Domain 3: Communication, partnership and teamwork
- Doctors must work in partnership with patients and good communication is vital if they are to do this successfully. Working in partnership is about supporting patients to make decisions about their treatment and care, by listening to and respecting their views about their health. Working in partnership is also about sharing information patients want or need, in a way that is tailored to their needs.
- As a medical student, you'll learn how to communicate effectively in a variety of clinical, simulated and non-clinical settings and it is important that you apply your learning in your interactions with patients.
- When communicating with patients you must:
- be honest when you don't know something. As a student, you're not expected to know the answers to all questions a patient may have, but you are expected to listen to them and respect their views. You should do your best to find out the answers to the patient's questions yourself, or pass the query on to someone who will be able to help
- take into account the patient's language and communication needs and other potential barriers to effective communication (for example, pain or anxiety) and ask for support to help you communicate effectively if necessary.
- be polite and considerate to anyone close to the patient, such as relatives, carers and friends at all times - not just during a consultation.
You can find more information and interactive resources aimed at helping doctors provide good care for people with a learning disability in the GMC's learning disabilities guidance.
Work collaboratively with colleagues to maintain or improve patient care
- Doctors must work collaboratively with other doctors and healthcare professionals to make sure patients are treated effectively.
- When on clinical placements, you must be aware of and contribute fully to the work of the healthcare team. You must contribute effectively to any team you are part of in your non-clinical training.
- You must treat your colleagues with respect. This includes your fellow students, clinical and non-clinical teachers, and those responsible for the administration of your course. You'll also learn with students from other health professions, which is important to help you develop a better understanding of the roles that different professions play in a multidisciplinary healthcare team.
- You must:
- work collaboratively with your teachers, trainers, administrative or support staff and fellow students, including those from other healthcare professions
- treat all peers and colleagues fairly and with respect
- understand that your own behaviour can influence how well a team works and be prepared to adapt your behaviour to achieve the goals of the team.
Teaching, training, supporting and assessing
- Every member of the medical profession is responsible for supporting less experienced members. This means doctors should be prepared to contribute to teaching and training other doctors and students, and should be willing to take on mentoring roles. The GMC also expects doctors to take part in the assessment of doctors in training and to give feedback for the appraisals of colleagues. They must complete these activities in an open and honest way.
- As a medical student, you may be expected to mentor other students or be asked to give feedback about your peers. If you are asked to do this, you must do so in an honest, constructive, open and fair way.
- As a medical student, you'll be asked to give feedback on the quality of your placements and teaching. You must give this feedback when asked, as it will help your medical school to improve the overall quality of the education it provides. You must be fair, constructive and professional in your feedback and make comments based on your own experience. You should try to highlight areas of good practice as well as identifying areas where improvements could be made.
Continuity and coordination of care
- Registered doctors must contribute to the safe transfer of patients between different doctors, teams and health and social care settings. This means they must make sure they share relevant information about the patient with the colleague or team that is taking over their care. They must be satisfied that when they hand over or delegate care, it is to someone with the appropriate qualifications, skills and experience to provide safe care for the patient.
- As a senior medical student, it is likely you'll be expected to look after patients, under supervision. When you are transferring the care of a patient, you must make sure you transfer care to an appropriate person and that you share relevant information with them. If you have any concerns about this process, you should ask a senior colleague for help.
Establish and maintain partnerships with patients
- All registered doctors must establish and maintain partnerships with patients. This means being polite and considerate and treating patients as individuals. It also means respecting their dignity and privacy and treating patients fairly and with respect, whatever their life choices and beliefs.
- As a medical student, you'll learn how to develop a partnership with patients. Therefore you must:
- be polite and considerate at all times
- listen and respond to patients' views and concerns
- respect patients' dignity, confidentiality and privacy
- treat patients fairly and with respect, no matter what your own thoughts are about their life choices or beliefs
- be clear with patients about the role you'll take in their care.
Maintaining patient confidentiality
- All patients have a right to expect that their doctors will hold information about them in confidence. Confidentiality is central to trust between doctors and patients.
- However, confidentiality is not absolute, and appropriate information sharing is essential to the efficient provision of safe, effective care. You'll learn about this at medical school, but you need to be aware that you must never share confidential information about a patient with anyone who is not directly involved in their care without the patient's permission.
- Many improper disclosures are unintentional. You must not share identifiable information about a patient where you can be overheard, such as in a public place or on social media, or include it in any work or logbooks you submit. You must be clear about what confidential information a patient has agreed can be shared with friends and family before you discuss their care. You can find more information about when and how you can disclose personal information about patients - with their consent, where the law requires it and in the public interest - in the GMC's guidance, Confidentiality.
- You must also follow any policies of your medical school, university or placement provider to make sure personal information is stored and disposed of securely.
How does confidentiality apply to my placements?
It's normal to want to talk about things you have seen on clinical placements with colleagues or friends. You'll see unusual medical conditions and may be put in situations where patients experience adverse outcomes. But you must never disclose patient identifiable information without a patient's consent. If you're not sure what to share if you're asked to provide information for an inquiry or logbook, you should ask for advice before you disclose any information.
You should also make sure you never discuss patients in a public place or on social media. Even if you don't mention a patient by name, there's a chance that someone nearby (or online, if you're on social media) might know whom you are talking about.
If you do want to talk to a colleague, friend or supervisor about what you have seen on a placement, you should only do that in a private place. And you shouldn't mention the patient by name, except to a clinician directly involved in their care.Consent: patients and doctors working together.
Social media dos and don'ts
- check your privacy settings so you know who can see what on the platforms you use. But remember that social media sites cannot guarantee confidentiality whatever privacy settings you use
- remember that the apps you use may link to your social media profile and that information from that site may be seen by users of the app
- maintain boundaries by not engaging with patients or others about a patient's care through your personal social media profiles or platforms. Instead, if appropriate, use a separate professional platform or profile to respond
- remember that once information is published on social media sites you may not be able to control how it is used by others and it can be difficult to remove it from the internet or the site it was originally posted on
- use social media to express your views, but don't behave in a derogatory manner to other users and don't post discriminatory content
- think carefully about how others, particularly patients both present and future, might perceive your content.
- share information about patients or post information that could identify a patient
- misrepresent your skills or level of training to others
- post complaints about your placement providers, medical school, teachers or trainers.
Making a conscientious objection
- Doctors may choose to opt out of providing certain types of treatment because of their personal beliefs and values, as long as this does not result in discrimination against individuals or groups of patients. If a doctor has a conscientious objection to arranging or providing a particular procedure, they must explain this to the patient, tell them about their right to see another doctor and make sure they have the information to do so. Doctors must not express disapproval of the patient's lifestyle, choices or beliefs in doing this. You can find more information in the GMC's guidance Personal beliefs and medical practice.
- Medical schools have an obligation to make adjustments for cultural or religious beliefs, but they must balance these adjustments against practical considerations. For example, they may need to schedule clinical placements or assessments during certain religious festivals or at times of religious observance.
- As a medical student, you also have the right to hold a conscientious objection to some types of treatment and you should discuss this with your medical school. However, you must achieve the capabilities described in Outcomes for graduates.