25 June 2009
Undergraduate Board
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To approve
Minutes of the Meeting on 31 March 2009
Present
Sir Rodney Brooke
Ms Sally Hawkins
Dr Joan Martin
Professor Jim McKillop (Chair)
Dr Mairi Scott
Mr Stephen Whittle
Paul Buckley
Suzanne Fuller
Ben Griffith
Martin Hart
Ross Hutchison
Neil Jinks
Alison Lightbourne
Tim Walker
Kirsty White
Chair’s Business
1.
The Chair welcomed Board members to the first meeting.
2.
Apologies for absence were noted from Professor Iqbal Singh and
Professor Trudie Roberts.
3.
Sir Rodney Brooke’s recent appointment as Chair of the Quality Assurance
Agency for Higher Education was noted.
Further information
4.
If you require further information about this paper, please contact us by email:
gmc@gmc-uk.org or tel. 0161 923 6602
Presentation: the Work of the Undergraduate Board in Context
5.
The Board received a presentation on the work of the Undergraduate Board in
the context of the GMC’s four statutory functions, the 2009 Business Plan and the
Education and Revalidation Directorate’s operational plan.
6.
During discussion on the application of the GMC’s four statutory functions to
the Board’s work, the Board noted that:
a.
The review of Tomorrow’s Doctors is seeking to ensure that the revised
guidance is mapped against Good Medical Practice. As other guidance on
standards and ethics is developed, the implications for medical students will
need to be considered.
b.
The GMC and the Medical Schools Council had recently published new
guidance on student fitness to practise, which now includes guidance on
health issues. The Council for Healthcare Regulatory Excellence is keen for
all healthcare regulatory bodies to develop such guidance.
7.
that:
During discussion on Key Aim 1 of the 2009 Business Plan, the Board noted
a.
The QABME cycle, which had begun in 2004, completes in 2009 and
all UK medical schools will have been quality assured by the end of the cycle.
A more intensive process had been applied at Swansea Medical School
(which is developing a curriculum to stand alone from Cardiff Medical School,
where their students spend their final years) and Keele Medical School (which
is developing a new curriculum).
b.
The review of Tomorrow’s Doctors, Lord Patel’s review and the merger
of PMETB with the GMC provide an opportunity to reflect on how best to
develop QABME beyond 2009.
c.
The Board would need to be kept informed of the development, and
quality assurance, of UK medical education delivered abroad.
8.
During discussion on the operational plan, the Board noted the research
project to explore the relationship between placement providers and medical
schools. The Research Reference Group would develop the GMC’s future research
agenda. However, the Education Team would engage in the process to identify
areas for future projects. International best practice in assessing professionalism,
rather than competence alone, will be a future issue to consider, and
recommendations might flow from Lord Patel’s review.
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9.
The Board discussed outstanding issues highlighted in the presentation.
Student registration
10.
The Board noted that the Chief Medical Officer (England)’s report,
Good Doctors, Safer Patients (2006) and the White Paper, Trust, Assurance and
Safety – the Regulation of Health Professionals in the 21st Century (2007), had
asked healthcare regulatory bodies to consider whether student registration was
necessary and appropriate. Council had decided that the registration of medical
students was neither: few medical students cause concern and medical schools can
deal with concerns much more quickly than can the GMC through regulatory
proceedings. Delays through regulatory proceedings could significantly impact on
medical students; and instilling in students an understanding of the purpose,
importance and contribution of regulation to the development of professional values
can be achieved more effectively than through student registration. Following a
substantive decision from Government, student registration might have to be
revisited.
11.
The Board noted that some professional regulatory bodies register students
and standards different from those applicable to fully registered professionals can be
applied to student professionals.
12.
The Board agreed that more work was required on student engagement, and
in particular the need for engagement in the training environment to create a more
positive picture of regulation, to promote our standards and ethics guidance more
effectively among medical students, and to ensure buy-in from medical schools.
13.
In the context of student fitness to practise, the Board agreed that
development of the QABME process beyond 2009 should include consideration of
how good practice can best be shared with medical schools, how to use QABME
reports more strategically, and the approach to be taken in respect of the next cycle
(for example, by adopting a risk-based approach).
Bologna process
14.
The Board noted that Ministers responsible for Higher Education had given
reassurance that they were not pushing for the application of the process in
medicine. The GMC would in due course need to reach a considered opinion of the
application of the process to medical schools. The Board agreed it would be helpful
to receive a more detailed update on the Bologna Process and other relevant
European issues at a future meeting.
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Undergraduate Board Statement of Purpose and External Membership
15.
