanding of the factors that affect human behaviour and performance are therefore central to high quality clinical care and underpin professional excellence.
We believe that postgraduate medical training has a vital part to play in developing these valuable insights and professional capabilities to effectively deal with the complexity, uncertainty and challenge of contemporary medical practice.
What led to this work
Shape of training report
The final Shape of Training report (pdf) supports our view and recommended that:
- ‘Appropriate organisations must introduce a generic capabilities framework for curricula for postgraduate training based on Good medical practice that covers, for example, communication, leadership, quality improvement and safety.’
The report states that medical education goes beyond learning the specialty specific knowledge and technical aspects of medicine, emphasising the importance of developing a doctor’s professional identity and preparing them for practice.
The healthcare system needs doctors who are increasingly able to respond flexibly and adaptively to the complex health needs of patients in different settings.
Patient safety inquiries
Major patient safety inquiries have also highlighted systemic problems around professionalism, particularly communication, leadership, inter-professional cooperation and providing safe, compassionate patient care.
Some examples are:
What others have said
Forum of key interests
In 2012 we gathered a forum of key interest groups. The forum felt that curricula for postgraduate training may have narrowed in scope over the past decade, listing competences and procedures that must be completed, with very little focus on developing generic professional capabilities.
The forum said that it is not enough to simply know how to do a medical procedure and tick a box. Knowing when to take no action, and how to move forward when guidelines and protocols do not cover the situation, are equally important. Managing this complexity comes with experience and is part of the process of developing as a professional.
The forum proposed that the development of these capabilities should be integrated into postgraduate training, addressing both general clinical and professional domains. It also said that training should promote the importance of valuing doctors as professionals and understand the importance of developing a doctor’s professional judgement, self-esteem and identity.
The forum considered that a generic framework would help to highlight these issues and provide a common platform for strengthening future postgraduate training.
Informal discussion group
Throughout 2014 we tested ideas for the framework through an informal discussion group, which involved experts in undergraduate and postgraduate curricula, assessment, patient and public involvement, quality improvement, medical leadership, and Human Factors and ergonomics.*
* A specialist academic and operational discipline that seeks to understand how to optimise the performance and behaviour of human beings as individuals, groups or teams or within organisations. Drawing on a wide range of academic fields, including sociology, psychology, engineering, training and leadership, it aims to promote excellence and reduce risk.