1. Review of Tomorrow’s Doctors Ben Griffith

2. The GMC’s role in medical education Promotes high standards Currently covers undergraduate education and the first year of training after graduation (F1) Quality assures delivery of standards and outcomes: QABME and QAFP PMETB to be merged with GMC from 2010 (and GMC will then regulate undergraduate, postgraduate and continued practice) Co-ordinates all stages of medical education

3. Tomorrow’s Doctors ( 2003 )  Sets standards for the knowledge, skills and behaviours undergraduate medical students learn in the UK  Provides a framework for UK medical schools to use in designing their own curricula/schemes of assessment  First published 1993  Last reviewed and published 2003

4. Tomorrow’s Doctors – changes since 2003…  Changes in continuum of medical education:  New schools and growth in student numbers  Foundation Programme  Streamlining of postgraduate education  PMETB created and to be merged with GMC  Changes in medicine:  Technology  Patient demography and expectations  Health care systems

5. Sources for the review  QABME  Research  GMC guidance  Educational frameworks  Engagement

6. Dr Jan Illing’s research findings  Graduates looked forward to ‘being a doctor’.  While communication is a strong area at graduation, F1s were under-prepared for some complex communication tasks.  Other clinical skills are well practised, but not in contexts which sufficiently mimic the clinical environment.  Knowledge of non-clinical areas such as legal and ethical issues, and the operation of the NHS, was lacking at the start of F1.  Prescribing was a significant area of under- preparedness.

7. Dr Jan Illing’s recommendations Undergraduates’ preparedness will be improved by more experiential learning in clinical practice:  Ensure that placements have more structure and consistency  Ensure that students are given a greater role in medical teams.  Establish fuller and more prescriptive guidelines on shadowing.  Specify the limits of the F1 role.  Address particular weaknesses in prescribing.

8. Tomorrow’s Doctors – proposed structure Tomorrow’s Doctors Standards for delivery of teaching, learning and assessment Outcomes for graduates

9. Standards for delivery of teaching, learning and assessment Standards for delivery of teaching, learning and assessment Patient safety Quality assurance, review and evaluation Equality, diversity and opportunity Student selection Design and delivery of curriculum including assessment Support and development of students, teachers and local faculty Management of teaching, learning and assessment Educational resources and capacity Outcomes

10. Domain 2 – Quality assurance, review and evaluation 26. Quality data will include evaluations by students and data from medical school teachers and other education providers… 31. …all education providers of clinical placements, clinical tutors and supervisors, students, employers and patients should be involved in quality management and control processes. Their roles must be defined and information made available to them about this. 36. Any problems identified…should be addressed…with documentation of actions and feedback to students and staff…

11. Standards for delivery: some key issues  Generally, whether proposed standards are appropriately prescriptive (Q3)  Whether to drop quantitative standard for SSCs (Q5)  Practical experience in all years:  Placements planned and structured  Agreements between schools and providers  Student Assistantships  Induction (Q8-Q10)  Feedback and assessment (Q13-Q16)

12. Outcomes for graduates Overarching outcome The doctor as a scholar and scientist The doctor as a practitioner The doctor as a professional

13. Overarching outcome ‘To make the care of patients their first concern in accordance with Good Medical Practice, applying their knowledge in a practical and ethical manner and using their ability to provide leadership and to analyse complex and uncertain situations.’

14. Outcomes for graduates: some key issues  Generally, whether outcomes meet expectations of public and needs of employers (Q19-Q21)  Impact on disabled students (Q22-Q23 and others)  Scientific knowledge and understanding (Q25-Q26)  Communication skills (Q28)  Prescribing skills (Q31)  List of practical procedures (Q32-Q35)  Leadership (Q37)  Knowledge of the NHS (Q38).

15. Timetable  Consultation to 27 March: 53 Qs or 10 Qs  Council approval to be sought 8 July 2009  Publication of new edition late summer 2009  Presentations to medical schools and revisions to QABME late 2009  Implementation in medical schools from 2010/11

16. Contacts  Consultation on-line: http://www.gmc-uk.org/tomorrowsdoctors  Email: tomorrowsdoctors@gmc-uk.orgtomorrowsdoctors@gmc-uk.org  Telephone: Ben Griffith on 020 7189 5283  Post: Tomorrow’s Doctors 2009 Consultation Education Section General Medical Council Regent’s Place 350 Euston Road London NW1 3JN