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Frequently asked questions

This page contains answers to your questions about our new standards for medical education and training.

You can download Promoting excellence: standards for medical education and training FAQs (pdf) which contains all the questions and answers below.

If you have any further questions, please contact your GMC regional education team or email quality@gmc-uk.org.

What is Promoting excellence: standards for medical education and training?

We have published a new single set of standards to promote excellence in medical education and training across the UK. For the first time, the standards cover both undergraduate and postgraduate medical education and training.

We have set ten standards we expect organisations responsible for educating and training medical students and doctors in the UK to meet. We have also set requirements describing what an organisation must do to show us they are meeting the standards. Most requirements apply across the continuum of medical education and training but some apply to a specific stage.

The standards and requirements are organised under five themes. The themes are:

  • Learning environment and culture
  • Educational governance and leadership
  • Supporting learners
  • Supporting educators
  • Developing and implementing curricula and assessments.

By creating a single set of standards we have sought to reduce the regulatory burden for organisations responsible for medical education and training.

Why has the GMC changed their education and training standards?

Since becoming responsible for postgraduate medical training in 2010, alongside our responsibility for undergraduate medical education, we have sought to achieve greater coherence and consistency across all stages of medical education and training to improve quality.

We also want to make sure our standards reflect the characteristics of a safe and supportive learning environment and culture.

We have developed a new single set of standards for all stages of medical education and training. Our standards put patient safety, quality of care, and fairness at the heart of the teaching and training of medical students and doctors in training.

The roles and responsibilities of organisations managing and delivering medical education and training are clearer and the requirements for teaching, supervision and support are more transparent. We have put a greater emphasis on environment, culture and the overall quality of medical education and training.

The standards highlight the importance of leadership and governance, ensuring those responsible for managing and providing medical education and training are accountable for the quality of training provided. At a time of service pressure on healthcare in the UK, the standards also emphasise the importance of supporting educators to help them deliver a supportive learning environment.

The standards are set at a high level and will support consistent management and delivery across all stages of medical education and training, while retaining flexibility to maintain local arrangements where they differ across organisations in the UK.

How did the GMC develop the standards?

We began reviewing our standards in 2013. The standards were developed with input from a wide range of organisations and individuals interested in medical education and training. We worked with an expert advisory group; engaged key interest groups at events across the UK; and held a public consultation early in 2015 to help shape the final standards.

The purpose of our standards is:

  • making sure medical education and training produces doctors who are safe and competent, fulfil the standards of Good medical practice, are able to provide high quality care, and meet the needs of patients and the public now and in the future
  • promoting excellence, innovation and improvement in medical education and training.

During the review, we looked at the previous standards in Tomorrow’s Doctors and The Trainee Doctor, to decide if it was feasible to develop a single set of standards for managing and delivering both undergraduate and postgraduate medical education and training. We confirmed that there was considerable crossover of content, although with some variation appropriate to the stage of education and training. We identified key areas that needed to be covered and developed a framework around which to structure the standards. Through workshops and our consultation we have identified and refined the new content for the standards and requirements.

Where can I see the standards?

The standards are available on our website at Promoting excellence: standards for medical education and training.

When will the standards come into effect?

The standards were published on 30 July 2015, and came into effect on 1 January 2016. All quality assurance activity undertaken from January 2016 onwards will be based on Promoting excellence: standards for medical education and training.

The first scheduled quality assurance activity is the regional review of the South West in early 2016, where we will look at undergraduate and postgraduate education and training in that region.

What is the status of Tomorrow’s Doctors and The Trainee Doctor?

The standards replace the standards for delivery of teaching, learning and assessment in Tomorrow's Doctors and the standards for postgraduate training in The Trainee Doctor but they do not replace the outcomes for graduates and provisionally registered doctors, which remain in force.

The outcomes for graduates are the knowledge, skills and behaviours that new UK medical graduates need. The outcomes for provisionally registered doctors are the competences that must be acquired in order to be eligible to apply for full registration.

