Education news from the GMC - May 2012
Our last education update was in February. Since then we have made progress in many areas of our work.
Professor David Greenaway, Vice-Chancellor of Nottingham University, has been appointed to lead the independent Shape of Training review of UK postgraduate medical education and training. The GMC is one of the sponsors of this review , together with the Academy of Medical Royal Colleges, Medical Education England, the Medical Schools Council, NHS Education Scotland, NHS Wales and the Northern Ireland Department of Health, Social Services and Public Safety. We will be following the progress of the review in subsequent education updates.
We have recently completed two major consultations. The consultation on our role in continuing professional development closed in February, and our consultation on proposals for the recognition and approval of trainers closed at the end of March. We received a substantial response to both consultations and are very grateful to all those who took the trouble to get involved. We will be publishing revised CPD guidance in June, and we will report to the GMC’s Council on the outcomes of the approval of trainers consultation in July.
The new Foundation Programme Curriculum, revised by the Academy of Medical Royal Colleges Foundation Committee and approved by us at the end of 2011, will be introduced from August this year. With the UK Foundation Programme Office and the Academy of Medical Royal Colleges, we held an engagement event about the revised curriculum for Foundation School Directors on 7 March 2012. The new Foundation Programme Curriculum is available on the UKFPO website.
We published new research which considers the prevalence and nature of prescribing and monitoring errors in general practice and explores ways to mitigate these kinds of errors in the future.
Finally, we have launched the National trainees' survey which will be open until the 15th of June.
The news items below will give you a more detailed update on our progress in other areas of education too. Please forward this update to any colleagues you think will find it interesting and, as always, let us know if you have any comments or feedback.
In this issue:
GMC education news
National trainees’ survey 2012 now open
This year, we’ve made several changes and improvements to the National trainees’ survey, which is completed by all trainees. For the first time, trainees will fill in their survey on GMC Online, a password-protected area of our website designed to make administration easier for doctors. This should make the process of responding easier for trainees. Trainees don’t need to wait for an invitation – their survey will be waiting for them on GMC Online from 30 April and they have until 15 June to complete it. We’ve made several other changes and improvements.
- The survey is shorter – we’ve reduced the number of questions by 50%.
- The survey will be open for a shorter period – for seven weeks from 30 April until 15 June.
- Deaneries will be able to manage their trainee records in GMC Connect, our secure partners’ portal.
- Survey reporting will be available from July – a faster turnaround of results than ever before.
You can find out more about this year’s survey at www.gmc-uk.org/nts.
There will be no trainer survey in 2012, as we have been concentrating on developing our new framework for the approval and recognition of trainers. The next trainer survey will be undertaken in 2013.
GMC education events
Between 22 February and 27 March, we held seven education consultations events across the UK. Delegates representing medical schools, postgraduate deaneries, royal colleges, employers and other stakeholder organisations were invited, along with students, trainees and trainers.
The events were designed to contribute to the consultation on the recognition and approval of trainers. But they also addressed other key developments in the regulation of medical education and training, such as:
- What critical issues need to be addressed regarding the health and disability of students and trainees?
- Should we set targets for generic outcomes for specialty training and, if so, what should they cover?
- How should we assess doctors who want to be added to the Specialist or GP Register through the equivalence route?
- How could our approach to quality assurance be improved?
The feedback from the events was extremely positive and helpful. A number of those who attended said they particularly appreciated the opportunity to discuss policy issues where our thinking was still at an early stage. We are grateful to all those who participated.
New work to support doctors and trainees with disabilities
In February, we held a roundtable meeting with disabled medical students and doctors. We heard about their experiences, including the barriers they face in their practice and reasonable adjustments that could help them. Those attending emphasised that disabled doctors need guidance early in their career and find peer support networks particularly helpful. They also discussed the important role of occupational health.
We will draw on the issues raised at this event in our review of disability. We have established a health and disability working group and the first meeting will take place in May.
The working group will consider issues and questions, including:
- How we can promote effective support and clearer transitions so that students and trainees with disabilities can progress?
- How should reasonable adjustments work in practice and are these administered equally across the UK?
- The impact of our Gateways guidance, and whether all disabled medical students will be able to complete foundation and specialty training
- How we can strike the right balance between protecting the rights and expectations of students and trainees while maintaining standards and protecting patient safety
- The experience of students and trainees, including those with longstanding disabilities and those who become disabled during their education and training, in accessing advice, occupational health services and other support
- Mental health issues amongst medical students, and how they can be supported and the risks addressed.
The working group will produce a report on these areas, setting out its conclusions and recommendations, in December 2012.
Our comprehensive review of quality assurance
Earlier this year, we started to review how we assure the quality of medical education and training. Terms of reference have been agreed and the review will run until the end of 2013.
To see the terms of reference and other details of the review please go to: Reviewing our approach to the quality assurance of medical education and training.
We have organised a number of workshops to be held in June in London, Edinburgh and Manchester. They will be an opportunity to explore quality assurance issues with a broad range of individuals and organisations involved in medical education and training. We will be looking at a range of issues including visits, how we use evidence and measure outcomes, and how we should report on the outcomes of quality assurance activity.
What does the GMC mean by that?
With the list of medical education terms and acronyms expanding by the day and with different (and often strongly-held!) opinions about definitions, documents can become very tricky to interpret, particularly if you are new to the field. So we’ve published a Glossary for the Regulation of Medical Education and Training (pdf). It covers all stages of medical education and training, from entry to medical school to the completion of postgraduate training. It’s not a completely exhaustive list, but we hope it is helpful and we’d welcome feedback on it.
