Foreword

Doctors must be capable of regularly taking responsibility for difficult decisions in situations of clinical complexity and uncertainty.

Medical schools equip medical students with the scientific background and technical skills they need for practice. But, just as importantly, they must enable new graduates to both understand and commit to high personal and professional values.

Medicine involves personal interaction with people, as well as the application of science and technical skills. In Good Medical Practice the GMC states: ‘Good doctors make the care of their patients their first concern: they are competent, keep their knowledge and skills up to date, establish and maintain good relationships with patients and colleagues, are honest and trustworthy, and act with integrity.’

Putting patients first involves working with them as partners in their own care and making their safety paramount. It involves dedication to continuing improvement, both in the doctor’s individual practice and in the organisation and environment in which they work.

It is not enough for a clinician to act as a practitioner in their own discipline. They must act as partners to their colleagues, accepting shared accountability for the service provided to patients. They are also expected to offer leadership, and to work with others to change systems when it is necessary for the benefit of patients.¹

In Tomorrow’s Doctors, we cover these themes under three headings, relating to the doctor as a scientist and a scholar, as a practitioner, and as a professional.

These categories cover the development of the knowledge, skills and behaviour students must demonstrate by the time they graduate. However, the categories and the specific outcomes should not be considered in isolation from each other. Doctors need to link them routinely in clinical practice.

Graduation is an early threshold in doctors’ careers. New graduates cannot be expected to have the clinical experience, specialist expertise or leadership skills of a consultant or GP. But they must be able to demonstrate all the outcomes in Tomorrow’s Doctors in order to be properly prepared for clinical practice and the Foundation Programme.

The Foundation Programme builds on undergraduate education, allowing new doctors to demonstrate performance in the workplace. It includes a range of clinical experience which often involves caring for unselected and acutely ill patients.

The outcomes set out what the GMC expects medical schools to deliver and what the employers of new graduates can expect to receive although medical schools are free to require their graduates to demonstrate additional competences. 

These outcomes mark the end of the first stage of a continuum of medical learning that runs from the first day at medical school and continues until the doctor’s retirement from clinical practice.

Professional regulation has changed dramatically since the first edition of Tomorrow’s Doctors was published in 1993. The GMC has published Good Medical Practice and other guidance which sets out the positive standards expected of good doctors in the new world of partnership with patients and colleagues. Registration and fitness to practise procedures have been transformed. Licensing and revalidation will also support regulation, professional values and lifelong learning. 

For this edition, among a number of important changes, we have responded specifically to concerns about scientific education, clinical skills, partnership with patients and colleagues, and commitment to improving health care and providing leadership.

We have also set out standards for the delivery of medical education with a new emphasis on equality and diversity, involving employers and patients, the professional development of teaching staff, and ensuring that students derive maximum benefit from their clinical placements.

We realise that meeting these outcomes and standards will be challenging. There are implications for resources and priorities both for medical schools and for the health service. But the benefit will be a further enhancement of the knowledge, skills and behaviour which new graduates will bring to their practice.

Today’s undergraduates – tomorrow’s doctors – will see huge changes in medical practice. There will be continuing developments in biomedical sciences and clinical practice, new health priorities, rising expectations among patients and the public, and changing societal attitudes.

Basic knowledge and skills, while fundamentally important, will not be enough on their own. Medical students must be inspired to learn about medicine in all its aspects so as to serve patients and become the doctors of the future. 

With that perspective and commitment, allied to the specific knowledge, skills and behaviours set out in Tomorrow’s Doctors and Good Medical Practice, they will be well placed to provide and to improve the health and care of patients, as scholars and scientists, practitioners and professionals.

Professor Sir Peter Rubin
Chair – General Medical Council