martin hart assistant director education
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Case study on accreditation: the GMC’s perspective. Martin Hart Assistant Director Education. Agenda. What GMC does How doctors are educated and trained How we accredit and quality assure Strengths of our process Issues and challenges. Our purpose. - PowerPoint PPT PresentationTRANSCRIPT
Martin HartAssistant Director Education
Case study on accreditation: the GMC’s
perspective
Agenda
What GMC does
How doctors are educated and trained
How we accredit and quality assure
Strengths of our process
Issues and challenges
Our purpose
‘to protect, promote and maintain the health and safety of the public by
ensuring proper standards in the practice of medicine’
Our aim
To secure a regulatory system which:
Enhances patient safety
Fosters professionalism
Commands the confidence of all stakeholders
Is independent, fair, efficient and effective
General Medical Council
A new council took office at the beginning of 2009:
All appointed by the Appointments Commission
12 lay members
12 medical members
Our functions
Education
Standardsand Ethics
Fitness to Practise
Registration
Medical School
(4-6 years)
F1 year
(1 year)
F2 year
(1 year)
Specialty/
GP training
(3-8 years)
Specialist/GP register
Provisional registration
Full registration
Certificate of completionof training (CCT)
Medical School
(4-6 years)
F1 year
(1 year)Career stage
Employment/regulatorystatus
Student, not licensed
Employed, in training, licensed by GMC Employed, licensed
Structure of UK education and training
Education standards
The GMC’s role in medical education
Responsible for promoting high standards of medical
education
In April 2010 PMETB will merge with the GMC
For the first time, one organisation will be responsible
for regulating all stages of medical education and
training
Medical School
Medical School
(4-6 years)
32 medical schools in the UK
35,000 medical students (60% female)
Have own approaches to curricula, teaching, assessment etc
But must all meet standards and outcomes in Tomorrow’s Doctors
Subject to fitness to practise, graduates receive provisional registration with GMC
GMC quality assures (QABME)
Foundation Programme
F1 year and F2 year
(2 years)
Foundation programme is a two year programme of general training with placements within various specialties and healthcare settings (hospital bias)
Foundation Programme has national application scheme (UKFPO) and is overseen by postgraduate deaneries
Curriculum developed by Academy of Medical Royal Colleges, approved by GMC and PMETB
F1 has outcomes set by the GMC which must be achieved to receive full registration
GMC and PMETB jointly quality assure Foundation Programme (QAFP)
14,000 junior doctors in Foundation Programme (2009)
Specialty training
Specialty/GP training
(3-8 years)
Medical royal colleges draw up criteria for specialist and GP training and assessments, which are approved by PMETB
National competition for selection, training overseen by postgraduate deans
PMETB* certifies completion of training, leads to entry on GMC GP or specialist register and eligibility to work as a consultant
PMETB* quality assures specialist training
*GMC from 2010
Maintaining Standards: Quality Assurance
Two quality assurance processes:
Foundation Programme (QAFP)
Medical Schools (QABME)
Focussed on the institution, not students and trainees
Key elements are analysis of documentation, interviews with academic staff, students and clinicians
Quality assurance of specialty training currently undertaken by PMETB
Quality Assurance of Medical Education
Make sure institutions comply with standards
Identify examples of innovation and good practice
Identify concerns and help to resolve them.
Identify changes institutions need to make to comply with and a timetable for their implementation
Promote equality and diversity in medical education
QA Visit Processes
QABME Medical Schools Quality
Management Curriculum content Examination framework 8 – 10 visitors Minimum 4 days visit over
6 months
QAFP Joint process with
PMETB Postgraduate Deaneries
quality management 6 visitors 4-day visit over 4 sites in
one week
QA Reports and institutions’ replies publish on website
QA Visit Teams
Undergraduate/ postgraduate deans & school/deanery staff
Medical education specialists
Clinicians
Students/ junior doctors
Lay Visitors
All are ‘full and equal members’ of visit teams
QA visit teams
Consistent approach to recruitment Same contracts (responsibilities, payment and
time) Mandatory annual training Same performance management framework Annual appraisal Share competencies
QA Monitoring Process
Targeted action plans & updates
Annual Returns of information
PMETB Survey of Trainees (for QAFP)
Data from all three sources published on GMC website
Strengths of QABME at the end of 5 years
In depth evaluation of School
Wide range of team expertise
Interactive with School
Triangulation from multiple sources
Seen as important and generally supportive by Schools
Transparent process and status of schools’ progress on requirements is available to students and the public
Strengths of QAFP midway through
Has galvanised postgraduate deaneries to evaluate and demonstrate improvements in quality management
Has given trainees a greater voice in the quality management and assurance of their training
Has identified areas where improvements are needed particularly in the supervision of trainees
Postgraduate deaneries have reported the process as challenging and helpful – perhaps particularly the self assessment
Issues in GMC accreditation
QABME & QAFP:
Resource intensive – GMC and institutions
Maintaining team focus/knowledge over cycle
Potential variability of teams
Potentially insufficient involvement of employers and patients in the QA process
Disseminating good practice/innovation
Challenges for accreditation generally
Is the QA focus on institutions sufficient for maintaining a register of professionals?
Sanctions – ‘nuclear option’: removal of accreditation
Reliance on others: can the GMC’s QA processes effectively identify areas of poor practice? Deaneries and Schools measure the quality of
individual students and junior doctors Health systems regulator measures quality of
care (and by extension doctors)
Issues for the future: Student Registration?
Medical students are not registered with the GMCBUT guidance for schools and a significant programme of student engagement
Has the challenge of keeping in touch with students and instilling professional values been met?
Could student registration strengthen the link between the GMC and students?
www.gmc-uk.org/education