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G
General Medical Council (GMC)
The General Medical Council (GMC) has strong legal powers, granted by the Medical Act (1984) and designed to maintain the standards the public have a right to expect of doctors. All doctors must be registered with the GMC to practise medicine in the UK. To register they must have a recognised medical qualification. Where any doctor fails to meet professional standards, the GMC acts to protect patients from harm - if necessary, by striking the doctor off the register and removing their right to practise medicine.
In addition to the general register, the GMC also hold the specialist and GP registers. These registers list those doctors who are eligible to apply to for consultant and GP principal posts.
The GMC is responsible for promoting high standards of medical education. Its Education Committee issues guidance on the education and training of doctors, defines and monitors the standards of undergraduate education and promotes good practice in postgraduate training. For example, the GMC’s publication Good Medical Practice (2006) is intended to be at the centre of all medical education and Tomorrow’s Doctor (2003) makes recommendations on undergraduate medical education. The GMC is accountable for ensuring that its recommendations are implemented by every medical school in the UK. This is done through visits and inspections of medical schools. The investigations focus on the GMC recommendations for both undergraduate medical education and general clinical training [25]. Reports of these visits are published on the GMC website.
The GMC issues guidance covering both general aspects of good medical practice and more specific areas, such as confidentiality and consent. This guidance describes the principles of good medical practice and standards of competence, care and conduct expected of doctors in all aspects of their professional work. Serious or persistent failures to meet these standards may put a doctor's registration at risk.
General professional training
General professional training must be completed before doctors in training can begin their specialist training. At present, all doctors are normally required to complete a minimum period of two years’ general professional training in approved senior house officer (SHO) posts [26]. This period of training is designed to equip doctors with the knowledge, skills and aptitudes required for entering a range of different specialty training programmes. Most of this period of training will be spent in the specialty of the doctor’s choice. A higher qualification such as a diploma for membership (or in some cases – a fellowship) of the appropriate medical royal colleges is usually necessary for a consultant appointment. This is obtained either at the end of general professional training or at the beginning of higher specialist training depending on the specialty.
Modernising Medical Careers was published in February 2003. It was produced by the four UK health departments and sets out permanent changes to the PRHO and SHO grades in the context of wider workforce reforms. Modernising Medical Careers set out plans for a new Foundation Programme implemented in 2004. This incorporates the current pre-registration house officer (PRHO) year and the first senior house officer (SHO) year. These years will be called foundation years 1 and 2.
Foundation programmes will be competency-based, with the second year of the programme allowing trainees to sample more specialities by working in three or four over the year with a ‘release’, typically once a week, into other specialities. The Department of Health hopes that the reforms to the training grades will ensure that all trainees pass through competence-based run-through training programmes. This should improve the current situation where training posts can be enormously variable [23]. For example, the reforms will prevent SHOs from continually adding on more six-month jobs at the end of their rotation. It will also identify doctors who haven’t yet decided which specialty to enter and will provide help with this choice.
GLADD
GLADD is the gay and lesbian association of doctors and dentists. The key aims of the organisation are as follows:
- provide professional and social support for gay, lesbian and bisexual doctors, dentists and medical and dental students
- combat discrimination against gays, lesbians and bisexuals particularly if expressed by or towards doctors and dentists
- collect and disseminate information on gay, lesbian and bisexual issues relevant to the practice of medicine and dentistry.
The General Medical Council (GMC) published its update to Good Medical Practice in 2006. This document describes the principles of good medical practice:
- good clinical care
- maintaining good medical practice
- teaching and training
- relationships with patients
- dealing with problems in professional practice
- working with colleagues
- probity
- health
GP principal
After successfully completing a period of training as a GP registrar, doctors can become GP principals. A GP principal is defined as a registered, vocationally-trained medical practitioner, who is contracted by the local health authority or health board to take unsupervised responsibility for patients [27]. For more information, see the BMA publication Medical specialties: the way forward. This guide is free to members and can be found on the BMA’s website. It can also be purchased by non-members for £10 from the BMJ Bookshop or by emailing the Department of Science and Education.
GP registrars
Doctors training to be GPs within a general practice setting are called GP registrars. GP registrars treat patients in the context of their training under the supervision of a trainer. Once the GP registrar has successfully completed this period of training they are awarded the Certificate of Completion of Training (CCT) by the Postgraduate Medical Education and Training Board (PMETB), placed on the GMC’s GP register, and are then eligible to become a GP principal. For more information, see the BMA publication Medical specialties: the way forward. This guide is free to members and can be found on the BMA’s website. It can also be purchased by non-members for £10 from the BMJ Bookshop or by emailing the Department of Science and Education.
GP tutors
GP tutors are appointed by the directors of postgraduate general practice education. They are responsible for coordinating local postgraduate education allowance (PGEA) activity. They accredit educational activity for the PGEA as well as coordinate and provide it at local postgraduate centres. For more information, see the BMA publication Medical specialties: the way forward. This guide is free to members and can be found on the BMA’s website. It can also be purchased by non-members for £10 from the BMJ Bookshop or by emailing the Department of Science and Education.
Graduate entry programmes
Graduate entry programmes to medicine are courses available only to those who have already completed a first degree. These courses are available at a number of UK universities but the length and structure of the course depends on the individual university. Graduate entry programmes are shorter than standard undergraduate medical degrees and are normally four years in duration. At Southampton, graduates who are able to show evidence of previous relevant study from their first degree can apply for an accelerated route during the first year. This reduces the length of the programme by six months. See accelerated medical degrees. Graduate entry programmes are usually offered to graduates with a first degree in a science subject, although St George’s medical school also considers applicants with a first degree in an arts subject. A list of graduate entry programmes, can be found in the BMA online guide Becoming a doctor.
Graduates are still able to apply for standard undergraduate medical courses.
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