Review of Tomorrows Doctors

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Review of Tomorrows Doctors

• Ben Griffith

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The GMCs 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

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Tomorrows 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

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Tomorrows 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

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Sources for the review

• QABME
• Research
• GMC guidance
• Educational frameworks
• Engagement

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Dr Jan Illings 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.

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Dr Jan Illings 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.

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Tomorrows Doctors proposed structure
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Standards for delivery of teaching, learning and
assessment
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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 identifiedshould be
  addressedwith documentation of actions and
  feedback to students and staff

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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)

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Outcomes for graduates
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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.

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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).

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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

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Contacts

• Consultation on-linehttp//www.gmc-uk.org/tomorr
  owsdoctors
• Email tomorrowsdoctors_at_gmc-uk.org
• Telephone Ben Griffith on 020 7189 5283
• Post Tomorrows Doctors 2009
  Consultation Education Section General Medical
  Council Regents Place 350 Euston Road London
  NW1 3JN