The GMC and Medical Education - Ben Griffith


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The GMC and Medical Education - Ben Griffith

  1. 1. Romanian authorities – 16 November 2011: The GMC and Medical Education Ben Griffith – Education Policy Manager
  2. 2. How doctors are trained Medical School (4-6 years) F1 year (1 year) F2 year (1 year) Specialty/GP training (3-8 years) Specialist/GP register (to retirement) Provisional registration Full registration Certificate of completion of training (CCT)
  3. 3. <ul><li>The hardest conviction to get into the mind of a beginner is that the education upon which he is engaged is not a College Course, a Medical Course but a Life Course, for which the work of a few years under teachers is but a preparation </li></ul><ul><li>William Osler, The Student Life, Address to Students at McGill University, April 1905 </li></ul>
  4. 4. <ul><li>Medical School </li></ul><ul><li>(4-6 years) </li></ul><ul><li>32 medical schools in the UK </li></ul><ul><li>Around 35,000 medical students </li></ul><ul><li>Have own approaches to curricula, teaching, assessment etc </li></ul><ul><li>Courses include clinical exposure </li></ul><ul><li>But must all meet standards and outcomes in Tomorrow’s Doctors </li></ul><ul><li>Subject to fitness to practise, graduates receive provisional registration with GMC </li></ul><ul><li>GMC quality assures </li></ul>
  5. 5. Map of UK medical schools
  6. 6. Tomorrow’s Doctors <ul><li>Outcomes for graduates : The doctor as … </li></ul><ul><ul><ul><li>Scholar and scientist </li></ul></ul></ul><ul><ul><ul><li>Practitioner </li></ul></ul></ul><ul><ul><ul><li>Professional </li></ul></ul></ul><ul><li>Standards for delivery: </li></ul><ul><ul><ul><li>Patient safety </li></ul></ul></ul><ul><ul><ul><li>Quality assurance, review and evaluation </li></ul></ul></ul><ul><ul><ul><li>Equality, diversity and opportunity </li></ul></ul></ul><ul><ul><ul><li>Student selection </li></ul></ul></ul><ul><ul><ul><li>Design and delivery of the curriculum, inc. assessment </li></ul></ul></ul><ul><ul><ul><li>Support and development of students, teachers, faculty </li></ul></ul></ul><ul><ul><ul><li>Management of teaching, learning and assessment </li></ul></ul></ul><ul><ul><ul><li>Educational resources and capacity </li></ul></ul></ul><ul><ul><ul><li>Outcomes </li></ul></ul></ul><ul><li>Practical procedures for graduates </li></ul>
  7. 7. <ul><li>Foundation programme </li></ul><ul><li>(2 years) </li></ul><ul><li>Foundation programme (FP) is a two year programme of general training with placements within various specialties and healthcare settings </li></ul><ul><li>Approximately 12,000 doctors in FP </li></ul><ul><li>First year has outcomes set by the GMC which must be achieved to receive full registration </li></ul><ul><li>GMC quality assures </li></ul>
  8. 8. <ul><li>Specialty/GP training </li></ul><ul><li>(3-8 years) </li></ul><ul><li>Medical royal colleges draw up criteria for specialist and GP training and assessments, which are now approved by GMC </li></ul><ul><li>National competition for selection, training overseen by postgraduate deans </li></ul><ul><li>GMC certifies completion of training, leads to entry on GMC GP or specialist register and eligibility to work as a consultant </li></ul><ul><li>GMC quality assures </li></ul><ul><li>Around 35,000 doctors in training </li></ul>
  9. 9. The Trainee Doctor <ul><li>Standards for postgraduate training: </li></ul><ul><ul><ul><li>9 domains </li></ul></ul></ul><ul><ul><ul><li>Standards for trainers </li></ul></ul></ul><ul><li>Standards for deaneries </li></ul><ul><li>Outcomes for provisionally registered doctors (first year after graduation from medical school) </li></ul><ul><li>Core skills for provisionally registered doctors. </li></ul>
  10. 10. Routes to Specialty training
  11. 11. <ul><li>Run through or coupled: progression to the next level of training is automatic provided you meet all the competency requirements </li></ul><ul><li>Uncoupled: split into ‘core’ and ‘higher’ training: two or three years of core training, followed by competition into higher training </li></ul>Source: Quick Guide to Recruitment in 2010 - DH
