Achieving good medical practice: guidance for medical students

Domain 1: Knowledge, skills and performance

Develop and maintain your professional performance

  1. As a registered doctor, you'll be expected to keep your skills and knowledge up to date so you can give your patients the best standard of care.
  2. Registered doctors must be familiar with and follow all laws and regulations relevant to their practice as well as any guidance the GMC issues. This will protect patients by making sure they receive safe and lawful treatment and will help doctors to provide the best care possible.
  3. As a medical student, you'll learn the basic skills and knowledge you need to treat patients, but you are also developing your ability to learn and acquire future skills. As you move through medical school and into postgraduate education and training, you'll continue to build on what you have learnt. For you, this aspect of good medical practice is about participating fully in this learning process.
  4. You must:
    • engage fully with your medical course by attending educational activities, including lectures, seminars and placements, and by completing coursework
    • listen to the advice of your lecturers and trainers
    • comply fully with the regulations and other systems or structures provided by your medical school or university in relation to your studies
    • respond constructively to verbal and written feedback from patients, lecturers, clinicians and members of the multidisciplinary team by critically reflecting on the feedback and making an action plan to improve where necessary
    • reflect on what you have learnt and look at ways to improve your own performance.

What is reflection?

You will hear about the concept of reflective practice throughout your time at medical school.

At its core, reflection is thinking about what you've done, what you did well and what you could do better next time. To do this, you need to think about what effect your actions have on yourself and on others, including patients and colleagues, across all aspects of your education and training.

For example, if you have an interaction with a patient or a colleague that didn't go as planned, you should explore how you approached the situation in a critical light to see if you can learn from what happened and use that learning to improve the way you approach similar situations in the future.

Reflection also means responding constructively to feedback from your teachers, trainers and colleagues. Think about what you have been told you can improve and aim to put those improvements into action. This is how medical students and registered doctors learn and improve.

See our guidance for students on being a reflective practitioner, where we use the views of medical students, doctors and medical educators to explain why reflection is important and show you how you can use it in your daily life as a student and beyond.

  1. As a medical student, you'll learn about relevant laws and professional guidance, and it's important that you apply that learning when you are on a clinical placement. On a clinical placement, it is your responsibility to know, and proactively find out, about these policies and procedures and apply them in your work. This includes following the relevant laws and guidance when you are on an overseas placement or elective.

Apply knowledge and experience to practice

  1. Registered doctors must recognise and work within the limits of their competence.
  2. As a medical student, this applies to you in relation to the time you'll spend with patients on a clinical placement. It also means you should only treat patients or give medical advice when you are under the supervision of a registered healthcare practitioner. You must not carry out procedures on friends or your family. You must:
    • recognise the limits of your competence and ask for help when necessary
    • make sure you clearly explain your level of competence to anyone who supervises you on a placement, so you are not asked to do anything you are not trained to do
    • make sure patients, carers and colleagues are aware that you are a medical student and not a registered doctor
    • take action if you think you're not being effectively supervised on a clinical placement (see paragraph 9)
    • engage in a timely fashion with routine evaluation systems provided by your medical school or university (for example, end of placement questionnaires or staff-student liaison committees).

Being professional on placements - practical steps

  • Always introduce yourself to patients, letting them know your name and that you are a medical student.
  • When you meet a patient for the first time, check if they have any objections to having a student present.
  • If your medical school or placement provider has given you an ID badge or similar, make sure it is visible at all times.
  • Dress smartly and in line with dress codes set out by your medical school or placement provider.
  • Arrive on time for your placement and do not leave your placement early unless you have agreed this with a relevant supervisor.
  • Attend induction sessions if they're offered.
  • Attend all mandatory training arranged for you while on a placement.
  • Make sure you know about and follow the rules and guidance specific to your placement, including how you should raise any concerns. If in doubt, make sure you ask if there is anything in particular you should know at the start of your placement.
  • Be honest with patients if you don't know the answer to their questions. Patients appreciate that you are there to learn.
  • Make sure you know who is responsible for directly supervising you on your placement and who has the overall responsibility for medical students where you are working. This will help you understand where to go if you need help and if you have any concerns you need to raise.
  • Be aware that while on any elective, in the UK or abroad, students should still apply the advice in this guidance wherever possible.
  1. If you are not sure you are able to carry out a procedure competently, you should ask for help from a more experienced colleague, such as a nurse or qualified doctor. You should only attempt practical procedures if you have been trained to do so, and only under supervision that is appropriate to your level of competence.
  2. If you think you are not being properly supervised on a placement, you should stop the work you are doing and raise your concerns with the placement provider and your medical school. This won't impact on your studies and will show that you are a responsible student acting in a professional manner. We also expect you to take prompt action if you have any concerns about possible risks to patients, as set out in paragraphs 20-28.
  3. While you are at medical school, you'll learn how to make good clinical decisions and how to be satisfied a patient has given consent. You'll learn that the consent process is about shared decision making between a doctor and a patient, where the doctor uses their specialist knowledge and experience to help their patient consider their options and make an informed decision.
  4. Towards the end of your studies, you may be responsible, under supervision, for explaining to a patient what will happen to them - and, in some cases, getting their consent for a minor procedure, such as taking a blood sample or a blood pressure reading. In almost all other cases, you won't be solely responsible for seeking consent. Whatever the circumstances, you should always check with the patient what they have already agreed to in terms of treatment and that they're happy for a student to be involved in their care.

You can find out more about consent in the GMC's guidance for registered doctors, Consent: patients and doctors making decisions together.

Consent - things to remember

Patients need to know that you are a student so they can make an informed decision about whether they want you to be involved in their care. Once they know you are a student, you can ask if they're happy for you to talk to them about their health or carry out a procedure.

Remember:

  • if you have any concerns about whether a patient has given consent to you being involved in their care or undertaking any type of procedure, talk to your supervisor about your concerns.
  • you should be aware that sometimes patients might not have the capacity to give consent.
  • you should not carry out any procedure on a patient without their consent for that specific procedure.
  • you must respect the decision of patients who do not want you to be involved in their care.

See Part 3 of Consent: patients and doctors making decisions together.

Record your work clearly, accurately and legibly

  1. Doctors must record their work clearly, accurately and legibly. Records should include:
    • relevant clinical findings
    • decisions made and actions agreed (and show who they were made by)
    • any drugs prescribed or other investigation or treatment
    • the information given to the patient.
  2. This helps to ensure effective team working, safe handover and continuity of care. Therefore, the information must make sure that anyone reading those notes can understand them and rely on the fact that the information is correct. This includes patients and their relatives or carers.
  3. As a medical student, you must make sure that the notes you write are clear, accurate and legible, even when made as part of the learning process, as this will help you develop the skills you'll need as a doctor.
  4. You should make sure all the documentation you submit to your medical school is written in a professional way. This includes the findings of activities, such as audit or research you carry out as part of your studies.

Recording your work - dos and don'ts

Do

  • make it clear that you're a medical student when you add anything to a patient's notes - you should put your name and year of study so what you write can be checked by a registered health professional
  • make sure the notes you take are dated, clear, accurate and legible - even if they're not going on a patient's official record
  • make sure your notes are recorded as soon as possible after your interaction with a patient
  • get rid of your notes carefully - especially when they relate to patients - using facilities designed for the disposal of confidential material.

Don't

  • write anything you would not want to be made public in notes, logbooks or reports
  • submit work that is difficult to read or poorly presented
  • store confidential material in places that aren't secure - this includes digital and paper files.