The General Medical Council (GMC)
The GMC’s role in medical education and training
The purpose of the GMC is to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine.
To achieve this, one of its core legal functions is to regulate medical education and training so that patients now and in the future can be confident that they will receive safe, high quality medical care. The GMC sets standards and requirements that must be met on the ground; and check that they really are met, through quality assurance activity. More information can be found here.
All stages of medical education and training
The GMC’s education work was significantly strengthened in April 2010 when it took on responsibility for all stages of medical education and training. For the first time in the UK, a single regulator oversees every stage of doctors' training and professional development, including:
Medical students typically study for five years. After they graduate they start to work in the NHS and enter a two-year Foundation Programme. After that, they choose to train in the NHS either for another three years to become a GP or longer to become a specialist consultant.
The GMC decides whether schools are entitled to issue medical degrees. To do this, it sets requirements on what it expects of new graduates and also standards that medical schools must meet in teaching and assessing medical students.
The GMC tests whether or not schools meet these requirements through quality assurance activity. It arranges for experts to visit the schools, inspect what goes on and discuss local arrangements.
Findings are published on the GMC website - http://www.gmc-uk.org/education/evidence_reports_and_surveys.asp . The medical schools also provide information in annual reports, and the GMC receives information from other areas of its work and other regulators. It also responds to concerns raised by students, medical schools, or patients, and arrange additional checks of schools if there is evidence that requires investigation.
Postgraduate education and training
The GMC decides whether or not to approve curricula and assessment systems, training programmes, GP trainers, and posts held by trainees.
To do this, it sets requirements for postgraduate medical education and training and tests whether or not these requirements are being met through quality assurance activity.
It arranges for experts to visit the deaneries, inspect what goes on, and discuss local arrangements. Findings are published on the GMC website. It also considers reports from the postgraduate deaneries that organise training and the medical Royal Colleges/Specialty Associations that set curricula and organise examinations.
The T&O curriculum is an area of principal interaction between the BOA and the GMC, through the Joint Committee on Surgical Training.
The GMC surveys trainees and trainers, and receives information from other regulators. It also responds to concerns raised by trainees, deaneries, local education providers, or patients, and arranges additional checks of deaneries if there is evidence that requires investigation
Continuing Professional Development
Doctors have a responsibility to keep up to date. The GMC publishes Guidance on Continuing Professional Development which sets out the principles on which continuing professional development should be based, and the roles of the relevant organisations involved in its delivery and quality assurance.
The Royal Colleges Of Surgeons
There are four Royal Colleges of Surgery in England, Edinburgh, Glasgow, and Ireland. Details are below. As a consequence of its national coverage, the BOA has links with them all, mainly through intercollegiate for focused on examinations and the curriculum.
Royal College of Surgeons of England (RCS Eng)
The Royal College of Surgeons of England (http://www.rcseng.ac.uk/) is committed to enabling surgeons to achieve and maintain the highest standards of surgical practice and patient care:
What RCS Eng does:
Supervise training of surgeons in approved posts
Provide educational and practical workshops for surgeons and other medical professionals at all stages of their careers
Examine trainees to ensure the highest professional standards
Promote and support surgical research in the UK
Support audit and evaluation of clinical effectiveness
Provide support and advice for surgeons in all stages of their careers
Provide a mechanism whereby trusts can seek independent advice
House a current and historical information resource centre for surgeons in the library and museums
Act as an advisory body to the Department of Health, health authorities, Trusts, hospitals and other professional bodies
Collaborate with other medical and academic organisations in the UK and worldwide
Seek to convey the importance of, and provide support for, good, effective communication and interpersonal relationships between patients and surgeons
What RCS Eng does not do:
Register or license surgeons to practise nor has responsibility for disciplinary actions; this is the responsibility of the General Medical Council (GMC)
Process complaints from patients; this is another responsibility of the GMC or a function of individual hospitals
Recommend individual surgeons to patients or offer patients medical advice; the College recommends that patients always seek referral through general practitioners
The Royal College of Surgeons of Edinburgh (RCSEd)
In 1505, the incorporation of the Barber-Surgeons of Edinburgh came into being with the granting of its Seal of Cause by the Town Council of Edinburgh. Since then The Royal College of Surgeons of Edinburgh has been dedicated to the maintenance and promotion of the highest standards of surgical practice, through its keen interest in education, training and rigorous examination and through its liaison with external medical bodies. Whilst being keenly aware of its antiquity (the College celebrated its quincentenary in 2005), the College prides itself also on its innovation and adaptability.