We have republished them as Outcomes for graduates (Tomorrow’s Doctors) and Outcomes for provisionally registered doctors (The Trainee Doctor). You can find these on the website at Outcomes for graduates and Outcomes for provisionally registered doctors.

What is the status of Tomorrow’s Doctors (2009) supplementary guidance?

We are reviewing our supplementary guidance and considering if there are areas where further supplementary guidance is needed. In the meantime this guidance will still be available for reference.

The supplementary guidance can be found at Supplementary guidance for medical schools.

How will the GMC quality assure against the new standards?

Our website outlines how we quality assure medical schools and postgraduate medical education and training at How we quality assure - the Quality assurance framework.

We don’t anticipate any major changes to our processes. For example, on a regional review we visit all the medical schools and the deanery or local education and training board in a geographical region (or country) to make judgements about each individual organisation against our standards, and to get a picture of education and training in that area. A new single set of education and training standards for all those organisations will support our regional reviews.

We will be developing and publishing exploratory questions to use when we quality assure against the standards. The questions will look at topics and areas we want to investigate when we are deciding if a standard is being met. This will make our work more transparent.

We will update all of our forms and resources, including the Dean’s Report and the Medical School Annual Report to reflect the new standards. Our Quality assurance framework (QAF) sets out how we secure the standards in Promoting excellence.

When will organisations involved in the delivery of education and training be expected to meet all of the new standards?

Organisations involved in the delivery of education and training will be expected to meet the new standards from 1 January 2016. The standards were published in July 2015 in order to allow organisations to prepare and begin to implement any changes necessary.

The standards have been carefully mapped against the previous standards to ensure that all key areas are covered. We have introduced some new requirements to support the standards. Medical schools, postgraduate deaneries and local education and training boards, and local education providers will need to review how these apply to their organisation.

If a requirement is proving particularly challenging, please do contact us to discuss.

When will organisations be expected to be actively using the new standards?

The new standards came into effect on 1 January 2016. However, we do understand that organisations will need to take some time to fully embed the standards into their processes and procedures. We would expect all documentation to have been updated by January 2017.

When will organisations have to report to the GMC using the new standards (eg in the Dean's Report or Medical School Annual Report)?

Reports to be submitted to us in 2016 will reflect the new standards. Please let us know if you have any questions or concerns about this. The Annual Specialty Reports we receive from Royal Colleges and Faculties should not be affected as they are not structured around our standards.

Will new schools and undergraduate programmes undergoing a rolling programme of quality assurance be expected to meet the new standards?

Yes, all organisations involved in the delivery of medical education and training will be expected to meet all of the new standards. Schools and programmes undergoing rolling programmes of quality assurance will be assessed against the standards from 1 January 2016. As noted above, new standards cover all key areas of Tomorrow’s Doctors but we have introduced some new requirements to support the new standards; organisations will need to review how these apply. Please let us know there is a specific requirement that is particularly challenging.

What will happen if an organisation doesn’t meet the standards?

GMC powers and sanctions are not changing with the new standards. We will still set requirements and recommendations if standards are not being met.

We work closely with organisations when standards aren’t being met. This includes setting action plans which outline the changes that need to be made in order for our standards to be met, who is responsible for the changes and when they need to happen. If organisations are not able to implement changes to address our concerns we can take additional action, including visiting the organisation or referring them to our enhanced monitoring process. Ultimately, we can also remove approval for education and training.

What support will there be to help organisations understand how to demonstrate they are meeting the new standards?

There are different ways of demonstrating that standards and requirements are met and many of the existing ways you demonstrate meeting the current standards will remain appropriate. The new standards introduce greater flexibility in how you may demonstrate that you are meeting the standards – we aren’t mandating evidence.

We will publish exploratory questions for each requirement that should help organisations understand what evidence we are looking for.

We are planning to test exploratory questions during our visit to the South West in early 2016, and publish them once the visit has concluded. We will consider producing additional guidance if it is felt necessary to further outline our expectations. If you think that guidance in a specific area would be helpful, please let us know.

Is there a summary of what’s new in the standards, or how the nine domains relate to the five themes?

