Academic standards - Medicine

This is a selection from the Subject benchmark statement

The complete statement is © The Quality Assurance Agency for Higher Education 2002.

It may be reproduced by educational institutions solely for educational purposes, without permission. Excerpts may be reproduced for the purpose of research, private study, or review without permission, provided full acknowledgement is given to the subject benchmarking group for this subject area and to the copyright of the Quality Assurance Agency for Higher Education.

Please refer to additional supplementary statement: http://www.qaa.ac.uk/crntwork/benchmark/supstat.htm

2 Defining principles

3 The goals of undergraduate medical education set out by the GMC in Tomorrow's Doctors 1993, are as follows:

a the student should acquire a knowledge and understanding of health and its promotion, and of disease, its prevention and management, in the context of the whole individual and his or her place in the family and in society;

b the student should acquire and become proficient in basic clinical skills, such as the ability to obtain a patient's history, to undertake a comprehensive physical and mental state examination and interpret the findings, and to demonstrate competence in the performance of a limited number of basic technical procedures;

c the student should acquire and demonstrate attitudes necessary for the achievement of high standards of medical practice, both in relation to the provision of care of individuals and populations and to his or her own personal development.

6 Generic graduate skills and clinical competencies

All medical graduates will possess a range of generic (transferable) skills which are those expected of all university graduates. They will also be competent in those core clinical, interpersonal, and practical/technical skills relevant to commencement of the pre-registration house officer year. In relation to all aspects of clinical practice, graduates will demonstrate appropriate professional behaviours, safeguarding confidentiality, understanding the need for informed consent, recognising their own limitations and being prepared to seek help from more experienced health care professionals when necessary.

6.1 Generic graduate skills

In relation to generic (transferable) skills, the graduate will be able to:

a adopt the principles of reflective practice and lifelong learning;

b retrieve, manage, and manipulate information by all means, including electronically;

c present information clearly in written, electronic and oral forms, and communicate ideas and arguments effectively;

d effectively manage time and resources and set priorities;

e apply the principles of scientific research and audit;

f study topics in depth;

g deal with uncertainty and work within a changing environment;

h teach effectively and act as a mentor to others;

i work effectively within a team.

6.2 Core competencies relevant to the pre-registration house officer year

1. In relation to clinical skills, the graduate will be able to:

a take a history which is patient-centred, sensitive, structured and relevant;

b undertake a relevant and systematic physical and mental state examination in a sensitive manner, appropriate for age, gender, culture and clinical condition;

c define problems and formulate a differential diagnosis;

d select appropriate investigations and interpret their results;

e make clinical decisions based upon evidence and findings;

f plan patient management, recognising the:

2 In relation to interpersonal skills, the graduate will be competent in the following areas of communication:

a listening, to patients, relatives/carers/partners, and other healthcare professionals;

b explaining, and providing patients and others with adequate information;

c mediating and negotiating with patients, carers and colleagues;

d handling complaints appropriately;

e liaising with other members of the healthcare team.

3 The graduate will be able to carry out those practical and technical procedures, including the prescribing and administration of medication, relevant to the role of the pre-registration house officer.

4 The graduate will be able to produce and maintain contemporaneous, legible, accurate and pertinent records for patients under their care.

5 The graduate will be familiar with basic communication and information technology relevant to their duties.

6 The graduate will be able to give advice on health promotion and disease prevention.

7 The graduate will be able to liaise with the different sectors of the health and social care systems and be able to manage those components relevant to the care of the patient.

6.3 Demonstration of competency

1 Graduates must be able to recognise and carry out the initial treatment of the following emergency situations, which require immediate action, such as:

2 Graduates must be able to recognise conditions which require early or immediate intervention by the healthcare team. Graduates will be able, under appropriate supervision, to undertake tasks to initiate and be involved in the care of acutely ill patients.

3 Graduates should be able to evaluate the health needs of patients with chronic illness and disability, initiate relevant medical investigations and interventions, and plan management including referral to members of the professional team and other agencies.

4 Graduates should be capable of giving appropriate input into the multi-disciplinary and multi-professional teams involved in the management of patients in need of rehabilitation or palliative care, including care of the dying.

7 Professional attributes and competence

3 Graduates must:

a be aware of the importance and therapeutic potential of the patient/doctor relationship;

b adopt an empathic and holistic approach to patients and the problems they present;

c respect patient autonomy and involve patients, or, if appropriate, relatives or carers as partners in therapeutic and management decisions;

d know of and respect different cultures, values, views and beliefs;

e have some familiarity with alternative medical practices, and be sympathetic and understanding if their patients choose to use them;

f remain non-judgemental in all aspects of their work, and avoid stigmatising any category of patient;

g understand and engage in reflective practice/audit and appraisal of their own and others' work.

4 Graduates should demonstrate their ability to work effectively within a team by:

a practising in a manner that promotes effective inter-professional activity, including shared learning;

b working within the limits of their responsibility and capability;

c making decisions in partnership with colleagues and patients.

5 Graduates should be able to:

a prioritise the care of ill patients;

b prioritise their own time;

c keep effective medical records;

d keep up-to-date with current medical practice;

6 Graduates need to apply ethical and legal knowledge to their practice, particularly in:

a applying the principles of confidentiality, consent, honesty and integrity;

b dealing effectively with complaints about either their own or colleagues' practice or behaviour;

c being aware and complying with legal and professional responsibilities, particularly with respect to death and dying; drug prescribing; mental health; physical and sexual abuse of children and adults; abortion; reporting unsatisfactory/inappropriate performance;

d considering the rights of patients;

e understanding and complying with requirements of clinical governance.

7 Outcomes for graduates' personal development include:

a self-awareness and reflection - evaluating their performance and personal capability, and recognising the limits of their competence;

b the ability to manage their learning with respect to continuing professional development;

c recognising the pressures on themselves and colleagues created by a busy professional career, and being aware of important issues in self care, eg stress reduction, avoidance of unhealthy practices such as alcohol misuse and self-medication.

9 Key characteristics

1 Graduation is the first landmark on the way to independent medical practice. The award of the medical degree leads to provisional registration with the GMC and gives right of access to practise as a pre-registration house officer. Graduates, from the outset, must demonstrate general competency and the full range of attributes that will allow them to function satisfactorily as doctors. Thus the competencies required for the pre-registration period must be present at graduation. Graduates must be aware of and adhere to the requisite attributes required as designated from time to time in the various publications of the GMC, eg Tomorrow's Doctors, The New Doctor, and Good Medical Practice, from which the material at paragraph 9.2 is taken.

2 Patients must be able to trust doctors with their lives and well-being. To justify that trust the medical profession has a duty to maintain a good standard of practice and care and to show respect for human life. In particular graduates must:

In all these matters graduates must never discriminate unfairly against their patients or colleagues, and they must always be prepared to justify their actions to them.

3 The benchmarks specified for medical degrees have been defined in terms of the intellectual attributes, the knowledge and understanding, the clinical, interpersonal and practical skills, and the professional competencies which will allow the graduates to function effectively as pre-registration house officers and develop as professionals. Much further speciality-specific training under the supervision of senior doctors will be required before medical graduates achieve independent status in their chosen fields.