Better support needed for doctors entering UK practice

Doctors entering the UK health service for the first time need better support in order to practise safely, according to a new report published today.

Every year, around 12,000 doctors from the UK, Europe and countries around the world, start working in the UK for the first time (1). The recommendation for an induction programme for all doctors new to the UK health service comes from the first State of Medical Education and Practice report published by the General Medical Council (GMC).

The report uses GMC and other data to provide a picture of the medical profession in the UK and identifies some of the challenges that persist. It concludes more needs to be done to ensure consistency of induction for all doctors, and especially for those coming here to work from outside the UK. This would ensure that they get an early understanding of the ethical and professional standards they will be expected to meet, and become familiar with how medicine is practised across England, Wales, Scotland and Northern Ireland.

While there are some good local schemes for supporting doctors who are new to practice, there is evidence of new doctors undertaking clinical practice with little or no preparation for working in the UK, or locum doctors taking on duties for which they have not been appropriately trained.

The GMC plans to work with doctors’ employers and professional organisations to develop a basic induction programme for all doctors.

The Chief Executive of the General Medical Council Niall Dickson said: 'While there is much to celebrate about medical practice in the UK, the challenges are also clear – we must do more to make sure that all doctors understand the standards expected of them.

'Developing an induction programme for all doctors new to our register will give them the support they need to practise safely and to conform to UK standards. This will provide greater assurance to patients that the doctor treating them is ready to start work on day one.

‘For the first time we have begun to use our data to try to understand more about the nature of medical practice today and the pressures facing front-line health services. This fits with our focus on becoming more responsive to the needs of patients, while supporting the profession and the healthcare system in raising standards of medical practice.

‘We hope this report will contribute to a better understanding of the challenges the profession faces as well as challenging us and those we work with to redouble our efforts to improve standards and protect patients.’

The challenges identified include:

• An ageing population with more complex health needs and co-morbidities, who will increasingly be cared for by multi-professional teams in primary and community settings.
• The tension between a health service that must deliver care with constrained funding and within European working time rules and the need to protect time for education and training.
• Common and consistent areas of complaints about doctors remain: clinical investigations or treatment; respect for patients; and communication with patients.

Other major areas identified in this report include:

• Professionalism and leadership are crucial to good medical practice. Revalidation, which will be introduced in 2012, will help to embed professional standards.
• Regulatory bodies need to redefine how they work; professional regulators such as the GMC and systems regulators such as the Care Quality Commission in England need to be proactive and work more closely together.
• In parts of the system there needs to be a culture change to encourage doctors to raise concerns; the GMC, professional bodies and employers all have a role to play to make this happen.
• Doctors need to be equipped to deal with changing healthcare needs. Postgraduate training should be flexible enough to allow doctors to be able to move between specialties.
• More information is needed on the output of medical education to make sure medical students have the right skills and knowledge when they start work.

Download the report

You can download the full report and a summary of the report at The state of medical education and practice 2011.