Overview of the QABME process

The General Medical Council (GMC) sets and monitors standards in medical education.

In order to ensure that UK Medical Schools maintain these standards we run a quality assurance programme, which involves regular monitoring and visits to schools and their partner institutions.

This programme is called QABME (Quality Assurance of Basic Medical Education).

Our statutory responsibilities

The GMC's Council has a statutory duty (Medical Act 1983) to set and maintain the standards for undergraduate medical education.

Our standards are set out in the publication Tomorrow’s Doctors.

The Council has the power to visit universities to make sure that undergraduate teaching is consistent with Tomorrow’s Doctors and to inspect examinations to make sure that the standards expected at qualifying examinations are maintained and improved.

The GMC holds a list of universities that can award a UK medical degree (Section 8 of the Act) and has the power to remove universities from that list (Section 9 of the Act).

We make recommendations to the Privy Council – the body which has powers to grant medical school status - about whether a university should:

• Be added to the list of universities that can award a UK medical degree (Section 8 of the Act).
• Be removed from the list of universities that can award a UK medical degree (Section 9 of the Act).

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Aims of the QABME programme

The QABME processes are designed to:

• Make sure medical schools meet the outcomes in Tomorrow's Doctors.
• Identify examples of innovation and good practice.
• Identify concerns and help to resolve them.
• Identify changes schools need to make to comply with Tomorrow’s Doctors and a timetable for their implementation.
• Promote equality and diversity in medical education.

The aims of the QABME programme are achieved through two core QABME processes – the Annual Return Process and the Visit Process - and continuous improvement of the QABME programme.

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The QABME Annual Return Process

Every year, each medical school must provide a return to the GMC that:

• Identifies significant changes to curricula, assessments or staffing.
• Highlights risks or issues of concern, proposed solutions and corrective actions taken.
• Identifies examples of innovation and good practice.
• Responds to issues of interest and debate in medical education, including promoting equality and valuing diversity.
• Identifies progress on any requirements or recommendations arising from the QABME visit process.

The GMC writes to each medical school towards the end of the calendar year to request the specific information required that year.

School returns allow the GMC Undergraduate Board to identify:

• Issues to explore with all medical schools.
• Examples of good practice that can be shared.
• Issues to be investigated with individual medical schools.

If we need to investigate an issue, for example the introduction of a new curriculum or significant changes to the curriculum or facilities, the school may be requested to submit detailed information for analysis or may be selected for the QABME visit process.

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The QABME Visit Process

a) Established school Visit Process

The GMC will visit each medical school at least twice within every 10 years.

Visits are undertaken on behalf of the GMC’s Undergraduate Board by a team of medical and educational professionals, medical students and lay members. The visiting teams are assigned to a school and are responsible for all stages of the visit process for their school.

The main stages of the visit process are:

• Stage 1: Collecting information (June to December)
• Stage 2: Confirming information (January to July)
• Stage 3: Integrating information and making judgements (June to August)

Note: These time frames may vary slightly to respond to individual school timetables.

This three-stage process ensures visiting teams collect information, explore information and observe parts of the teaching and learning process in a systematic way. Evidence is triangulated and evaluated against the standards in Tomorrow’s Doctors.

During the visit process all communication must be addressed to the offices of the GMC. Schools must not contact visitors outside of scheduled visit activities and visitors must not contact the school outside of scheduled visit activities.

The visiting teams provide a report on their findings to the Undergraduate Board.

The visit process for an established school is generally 18 months from notification of selection to the Undergraduate Board’s endorsement of the visiting team's report.

The visit process may vary for established schools proposing major changes to curriculum, facilities or supervisory structures. For example, if changes are limited to one or two years of the school’s curriculum the visit process may be completed in the standard 18 month timeframe. Alternatively, if extensive changes are planned across the curriculum the visit process may be repeated over a number of years as the changes are rolled out.

Similarly, the visit process will vary for established medical schools wishing to change their degree awarding arrangements.

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b) New school visit process

Four new medical schools have been established in England:

• Brighton and Sussex Medical School (Universities of Brighton and Sussex)
• Hull and York Medical School (Universities of Hull and York)
• Peninsula Medical School (Universities of Exeter and Plymouth)
• University of East Anglia Medical School

All four schools have successfully completed a quality assurance cycle which involved the same systematic three-stage process applied to established schools.

However, quality assurance activities were carried out for each year for the duration of the first medical student intake’s degree course, assessing the development and delivery.

Once a new school has been added to the list of universities that can award UK medical degrees it will be quality assured in the same way as established medical schools.

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Support for medical schools not in the visit process

On request, we also facilitate the twinning of medical schools so that those that have been quality assured can support schools going through the process.

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Continuous improvement of the QABME programme

We have built in a number of mechanisms to allow us to continually improve our quality assurance processes. These include:

• Annual evaluation of the programme
• A targeted annual training programme for visitors
• Informal and formal feedback processes for visited schools.

The views of schools help us review and improve our processes. Schools are therefore requested to keep a log of issues with the process so concerns are identified and addressed in a consistent way.

If the school identifies an urgent problem it should contact the GMC staff member responsible for managing their visits. Non-urgent concerns are reported in the formal school feedback process at the end of the visit cycle.

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