With the advent of the College website, the College has been able improve the accessibility to information for both its surgical community and allied professionals as well as for the community at large: http://www.rcsed.ac.uk/site/344/default.aspx
The Royal College of Physicians and Surgeons of Glasgow (RCPSG)
By offering postgraduate medical education, examinations and assessments, as well as continuing professional development, RCPSG Fellows and Members are equipped to deliver the best possible care and medical practice that Scotland has to offer. RCPSG has a long history of excellence and innovation in medicine, and continues to develop its sound reputation world-wide.
The growing collegiate body is unique to the UK. It includes professionals in surgery, medicine, dentistry, and travel medicine.
As a multidisciplinary body with 9,500 members across all five continents, the RCPSG footprint for improving health is considerable.
RCPSG is however more than a place of professional learning and development for the Medical Community.
It is a historical site, a charity, a place of work, an information provider, and a body that influences governments and public policy.
Royal College of Surgeons of Ireland (RCSI)
For over 200 years RCSI has played a major role in medical education and training in Ireland. Founded in 1784 to train surgeons, today the College provides extensive education and training in the healthcare professions at undergraduate and postgraduate level: http://www.rcsi.ie/
The medical school in RCSI is one of the world’s leading international medical schools and is the largest medical school in Ireland. The College also provides undergraduate courses in pharmacy and physiotherapy.
RCSI delivers postgraduate training and education through its Faculties of Radiology, Dentistry, Sports & Exercise Medicine, the School of Postgraduate Studies, the Institute of Leadership and the National Surgical Training Centre.
The RCSI Research Institute is one of Ireland’s foremost research centres. RCSI is committed to performing high levels of research activity, to commercialising intellectual property arising from its research, and to developing collaborative links with industry, educational and research institutions both nationally and internationally.
More than 60 countries are represented on RCSI’s international student body. The College has a strong international presence with Schools in Malaysia, Dubai and a University in Bahrain. The Royal College of Surgeons in Ireland is independent, international and progressive.
Facts and Figures
- RCSI was established on 11th February 1784
- Total Number of Students: 3384
- Number of Staff: 800
- Amount spent by RCSI on Research Projects in 2008: €22m
The Royal Society of Medicine - Trauma & Orthopaedics Section
The Royal Society of Medicine is an independent, apolitical organisation, founded over 200 years ago.
One of the largest providers of continuing medical education in the UK, the RSM provides accredited courses for continuing professional development, which is so vital in allowing doctors, dentists, veterinary surgeons and other healthcare professionals their continuing freedom to practise.
The RSM’s aims are:
- To provide a broad range of educational activities and opportunities for doctors, dentists and veterinary surgeons, including students of these disciplines, and for allied healthcare professionals.
To promote an exchange of information and ideas on the science, practice and organisation of medicine, both within the health professions and with responsible and informed public opinion.
Further details of the RSM’s Trauma and Orthopaedic section may be found here
The Joint Committee on Surgical Training (JCST)
The JCST is an advisory body to the four surgical Royal Colleges of the UK and Ireland, the Specialist Surgical Associations in Great Britain and Ireland, for all matters in relation to surgical training. Its membership - http://www.jcst.org/sac_members/jcst_membership - comprises the Presidents and other representatives form the various Colleges of Surgery, together with all the Chairs of the Specialty Advisory Committees (SAC) charged with setting training standards and submission of curricula to the GMC for approval. The role of the JCST may be found in the Regulations for Higher Surgical Training (the Pink Book)
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Specialty Advisory Committee (SAC) for T&O
T&O Training Programme Directors
The Training Programme Director has a key role in managing the specialist training programme of the specialty. The fundamental role is that of co-ordinator and communicator between Specialist Registrars, the Postgraduate Dean, the local Specialty Training Committee, and the Faculty.