The Board considered and agreed its draft statement of purpose for Council’s
approval, subject to amendment of paragraph four to read:
‘4.
The purpose of the Undergraduate Board is to enhance the GMC’s
ability to protect, promote and maintain the health and safety of the public by
co-ordinating the GMC’s four regulatory functions as they apply up to the
completion of the undergraduate curriculum.’
16.
The Board discussed and agreed proposals for its external membership.
17.
The Board also agreed that it will be important for external members to feed
not only into the GMC but also back to their sectors. If not representative, there
would be no obligation on external members to fulfil the latter function. External
membership of the Board will not be the only means of engagement: wider
engagement will be required to capture other contributions.
18.
Council’s approval for the Board’s proposed external membership would be
sought on 7 May 2009 with a view to nominated external members attending the
meeting on 25 June 2009. However, it is unlikely that a patient representative from
the Reference Community would be recruited in time.
Tomorrow’s Doctors
19.
The Board received an update on progress of the review, noting that 127
completed long questionnaires, 362 short questionnaires and 99 unstructured
responses had been received in response to the consultation. Responses were
generally favourable, with support for enhancing experiential experience during
clinical placements and for better sharing of information on poorly performing
students and graduates between medical schools and the Foundation Programme.
There were calls for restructuring and a more inspirational introduction.
20.
62 identical emails regarding discrimination of lesbian, gay, bisexual and
transgender people had also been received.
21.
The Board agreed generally that the consultation had been wide and
effective. Some initial feedback indicated that the consultative event on
2 March 2009, while extremely productive, had perhaps been a little top heavy in
terms of presentations and the format of the breakout groups, while maintaining
focus, had not fully maximised the opportunity for wide-ranging feedback.
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22.
The Board noted the rationale for the generalist list of required practical skills.
The aim of the Gateways project had been to encourage disabled people into
medicine. However, this had to be balanced against the GMC’s statutory duty to
protect patient safety. Doctors register as doctors rather than doctors in a particular
field of medicine. All doctors therefore need to demonstrate that they are able to
perform the core skills before going on to specialise. However, these may be
performed in different ways with reasonable adjustments, although such adjustments
may be easier to organise after full registration.
23.
During discussion, the Board agreed the need to ensure that:
a.
The list of required practical skills was demonstrably necessary and
therefore defensible (so as not to discriminate against disabled students), and
fits with the competencies in the Foundation Programme curriculum.
b.
The revised guidance includes a focus on preparing medical students
for the Foundation Programme, and on what it means to be a doctor and a
professional.
24.
The Board agreed:
a.
That members of the Undergraduate Board be closely involved in
drafting the 2009 edition of Tomorrow’s Doctors.
b.
That the current drafting sub-group be supplemented by up to three
members of the Undergraduate Board.
25.
Dr Martin, Dr Scott and Mr Whittle expressed interest in joining the sub-group.
Student Engagement
26.
The Board discussed the programme of work to engage with medical students
during 2009.
27.
The Board noted a survey being piloted among medical students at five
medical schools and agreed that, while an early piece of work and while feedback
from students is already an important part of the QABME process, surveys could be
a useful engagement tool. For example, surveying student populations in advance of
QABME visits to identify issues at particular medical schools; or mass surveys as
tools to select the schools for assessment.
28.
The Board also agreed that QABME visits afford an opportunity to engage
with medical students, noting that pre-registration events at medical schools are
already used as an opportunity for engagement. Such events had been successfully
used to distribute questionnaires for the Tomorrow’s Doctors consultation and would
similarly be used for the consultation on draft revised guidance on end of life care.
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29.
The Board considered that some way of amending objective four should be
found to reflect the duty and obligation on medical students to contribute to the
profession and its work.
Developing the QABME programme 2009/10
30.
The Board discussed and endorsed the proposed approach to developing the
QABME programme 2009/10.
31.
During discussion, the Board noted the importance of continued engagement
with visitors (as a resource) during the fallow year and the possibility of using visitors
as part of the engagement road shows.
QABME Annual Monitoring Returns 2008/09 and responses to QABME reports
2007/08
32.
The Board noted the QABME Annual Monitoring Returns 2008/09 and
responses to QABME reports 2007/08.
33.
The Board also noted that they would receive reports on the schools currently
being quality assured on 15 September 2009.
Operational Report
34.
The Board noted the operational report.
Any other Business
35.
The Board agreed that members without a background in medical education
would find a workshop with medical students helpful to understand the challenges
that the GMC faces in the context of undergraduate education.
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