Practical Skills and Procedures - GMC

1 Practical Skills and Procedures Practical Skills and Procedures Practical Skills and Procedures Purpose of the Practical Skills publications Welcomed and valued (2019, pdf), promoting Excellence (2016, pdf) and promoting and Procedures excellence - equality and diversity considerations We set the standards and requirements for all stages (2017, pdf). of medical education and training in promoting excellence: standards for medical education and How the Procedures relate to our training (2016, pdf) and hold a list of universities other standards and guidance entitled to award a medical degree recognised as a Our Outcomes for graduates (the outcomes) set UK primary medical qualification. out what newly qualified doctors from all medical Our Outcomes for graduates (2018) set out what schools who award UK primary medical qualifications newly qualified doctors from all medical schools must know and be able to do.

2 The Practical Skills and must know and be able to do. Procedures supplements the outcomes by defining The Practical Skills and Procedures outline the core set the core diagnostic, therapeutic and Practical Skills of Practical Skills and Procedures , and minimum level and Procedures newly qualified doctors must be able of performance that newly qualified doctors must to perform safely and effectively, and identifying the have when they start work for the first time so they level of supervision needed to ensure patient safety. can practise safely. promoting excellence sets out the standards and requirements for the management and delivery of Provisions for encouraging diversity undergraduate and postgraduate medical education in medicine and training.

3 The outcomes and the Practical Skills and Procedures set out what we expect newly We believe that equality, diversity and inclusion qualified doctors to be able to know and do and are integral to our work as a regulator. We are should be read alongside promoting excellence. committed to supporting diversity in medicine. We expect all newly qualified doctors to practise in We expect organisations to make supportive and accordance with the professional requirements set pragmatic adjustments for learners to enable out in Good medical practice and related guidance. achievement of the Practical Skills and Procedures , including where learners have long-term health Responsibility for delivering the conditions and disabilities, while also abiding by the Equality Act 2010 and the Disability Discrimination Procedures Act 1995.

4 Medical schools must provide an education Students need to be able to perform the Practical that allows newly qualified doctors to meet all skill or procedure using the specified method, but the outcomes, including the Practical Skills and reasonable adjustments could be made to other Procedures specified in this list, and therefore to aspects. For example, an adapted chair if the student be fit to practise safely as a doctor when needs to sit down while carrying out the procedure. they graduate. Further detailed information can be found in our 2 General Medical Council Practical Skills and Procedures Local education providers, working with medical Safe to practise under indirect supervision schools, must provide and quality manage clinical The newly qualified doctor is ready to perform the placements and learning opportunities that give procedure on a patient under indirect supervision.

5 Medical students the opportunities to build This means that the newly qualified doctor will have knowledge, Skills and Practical experience to meet performed the procedure on real patients during the outcomes and to safely and effectively carry medical school under direct supervision at first and, out the Practical Skills and Procedures by the time as their experience and skill became sufficient to they qualify. allow them to perform the procedure safely, with indirect supervision. By indirect supervision, we Medical students are responsible for their own mean that the newly qualified doctor is able to learning. They should refer to the outcomes and access support to perform the procedure if they need the Practical Skills and Procedures specified in to for example by locating a colleague and asking this list during their undergraduate education to for help.

6 Understand what we expect them to be able to know and do by the time they graduate. Generic requirements There are both generic requirements and specific What must newly qualified doctors procedure requirements for each procedure. Newly demonstrate for satisfactory qualified doctors should comply with local and national guidelines, and employers will also typically completion? have protocols for the safe performance of each Three levels of competence procedure which should be followed. Safe to practise in simulation Generic requirements for each procedure The newly qualified doctor is safe to practise in a The following generic requirements apply to each simulated setting and is ready to move to direct procedure: supervision.

7 This means that the newly qualified introduce themselves doctor will not have performed the procedure check the patient's identity on a real patient during medical school, but on a confirm that the procedure is required simulated patient or manikin. This means that they explain the procedure to the patient (including will have some knowledge and skill in the procedure possible complications and risks) and gain but will require direct supervision when performing informed consent for the procedure (under direct the procedure on patients. supervision where appropriate). Safe to practise under direct supervision follow universal precautions to reduce the risk of The newly qualified doctor is ready to perform the infections, including: procedure on a patient under direct supervision.

8 Control the risk of cross infection, and take This means that the newly qualified doctor will have appropriate steps for personal safety performed the procedure on real patients during follow approved processes for cleaning hands medical school under direct supervision. By direct before Procedures or surgical operations supervision, we mean that the medical student or newly qualified doctor will have a supervisor with correctly use personal protective equipment them observing their practice as they perform the (for example gloves, gowns and masks). procedure. As the newly qualified doctor's experience employ safe disposal of clinical waste, needles and skill becomes sufficient to allow them to and other sharps perform the procedure safely they will move to ispose of all equipment in the appropriate d performing the procedure under indirect supervision.

9 Receptacles General Medical Council 3. Practical Skills and Procedures label samples appropriately according to local It's important to remember that newly qualified guidelines doctors who enter the Foundation Programme will work under educational and clinical supervision and accurately document the procedure according to in a multidisciplinary team. In accordance with the local guidelines Foundation Programme Curriculum, they will need ensure confidentiality to demonstrate that they are refining their Skills and that they are able to take responsibility appropriately interpret any results and act appropriately on whilst recognising and working within the limits of them;* and their competence.

10 Arrange appropriate aftercare/monitoring. Assessment of patient needs No Procedure Description Level of competence 1 Take baseline Measure temperature, respiratory rate, pulse rate, Safe to practise under physiological blood pressure, oxygen saturations and urine indirect supervision observations and output. record appropriately 2 Carry out peak Explain to a patient how to perform a peak Safe to practise under expiratory flow expiratory flow, assess that it is performed indirect supervision respiratory function adequately and interpret results. test 3 Perform direct Perform basic ophthalmoscopy and identify Safe to practise under ophthalmoscopy common abnormalities. indirect supervision 4 Perform otoscopy Perform basic otoscopy and identify common Safe to practise under abnormalities.