  12. 12. Map of UK Deaneries <ul><li>20 Deaneries are responsible for postgraduate medical and dental training </li></ul><ul><li>In England, they are aligned to the Strategic Health Authorities </li></ul><ul><li>In Scotland, the deaneries are aligned to NES (NHS Education for Scotland) </li></ul><ul><li>COPMeD (Conference of Postgraduate Medical Deans) provides a forum for medical deans to meet and discuss issues </li></ul><ul><li>Also COGPeD (for deans responsible for general practice) </li></ul>
  13. 13. Medical Royal Colleges <ul><li>General responsibility for training and assessing doctors within specialties </li></ul><ul><li>14 Medical Royal College, and 4 medical faculties </li></ul><ul><li>Colleges in Scotland and Ireland </li></ul><ul><li>Largest in England include: </li></ul><ul><ul><ul><li>Royal College of Surgeons of England </li></ul></ul></ul><ul><ul><ul><li>Royal College of Physicians </li></ul></ul></ul><ul><ul><ul><li>Royal College of General Practitioners </li></ul></ul></ul><ul><ul><ul><li>Royal College of Paediatrics and Child Health </li></ul></ul></ul><ul><ul><ul><li>Royal College of Anaesthetists </li></ul></ul></ul><ul><ul><ul><li>Royal College of Radiologists </li></ul></ul></ul><ul><ul><ul><li>Royal College of Psychiatrists </li></ul></ul></ul>
  14. 14. <ul><li>Specialist/GP register </li></ul><ul><li>(to retirement) </li></ul><ul><li>Revalidation </li></ul><ul><li>Role of CPD (see current consultation) </li></ul><ul><li>Framework based on Good Medical Practice </li></ul><ul><li>Colleague and patient questionnaires </li></ul>
  15. 15. But it’s not quite that simple … <ul><ul><li>Not everyone can (or wants to) become a consultant </li></ul></ul><ul><ul><ul><li>Staff, Associate Specialist and Specialty (SAS) doctors (around 14,000) </li></ul></ul></ul><ul><ul><ul><li>Challenge is to develop this grade </li></ul></ul></ul><ul><ul><li>Not everyone stays in clinical practice: </li></ul></ul><ul><ul><ul><li>Public health </li></ul></ul></ul><ul><ul><ul><li>Academic research </li></ul></ul></ul><ul><ul><ul><li>Medical law </li></ul></ul></ul><ul><ul><ul><li>Management </li></ul></ul></ul><ul><ul><ul><li>Pharmaceutical industry </li></ul></ul></ul><ul><ul><ul><li>Journalism </li></ul></ul></ul>
  16. 16. But it’s not quite that simple … <ul><ul><li>There are other routes to the specialist and GP register: </li></ul></ul><ul><ul><ul><li>CESR (Certificate confirming eligibility for specialist registration) </li></ul></ul></ul><ul><ul><ul><li>CEGPR (Certificate confirming eligibility for GP registration) </li></ul></ul></ul><ul><ul><li>Designed to assess applications from doctors who have not followed a traditional training programme but who may have gained the same skills and knowledge </li></ul></ul><ul><ul><li>Assessment is now undertaken by GMC </li></ul></ul>
  17. 17. Some trends in medical workforce - England <ul><li>Doctors in training current represent 36% of NHS medical workforce (135,916) </li></ul><ul><li>DH workforce projections suggest by 2029 doctors in training will represent 28% of NHS medical workforce (168,000) </li></ul><ul><li>Training numbers broadly the same </li></ul><ul><li>Aim is for 54,000 GPs (now 34,000), 52,000 specialists (now 35,000) </li></ul><ul><li>Future need for more GPs (many retiring), and particularly in UK urban centres </li></ul>Source: MMC (England) Workforce Review team, NHS Information Centre
  18. 18. Workforce statistics - UK Sources: UK Departments of Health 2.8 7250 162,400 2008 +47% 1.9 Drs/1000 population +61% 4500 Medical graduates pa +44% 112,400 NHS Doctors Increase 1998 France Australia Canada US 2.7 2.7 2.7 3.3 3.2 England 3.5 Northern Ireland 2.8 Wales 2.4 European average 2.2 Scotland Drs/1000 population
  19. 19. Further information
  20. 20. GMC’s Education Strategy
  21. 21. Education strategy projects <ul><li>Co-ordination of quality assurance </li></ul><ul><li>Reviews of CPD and equivalence routes to Specialist and GP registers </li></ul><ul><li>Transition issues </li></ul><ul><li>Approval of trainers </li></ul><ul><li>Generic learning outcomes in postgraduate education </li></ul><ul><li>Assessment </li></ul><ul><li>Evaluating the case for student registration </li></ul>
  22. 22. Other useful web links <ul><li>Medical Schools Council – </li></ul><ul><li>Foundation Programme Office – </li></ul><ul><li>Academy of Medical Royal Colleges – </li></ul><ul><li>BMA – </li></ul>
  23. 23. Any questions?