We have mapped the new standards against Tomorrow’s Doctors and The Trainee Doctor. We have prepared a broad guide indicating how, and where, the previous standards have been addressed in Promoting excellence: standards for medical education and training and showing how all key areas are covered. This is provided as a tool to assist you to embed the new standards into your processes and procedures. However, we have introduced some new requirements to support the new standards; medical schools, postgraduate deaneries and local education and training boards, and local education providers will need to review how these apply to their organisation.

The guide for stakeholders is available on the Resources web page for Promoting excellence.

How will the new standards affect patients?

Patient safety is at the core of these standards. Just as good medical students and doctors make the care of their patients their first concern, so must the organisations that educate and train medical students and doctors.

The new standards place patient safety at the heart of the learning environment. The learner’s ability to develop the appropriate professional values, knowledge, skills and behaviours is influenced by the learning environment and culture in which they are educated and trained. Where our standards previously focused on protecting patients from any risk posed by medical students and doctors in training, we will now make sure that education and training takes place where patients are safe, the care and experience of patients is good, and education and training are valued.

We have prefaced the standards with a statement that patient safety is the first priority.

Why does the GMC set standards for the environment which medical students and doctors train in?

Patient safety is inseparable from a good learning environment and culture that values and supports learners and educators. The new standards ensure that environments value and support learners to provide safe, compassionate care and experience for patients.

How will the new standards help medical students and doctors in training?

The standards clarify the standard of teaching, supervision and support medical students and doctors in training can expect to receive from their medical school; postgraduate deanery / local education and training board; and local education provider.

How will the new standards help organisations delivering medical education and training?

The new standards seek to simplify, clarify and unify undergraduate and postgraduate standards to reduce the regulatory burden for organisations responsible for medical education and training. We have also made the roles and responsibilities of organisations delivering and managing medical education clearer.

Why isn’t there a separate theme for equality and diversity?

We have addressed equality and diversity in Theme 2: Educational governance and leadership. The standard is that ‘the educational governance system makes sure that educational and training is fair and is based on principles of equality and diversity.’ We also have requirements that support equality and diversity.

The national training survey measures the quality of training posts against the current standards – will this be updated too?

Yes. A review of the survey is underway to make sure that it continues to be fit for purpose under the new standards. We expect to update the questionnaire in 2017, by which time the new standards will have had a year to bed in.

Why haven’t performance measures / indicators / formal quality metrics been used?

We looked at an approach of developing prescriptive standards with associated measures and evidence with our expert advisory group. We determined that this approach could be superficial (a ‘tick-box’ approach), whereas setting standards that describe what good medical education and training looks like, and allowing organisations to develop their own evidence would encourage innovation and could help identify areas needing improvement. We need to assess the learning environment and culture and the overall impact on quality, not prescribe processes for managing and delivering medical education and training.

What happened to the idea of having core and developmental standards?

The new standards set out our expectation of the quality of education and training that organisations must demonstrate. The standards are set at a high level and as such will provide greater scope and flexibility to allow for innovation and drive improvement, in comparison to a tick box approach carried out purely to satisfy minimum requirements.

We are developing our quality assurance processes so we can better identify evidence-based good practice, and encourage excellence. We want these standards to be dynamic, so when we identify good practice, we will consider whether it should be published as a developmental requirement and, over time, become a core requirement.

What is the GMC’s role in medical education and training?

We are an independent organisation that helps to protect patients and improve medical education and practice across the UK.

We set the educational standards for all UK doctors through undergraduate and postgraduate education and training. We promote high standards and make sure that medical education and training reflects the needs of patients, medical students and doctors in training, and the healthcare systems across the UK.

To test whether or not medical schools meet our standards for undergraduate education we carry out monitoring and inspections, including talking to medical students about their experiences, and responding directly to any concerns raised.

We also approve postgraduate medical education and training – this includes approving training programmes, curricula and assessments. Rigorous reviews and monitoring activities, such as our annual survey of doctors in training, help us to deal quickly with any concerns and to make sure that doctors are receiving the supervision and experience they need to treat patients safely and well.