United Kingdom
New Era for Medical Education and Training Begins in the UK
On April 1, 2010, the General Medical Council (GMC) became responsible for regulating every stage of medical education in the United Kingdom. For the first time ever, one organization now sets standards for education and practice, oversees medical education and training, operates the registration of doctors and ensures they are competent and fit to practice.
The new arrangement follows the merger of the Postgraduate Medical Education and Training Board (PMETB) with the GMC, which is intended to create a simpler and more coordinated system of regulation that seeks to raise standards and spread good practice. The four main functions of GMC are:
Keeping an up-to-date registry of qualified doctors
Fostering good medical practice
Promoting high standards of medical education
Dealing firmly and fairly with doctors whose fitness to practice is in doubt
Report Offers Implementation Recommendations
The GMC will soon publish the final report of the Patel review, which has examined the details of the merger. The report addresses the different stages of education and training (undergraduate, postgraduate and continuing practice) and the links between them, as well as the position of medical graduates from other countries.
The report's recommendations have implications not only for doctors and those involved in their training, but also for patients and for health care organizations throughout the UK. The GMC will consider the review's recommendations and take forward any further actions to achieve the full benefits of the merger.
“Bringing all stages of the regulation of medical education and training under the GMC will bring a number of significant benefits, including a more robust and streamlined system of quality assurance that is more effective and less burdensome on the NHS,” said Ann Keen, health minister with responsibility for professional regulation. “This is a significant step towards achieving our aspiration for excellence in medical education and training.”
For now, PMETB's structures and standards will carry on unchanged within the GMC. This includes setting national requirements for specialty and GP training as well as the quality assurance of training and of the routes and processes for certification.
The GMC will remain the regulator for doctors, continuing to set the standards for professional practice and receiving and investigating allegations about their fitness to practice.
Starting in April of 2011, the adjudication of fitness-to-practice cases involving physicians will transfer from the GMC to a new body called the Office of the Health Professions Adjudicator (OHPA). OHPA is being created to ensure clear separation between the investigation of fitness-to-practice cases and the process of determining whether a professional's fitness to practice is impaired.
Source: General Medical Council news release and website, April 1, 2010
GMC Launches Professionalism Podcast and e-Bulletin for Medical Students
A major new initiative has been launched by the General Medical Council (GMC) to help medical students to develop and maintain high standards of professionalism throughout their training and careers.
Medical students featured on a new podcast describe how good clinical knowledge, patient confidentiality and other attributes help demonstrate high standards of professionalism. Newly qualified doctors discuss the challenging issues they can face and how the professionalism training they received at medical school helps them to offer high standards of care to patients.
“Doctors must demonstrate good clinical competence and be able to communicate complex information to their patients effectively,” said Professor Jane Dacre, GMC Council member and vice dean and head of education at UCL Medical School in London. “We spoke to doctors and medical students who acknowledge on the podcast that this is one of the most challenging parts of a doctor's role, especially when facing testing situations on issues like patient confidentiality.”
The GMC plans to engage medical students on professionalism using both the podcast and an e-bulletin to which they are encouraged to sign-up.
The e-bulletin updates medical students on developments related to medical education and regulation and asks them to contribute ideas on ethical issues that should be covered in future issues. In the latest edition, the GMC updated students on the recent merger of PMETB with the GMC and new guidance from the GMC being launched this year.
GMC's activities promoting professionalism include creation of “Tomorrow's Doctors,” a guide that sets the standards that medical students have to meet before they graduate. The guide was first published in 2009 and among other things highlighted the importance of communication skills and a good bedside manner as well as ensuring that medical students acquire the scientific background and technical skills they will need to be effective doctors.
To listen to the podcast and subscribe to the e-bulletin, please visit www.gmc-uk.org/students.
For more information, visit the GMC website: http://www.gmc-uk.org/information_for_you/uk_medical_students.asp
Source: General Medical Council website and news release, March 4, 2010.
Australia
New Medical Board of Australia Continues To Define Roles, Responsibilities
The newly constituted Medical Board of Australia met for its sixth meeting March 23–24, 2010.
The Board was established under the Health Practitioner Regulation (Administrative Arrangements) National Law Act 2008 and had its first meeting in September 2009.
At its March meeting, the Board held a planning day to consider the role of State and Territory boards and the delegated powers that they should exercise after July 1, 2010. The Board also agreed on a work-plan to develop additional policies and guidelines specific to medicine.
The Board also made decisions about a range of matters that will impact the transition to Australia's new national registration and accreditation structure.
State and Territory Board Structures and Delegations
The Medical Board of Australia will be responsible for developing and approving registration standards, codes and guidelines, approving accreditation standards and negotiating the health professions agreement which determines funding and service arrangements with the Australian Health Practitioner Regulation Agency (AHPRA).
