Memorandum from the General Medical Council
INTRODUCTION
1. The General Medical Council
(GMC) welcomes the opportunity to assist the Defence Select Committee
in its inquiry into medical care for the armed forces.
2. All doctors working in
the armed forces must be registered with the GMC to practise and
we have taken the opportunity provided by this inquiry to clarify
our role in this area and also where we have a role in the education
and training of doctors. The GMC is not, however, responsible
for the delivery of healthcare in the UK or healthcare provided
overseas within the armed forces.
About the GMC
3. 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.
4. The Medical Act 1983 gives
us four main functions which are:
— keeping up-to-date registers
of qualified doctors;
— promoting high standards of
medical education;
— fostering good medical practice;
and
— dealing firmly and fairly
with doctors whose fitness to practise is in doubt.
5. Our governing body, the
Council, has 35 members consisting of 19 doctors elected by the
doctors on the register, 14 members of the public appointed by
the NHS Appointments Commission and 2 doctors appointed by educational
bodies—the universities and medical royal colleges.
SUMMARY
6. In accordance with the
Medical Act 1983, doctors in the armed forces must be registered
with the GMC if they wish to practise medicine.
7. All doctors are required
to hold full registration with the GMC in order to be able to
carry out unsupervised medical practice in the NHS or private
practice in the UK. This requirement includes those doctors working
within the armed forces. To obtain full registration, doctors
must hold a medical qualification registrable with the GMC and
have undertaken at least twelve months in a recognised training
post. This training can be undertaken in the armed forces.
8. All registered doctors
are required to practise in accordance with the principles set
out in Good Medical Practice. These principles are the same for
all doctors regardless of their place of work.
9. Doctors working in the
armed forces are also subject to the same fitness to practise
processes of the GMC as their colleagues working in the NHS.
REGISTRATION AND
EDUCATION
10. The Medical Act 1983 requires
doctors holding appointments in the naval, military or air service
to be fully registered with the GMC.
11. A doctor whose undergraduate
medical education takes place in the UK needs the experience described
in the GMC's recommendations on general clinical training, as
set out in The New Doctor (2007). We also quality assure the delivery
of undergraduate medical education.
12. On first graduating, new
UK qualified doctors are eligible for provisional registration.
They must complete 12 months provisional registration before becoming
eligible for full registration.
13. Most doctors graduating
in the UK undertake a two year Foundation Programme immediately
after graduation. Doctors in the first year of this programme
are often referred to as F1 (or FY1) trainees, doctors in the
second year as F2 (or FY2) trainees. Doctors, including those
serving in the armed forces, with provisional registration may
be employed in F1 posts in hospitals or other institutions that
have been approved by the universities, including the armed forces,
for the purpose of Foundation Programme training.
14. The Defence Medical Services
have a number of Foundation Training Programmes based in the Ministry
of Defence Hospital Units (MDHU) within NHS Host Trust Hospitals
(in Northallerton, Peterborough, Frimley Park, Portsmouth and
Derriford). These posts are fully integrated into foundation training,
carry full educational approval and deliver the required competencies
of the Foundation Training Programme. Cadets selected for an MDHU
placement undertake the full two year programme at the MDHU facility.
These programmes would fall within the GMC's quality assurance
programme for F1 medical training.
15. The GMC is aware that
its quality assurance processes will include doctors who will
work in military environments. Our quality assurance visitors
include a medical officer now serving in the Royal Army Medical
Corps who is currently engaged in the GMC's process for quality
assuring the foundation programme and has previously worked for
one of the teams quality assuring medical schools.
STANDARDS AND
FITNESS TO
PRACTISE
16. The outcome of military
tribunals and courts marshal, which suggest that a doctor's fitness
to practise maybe impaired, should be notified to the GMC
REVALIDATION FOR
ALL DOCTORS
17. Revalidation, which can
be defined as the periodic evaluation of a medical practitioner's
fitness to practise, is a policy which has been advocated by the
GMC and has been endorsed in the recent White Paper, Trust, Assurance
and Safety—The Regulation of Health Professionals in the
21st Century. The White Paper, which was published on 21 February
2007, gave further details about what revalidation would include.
18. It is proposed that revalidation
will have two core components of (relicensure the process of renewal
of a licence to practise) and recertification (which is the process
by which specialists will demonstrate that they continue to meet
the particular standards that apply to their specialty).
19. Our approach to revalidation
is likely to take account of the type of environments within which
doctors are working. Where doctors are practising in environments
which provide effective appraisal and governance systems, these
systems should be capable of generating much of the evidence necessary
for doctors to revalidate. We have enjoyed a positive working
relationship with the armed forces as we consider in detail how
this approach will work for this group of doctors.
18 May 2007
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