ImE

1. Standards and ethics in the UG curriculum • ImE Jim McKillop Chair, GMC UG Board, IME, Glasgow 24th June 2011

2. What we do Education Register Fitness to Practise Standards

3. GMC role in medical education • GMC sets outcomes and standards • Ensures outcomes and standards are met.

4. Key developments in GMC educational role • Regulation across the continuum from April 2010 • GMC Education Strategy 2011-2013 • Quality Improvement Framework (QIF) – superseding QABME, QAFP and QF • Tomorrow’s Doctors (2009) to apply from 2011/12

5. Professionalism Ethics are integral to the expectations around professionalism as part of : • Good Medical Practice • Tomorrow’s Doctors • Our guidance (eg on consent, confidentiality, end of life care...)

6. Standards & Ethics in the UG Curriculum 2003 2009 1993

7. Tomorrow's Doctors: Outcomes 2 - The doctor as a practitioner • Confidentiality • Use information effectively in a medical context...... • (c) Keep to the requirements of confidentiality and data protection legislation and codes of practice in all dealings with information.

8. Tomorrow's Doctors: Outcomes 3 - The doctor as a professional • Know about and keep to the GMC's ethical guidance and standards…. • Demonstrate awareness of the clinical responsibilities and role of the doctor, making the care of the patient the first concern. • Be polite, considerate, trustworthy and honest, act with integrity, maintain confidentiality, respect patients' dignity and privacy, and understand the importance of appropriate consent.

9. Tomorrow's Doctors: Outcomes 3 - The doctor as a professional • Respect all patients, colleagues and others regardless of their age, colour, culture, disability, ethnic or national origin, gender, lifestyle, marital or parental status, race, religion or beliefs, sex, sexual orientation, or social or economic status….. • Recognise the rights and the equal value of all people and how opportunities for some people may be restricted by others' perceptions.

10. Tomorrow's Doctors: Outcomes 3 - The doctor as a professional • Understand and accept the legal, moral and ethical responsibilities involved in protecting and promoting the health of individual patients, their dependants and the public including vulnerable groups such as children, older people, people with learning disabilities and people with mental illnesses. • Demonstrate knowledge of laws, and systems of professional regulation through the GMC and others, relevant to medical practice….

11. IME Core Curriculum • Available as link on GMC TD2009 website: • http://www.gmc-uk.org/MEL_for_Doctors_of_Tomorrow___JME_Jan_2010_29451024.pdf

12. Student professionalism & fitness to practise GMC and the Medical Schools Council joint publication (2009) Aimed at medical schools and students Advice on the kinds of professional behaviour expected of students Advises schools on FtP procedures

13. Student FtP

14. Student fitness to practise ..deliberate or reckless disregard of professional and clinical responsibilities.... ...isolated lapse.....would not in itself suggest that the student’s fitness to practise is in question. ....persistent misconduct, whether criminal or not... indicates a lack of integrity....unwillingness to behave ethically or responsibly.....serious lack of insight into obvious professional concerns.....

15. EAR - SFTP Cases AY 2009/10 • Total number of cases – 572 • Average - 18.5 cases per school

16. AY 2009/10 - Cases by FTP Concern Conduct = 391 Health = 64 Conviction/Caution = 43 Health & Conviction = 74

17. AY 2009/10 - Cases by year of course Yr 1 = 69 Yr 2 = 138 Yr 3 = 129 Yr 4 = 122 Yr 5 = 106 Yr 6 = 3

18. AY 2009/10 - Cases by outcome Incomplete = 26 No action = 59 Support = 300 Warning =13 Conditions/undertakings = 42 Withdrawal = 28 Suspension Expulsion = 11

19. Student registration • GMC re-examining case for student registration • Effectiveness of our student engagement programme. • Whether benefits outweigh disadvantages. • Background context - Coalition Government less inclined toward statutory regulation.

20. Student Registration - Next steps Not just about solving student FtP concerns Key test - whether registration would contribute positively to: - promotion of professional values; and - to supporting a smoother transition to practice. (* November 2011 update: Decision has now been made not to introduce student registration in the foreseeable future.)

21. Provisional Registration • FtP declaration introduced 4 years ago. ~ 20,000 applications from UK graduates since • ~ 10% declare something – mostly trivial • 3 refused registration – complex or multiple problems or failure to declare

22. Review of Good Medical Practice • Last published 2006 • Updating rather than extensive fundamental changes • Scoping consultation complete – 2,000+ responses

23. GMP Review – some of the issues raised (1) • Is alignment with the 4 domains of revalidation possible/desirable? • (1: Knowledge, skills & performance; 2: Safety & quality; • 3: Communication, partnership & teamwork; 4: Maintaining trust) • Conflicts of interest • Delegation and referral • Interactions between NHS and private healthcare • Best use of resources/individual patient need

24. GMP Review – some of the issues raised (2) • Best use of resources/individual patient need • Doctor’s responsibility for environmental concerns • Doctor’s responsibility to promote return to work • Relevance of doctor’s private/non-professional activities • Social networks

25. GMP Review – Next Steps • Ongoing questions on consultation website • Draft text for public consultation Oct 2011 – Jan 2012 • Revision of supplementary guidance where necessary • New GMP issued Autumn 2012