State and territory boards will become committees of the national board and will be known as, for example, the ‘Queensland Board of the Medical Board of Australia.' The National Board has decided to delegate responsibility for all matters related to individual practitioners to state and territory boards. It will rely on these boards to make decisions about applications for registration and about notifications (complaints). The state and territory boards will be supported by a range of committees, made up of state and territory board members and as necessary, external experts. These committees will be delegated some decision-making powers, but very serious decisions, and those open to appeal, will be made by the full state and territory board.
Likely Committee Structure
Committees are likely to include a Registrations Committee, Assessment Committee, Health Committee and one or more Performance and Professional Standards Committees. The number of committees and their role may vary between jurisdictions, subject to local needs.
The Board will delegate to the AHPRA decisions that it considers to be routine and all administrative functions. The National Board plans to host regular teleconferences and collaboration across states and territories with members of functionally similar committees; in addition, an annual national conference of Board members is planned.
Codes and Guidelines
The Board has decided to reissue Good Medical Practice, a code of conduct for doctors in Australia, with minor modifications to reflect the Health Practitioners Regulation National Law Act 2009 (the National Law). In addition, the Board will develop specific guidelines about a range of issues, including professional boundaries, sexual misconduct, medical practitioners and medical students with blood-borne infectious diseases and unconventional medical practice. Consistent with the national law, the Board will consult widely about any guidelines that it develops.
Transition Arrangements April Letter
The Medical Board of Australia will write to every registered medical practitioner in late April, in an effort to support the transition of all registrants into the national structure. The letter will explain each practitioner's registration type starting on July 1, 2010. The letter will also detail the information that will appear on the online national Register of Medical Practitioners. The Board is urging all medical practitioners to make sure the contact details held by their current State or Territory Board are accurate and up to date before June 30, 2010.
The Board made a range of decisions about this transitioning process. In general, medical practitioners will transition to the type of registration that matches their current registration. While the name of some registration categories will change, the Board has no intention of changing any medical practitioner's scope of practice
Specialist Register
In order to ensure that a specialist register is in place when the new structure begins, the Board agreed to use data from trusted sources to establish the register. State and Territory Boards with specialist registers, specialist colleges and Medicare Australia will all be asked to provide data. Specialist colleges will be asked to provide lists of fellows and a list of international medical graduates (IMGs) who have been found to have qualifications that are substantially comparable to Australian qualifications and who have completed any additional requirements for eligibility for fellowship. Medicare Australia will be asked to provide lists of medical practitioners who are recognized as specialists. The Board agreed to include on the specialist register medical practitioners assessed by the Specialist Recognition Advisory Committees (SRACs) or the Overseas Specialist Advisory Committees (OSACs) as specialists.
Because construction of the specialist register is a complicated process requiring data to be sourced, cleansed and de-duplicated, the Board's April letter will include reference to specialist registration and medical practitioners, encouraging them to check that the information that AHPRA proposes to enter about them in the specialist register is correct.
Medical Courses and Specialist Qualifications
The Board confirmed that the graduates of medical courses that are currently accredited by the Australian Medical Council (AMC) will continue to be accepted for provisional or general registration after July 1, 2010. Similarly, fellows of medical colleges that are currently accredited by the AMC will be accepted for specialist registration after July 1, 2010.
Conditions, Undertakings and Reprimands on the Register
The national law requires the Board to publish conditions imposed and undertakings accepted from medical practitioners on the Register of Medical Practitioners. However, the law also allows the Board to choose not to record a condition imposed or an undertaking accepted if the practitioner has an impairment, it is necessary to protect the practitioner's privacy, and there is not an overriding public interest for the condition or the details of the undertaking to be recorded.
The Board decided that it would not routinely publish the details of conditions imposed or undertakings accepted as a result of impairment. However, in the interests of transparency, the Board will place the statement that the practitioner has conditions related to health in the register. There may be circumstances when the Board will decide on a case-by-case basis to publish the details of some practice restrictions imposed due to impairment when there is an overriding public interest.
For the first time, the Board is required to publish in the Register reprimands issued to a practitioner. The Board decided that it will routinely remove reprimands from the registers after five years if there has been no other health, conduct or performance action against the practitioner during that period. This applies to reprimands issued after July 1, 2010.
Proof of Identity
The Board approved an approach for authenticating the identity of an individual who applies for registration. This approach relies on a 100-point check, consistent with the Attorney General's standard. It applies to all new applications for registration beginning July 1, 2010.
The Board will require applicants for limited registration to have their documents certified by a staff member of AHPRA or a nominated delegate. Applicants for other types of registration can have their documents certified by an authorized officer. A list of class of persons that are authorized officers will be published.
Registration Standards
The Board approved for consultation registration standards for limited registration for teaching and research and limited registration in the public interest. The draft statements will be published and stakeholders are encouraged to provide feedback to the Board.
Communications Plan
The Board approved a communications plan with the key features that include risk assessment and issues management, external communications, stakeholder engagement, government relations, media management and consultation strategies.
Source: Medical Board of Australia Communiqué and website, March 2010