Postgraduate Schools of Surgery
Schools of Surgery have been created nationally within each Postgraduate Deanery in England, Wales and Northern Ireland and the Surgery Specialty Training Board (SSTB) within NHS Education for Scotland. The School of Surgery oversees all aspects of training in the nine recognised surgical specialties. The School’s core function is to co-ordinate the educational, organisational and quality management activities of surgical training programmes.
They ensure the implementation of curricula and assessment methodologies with associated training requirements for educational supervision. They also provide both core and specialist training to ensure those exiting the training programme have all of the knowledge and skills required for professional practice as a consultant.
The School draws together the representatives and resources of Deaneries/SSTB, Colleges, Trusts and NHS service delivery and other relevant providers of training and stakeholders in postgraduate medical education. To carry out its core functions, each School has established a Board and key committees, although precise structures may differ across the UK.
The School is led by the Head of School, a joint Deanery-College appointment and this is a key strategic and management role. The Head of School is supported by a range of roles, which would normally include Programme Director, Surgical Tutor, Assigned Educational Supervisor, College Coordinator and College Council Member. More information can be found here: http://www.rcseng.ac.uk/regional/heads-of-schools
British Orthopaedic Trainees Association (BOTA)
The British Orthopaedic Trainees Association, BOTA, was set up in 1987 following a meeting in Oxford when 45 Senior Registrars met at a symposium entitled 'Planning a career in Orthopaedic Surgery'. It subsequently became affiliated to the British Orthopaedic Association. Since its foundation its membership has increased from the founding 45 to the current level of in the order of over 1000 Specialist Registrars (and recently appointed consultants).
Orthopaedic Surgeons make up around 40% of the membership of the Royal Colleges, and as the largest surgical subspecialty BOTA devolved from ASiT, the Association of Surgeons in Training, to represent the views of Orthopaedics specifically. However, ASiT and BOTA have a very good working relationship, and work together on many issues to represent surgical trainees as a collective.
Currently, full membership is available to all doctors holding an NTN in Trauma & Orthopaedics. As of 2010, junior membership is available to all other qualified doctors in approved training programmes (i.e. FY, CT or non-RTT ST).
Intercollegiate Surgical Curriculum Programme (ISCP)
Over the last two years, the Intercollegiate Surgical Curriculum Programme has worked towards reforming and modernising surgical training in line with changing societal, political and professional expectations.
The ISCP aims to improve surgical training and to offer better support to surgical trainees and trainers in order to uphold the world-renowned standard of surgical care provided in the United Kingdom. To achieve these aims, changes to surgical training will include the introduction of a new, transparent, nationally-standardised curriculum which is underpinned by clearly defined standards and competency-based assessments for each stage of surgical training.
The ISCP benefits from the input of Specialty Advisory Committees (SACs), representing each of the nine surgical specialties. It also forms a collaboration between the Surgical Royal Colleges of Great Britain and Ireland and other professional bodies responsible for surgical training, including postgraduate deaneries and the General Medical Council (GMC). Trauma and Orthopaedics led the way in development of the e-curriculum through the Orthopaedic Competence and Assessment Project. This was subsequently integrated into ISCP in early 2011.
Medical Education England (MEE)
The concept of MEE and its proposed functions were recommended in Aspiring to Excellence, the report of Professor Sir John Tooke’s independent inquiry into Modernising Medical Careers and the recruitment problems of 2007. There was professional support for a body that would, in summary, cover medical education and training and workforce planning.
The Next Stage Review detailed review of NHS workforce and education policy was named A High Quality Workforce. The work that went into this document included extensive consultation with stakeholders. Partly as a result of that consultation, it was announced that a new body called MEE would be created.
MEE is an Independent Advisory Non-Departmental Public Body with a remit for medicine, dentistry, pharmacy and healthcare science. It brings a coherent professional voice on education and training matters as they relate to the four professional groups outlined above and will advise the Department of Health on policy. MEE will provide high-level scrutiny of, and advice on, the quality of workforce planning at national level.
The organisation met for the first time in February 2009, to begin discussions on its work programme and agree working arrangements. Under current plans for healthcare reform, MEE’s remit is due to expand further to encompass the totality of the healthcare workforce, with a change of name to Healthcare Education England. For more information - http://www.mee.nhs.uk/default.aspx