The transition from medical student to doctor is one that is often made with much trepidation. While medical schools work hard to equip students with the necessary skills, the role undertaken by employers is playing an increasingly significant part in this process.
The GMC has recently launched a new version of its guidance Tomorrow’s Doctors which sets out the outcomes the GMC expects medical schools to deliver and makes clear what needs to happen on placements. It also shows what the employers of new graduates can expect to receive in terms of knowledge, skills and behaviour. These outcomes mark the end of the first stage of a continuum of medical learning that runs from the first day at medical school and continues until the doctor’s retirement from clinical practice.
This edition of Tomorrow’s Doctors responds specifically to issues about scientific education, clinical skills, partnership with patients and colleagues, and commitment to improving healthcare and providing leadership.
Skills for Health undertook an extensive consultation with chief executives, medical directors, directors of workforce and clinical directors among others, on behalf of the General Medical Council, as part of a wide ranging and comprehensive consultation process which fed into this latest version of Tomorrow’s Doctors.
The report of the consultation showed there are many challenges in helping to develop future doctors. Employers need to take a direct and proactive interest in the practical arrangements for training medical students and doctors. This is particularly important as the new edition of Tomorrow’s Doctors places a clear emphasis on clinical placements and the importance of “hands on” experience.
There is also an onus on medical students to embrace their placements and make the most of the opportunities presented to them. One medical student is quoted in the Skills for Health report as saying “I don’t want to clerk Mrs X – I’ve already seen one of those (condition)”. By contrast, some students stated how they “felt I was getting in the way all the time” and their impression is that “some consultants don’t want medical students”.
Clinical placements are a two way process and it is important that both medical educators and employers consider some key points when working with medical students. These include:
- ensuring that each contribution in the system works with the last and next in a planned and convergent way
- everyone ensuring that learning includes the broader context of healthcare delivery
- protecting patients and minimising any risk as a result of training medical students
- managing the huge stresses that many medical students experience when faced with real clinical practice for the first time
- making sure that patients have consented to student involvement in their treatment.
Medical students must be prepared to work hard assisting their new colleagues and gaining as much from the experience as possible. Tomorrow’s Doctors is capitalising on this willingness and enthusiasm, for example by stating that new graduates must:
- understand and respect the roles and expertise of health and social care professionals in the context of working and learning as a multi-professional team
- understand the contribution that effective interdisciplinary team working makes to the delivery of safe and high-quality care
- work with colleagues in ways that best serve the interests of patients, passing on information and handing over care, demonstrating flexibility, adaptability and a problem-solving approach
- demonstrate ability to build team capacity and positive working relationships and undertake various team roles including leadership and the ability to accept leadership by others.
The challenge in implementing Tomorrow’s Doctors should not be under-estimated and it is important that organisations ensure they have the capacity to offer enough trained staff members with the necessary expertise and experience to assist and support medical students.
But that investment will reap a rich reward. Skills for Health will work with the GMC and local employers to develop and highlight examples of best practice as a part of the Tomorrow’s Doctors implementation.
Training medical students on the wards is undoubtedly central to their knowledge and understanding of what is involved in becoming a doctor. They experience patient liaison as well as the responsibility of working alongside established doctors in teams that they contribute to and learn from.
Today’s undergraduates – tomorrow’s doctors – will see huge changes in medical practice. There will be continuing developments in biomedical sciences and clinical practice, new health priorities, rising expectations among patients and the public, and changing societal attitudes.
Basic knowledge and skills, while fundamentally important, will not be enough on their own. Medical students must be inspired to learn about all aspects of medicine and healthcare delivery, including the contributions of other members of the workforce so as to serve patients and become the doctors of the future.
With that perspective and commitment, allied to the specific knowledge, skills and behaviours set out in Tomorrow’s Doctors and Good Medical Practice, they will be well placed to provide and to improve the health and care of patients, as scholars and scientists, practitioners and professionals.
Chris Pearson is executive director of strategic workforce development at Skills for Health and Paul Buckley is director of education and revalidation at the General Medical Council.