Consulting on equivalence routes
We’ve launched a consultation on proposed changes to the way we award certificates of eligibility for specialist or GP registration (CESR or CEGPR). The consultation document is the output from a working group we set up in 2010 to review the equivalence routes that doctors can use to apply to join the specialist and GP registers.
At the moment, candidates need to send us extensive documentary evidence to prove that their knowledge, skills and experience are equivalent to those of a doctor who's been awarded a certificate of completion of training (CCT). Although some documentary evidence will continue to have an important role in the application, the group has formulated a set of proposals to help improve the process including:
- When we assess doctors' knowledge, skills and experience, we should focus on evaluating their performance in practice using appropriate assessment tools.
- Doctors new to the UK should work here for a minimum of six months before applying for CESR or CEGPR. This is so they can acclimatise to UK health systems before being able to work more autonomously.
The report also considers whether we should ask doctors to demonstrate their specialist knowledge through a formal knowledge test.
We need to be sure that any changes we make will continue to protect patients, be fair to doctors and have the confidence of employers. We want to hear your views of the report's recommendations. You can read more about the review and respond to the consultation until 15 June 2012 at www.gmc-uk.org/education/12287.asp.
CCT, CESR and CEGPR fees are now tax deductible
HMRC has updated its position on tax deductions relating to professional subscriptions to include the fees that doctors pay when they are applying to join the specialist and GP registers.
This also affects specialist societies. You can find an exhaustive list of these deductions for fees and subscriptions paid to professional bodies or learned societies on the HMRC website.
Prescribing errors in General Practice – new research published
We have released new research which provides an important insight into how errors in prescribing occur. The study, commissioned by the GMC and led by the University of Nottingham, looked at a sample of GP practices in England.
In the largest-scale research of its kind, researchers examined the anonymised medical records of nearly 2,000 general practice patients to look for errors in how drugs had been prescribed, including whether doctors had made adequate provisions to monitor patients on medications where that was required. Of prescriptions with errors, the majority were classed as mild or moderate errors, with only 1 in every 550 prescription items associated with a severe error in prescribing.
Errors were however noted in prescriptions for 1 in 20 medicines issued to patients, resulting in as many as 1 in 8 patients receiving a medicine with a prescribing or monitoring error. The most common errors were missing information on dosage, prescribing an incorrect dosage, and failing to ensure that patients get necessary monitoring, such as blood tests. The researchers identified the Lack of curent emphasis in training on the skill of prescribing and GPs being under significant time pressure as contributing factors to prescribing errors.
Recommendations in the research report include a greater role for pharmacists in quality assurance of prescribing and better software to alert GPs to problems with prescriptions before they are issused.
Commenting on the research, Professor Sir Peter Rubin, Chair of the General Medical Council, said:
‘GPs are typically very busy, so we have to ensure they can give prescribing the priority it needs. Using effective computer systems to ensure potential errors are flagged and patients are monitored correctly is a very important way to minimise errors. Doctors and patients could also benefit from greater involvement from pharmacists in supporting prescribing and monitoring. We will be leading discussions with relevant organisations, including the RCGP, the CQC and the Chief Pharmacist in the Department of Health, to ensure that our findings are translated into actions that help protect patients.’
Read the report in full at: http://www.gmc-uk.org/news/13017.asp.
Other GMC news
Consulting on short explanatory guidance about good medical practice
Our recent review of Good Medical Practice, our core guidance for doctors, highlighted a number of issues where additional explanatory guidance would be helpful. We’ve now launched a consultation to hear your views about nine short pieces of additional draft guidance, including new guidance on doctors’ use of social media. This guidance will be published at the end of 2012, together with a new edition of Good Medical Practice, learning materials and other supporting resources, which aim to help doctors apply our guidance to their day-to-day practice.
We want to find out if you think we’ve got this guidance right, especially the pieces that relate to you. You can find out more and contribute to the consultation, which closes on 13 June 2012, by visiting www.gmc-uk.org/gmp2012.
New guidance on leadership, management and raising concerns
In January we published new guidance on Leadership and management for all doctors and Raising and acting on concerns about patient safety, both of which came into effect in March 2012.
Our guidance on leadership and management sets out the responsibility of all doctors in the workplace to raise any concerns they may have about patient safety. Our guidance on raising concerns sets out our expectation that all doctors will, whatever their role, take appropriate action to raise and act on concerns about patient care, dignity and safety. This new guidance and online learning materials can be found at www.gmc-uk.org/leadership and www.gmc-uk.org/raisingconcerns.
Should we limit provisional registration to three years?
We are proposing that provisional registration should be limited to three years. This time limit would allow a trainee doctor to hold provisional registration for the first year of the Foundation Programme, an additional year of training allowed by the deanery, and a further year for contingencies. Although the overall time limit would not be flexible, doctors would be able to put their provisional registration on hold if they need to, and take it up again when they are ready to start or resume their training post.
We would welcome your views. You can find out more about our proposals on our website and access a short questionnaire to provide your feedback. Once we’ve reviewed your initial comments, we’ll undertake a formal consultation on the proposed changes in the autumn.
Education news from the GMC is a regular e-bulletin which contains the latest news and developments in medical education and training from the GMC. To receive the update, please send an email to education@gmc-uk.org.