Achieving good medical practice:

Transcription

1 Achievig good medical practice: guidace for medical studets

2 Achievig good medical practice: guidace for medical studets The duties of a doctor registered with the Geeral Medical Coucil Patiets must be able to trust doctors with their lives ad health. To justify that trust you must show respect for huma life ad make sure your practice meets the stadards expected of you i four domais. Kowledge, skills ad performace Make the care of your patiet your first cocer. Provide a good stadard of practice ad care. l Keep your professioal kowledge ad skills up to date. l Recogise ad work withi the limits of your competece. Safety ad quality Take prompt actio if you thik that patiet safety, digity or comfort is beig compromised. Protect ad promote the health of patiets ad the public. Commuicatio, partership ad teamwork Treat patiets as idividuals ad respect their digity. l Treat patiets politely ad cosiderately. l Respect patiets right to cofidetiality. Work i partership with patiets. l Liste to, ad respod to, their cocers ad prefereces. l Give patiets the iformatio they wat or eed i a way they ca uderstad. l Respect patiets right to reach decisios with you about their treatmet ad care. l Support patiets i carig for themselves to improve ad maitai their health. Work with colleagues i the ways that best serve patiets iterests. Maitaiig trust Be hoest ad ope ad act with itegrity. Never discrimiate ufairly agaist patiets or colleagues. Never abuse your patiets trust i you or the public s trust i the professio. You are persoally accoutable for your professioal practice ad must always be prepared to justify your decisios ad actios. 02 Geeral Medical Coucil ad Medical Schools Coucil

3 Achievig good medical practice: guidace for medical studets About this guidace The Geeral Medical Coucil (GMC) ad the Medical Schools Coucil (MSC) have published this guidace for medical studets to outlie the stadards expected of them both iside ad outside of medical school. This guidace shows how the priciples ad values of the GMC s core guidace for doctors, Good medical practice, apply to you as a studet. Uderstadig how the core guidace for doctors applies ow ad i your career will help you be a good studet ad, i the future, a good doctor. Geeral Medical Coucil ad Medical Schools Coucil 01

4 Achievig good medical practice: guidace for medical studets Cotets Page What does this guidace cover? 1 Maitaiig a high stadard of professioal behaviour 4 About Good medical practice 5 Usig this guidace 6 Domai 1: Kowledge, skills ad performace 8 Develop ad maitai your professioal performace 8 Apply kowledge ad experiece to practice 11 Record your work clearly, accurately ad legibly 16 Domai 2: Safety ad quality 18 Cotribute to ad comply with systems to protect patiets 18 Respod to risks to safety 19 How to raise a patiet safety cocer 20 Protect patiets ad colleagues from ay risk posed by your health 24 Domai 3: Commuicatio, partership ad teamwork 29 Commuicate effectively 29 Work collaboratively with colleagues to maitai or improve patiet care 30 Teachig, traiig, supportig ad assessig 31 Cotiuity ad coordiatio of care 32 Establish ad maitai parterships with patiets 32 Maitaiig patiet cofidetiality 33 Makig a coscietious objectio Geeral Medical Coucil ad Medical Schools Coucil

5 Achievig good medical practice: guidace for medical studets Page Domai 4: Maitaiig trust 39 Show respect for patiets 39 Treat patiets ad colleagues fairly ad without discrimiatio 40 Act with hoesty ad itegrity 42 Opeess ad legal or discipliary proceedigs 44 Professioalism key areas of cocer 47 Persistet iappropriate attitude or behaviour 47 Failig to demostrate good medical practice 48 Drug or alcohol misuse 49 Cheatig or plagiarisig 49 Dishoesty or fraud, icludig dishoesty outside the professioal role 50 Aggressive, violet or threateig behaviour 51 Ay cautio or covictio 52 Health cocers ad isight or maagemet of these cocers 53 Aex: Professioalism ad fitess to practise processes i medical schools ad uiversities 54 Moitorig low-level cocers 55 A formal fitess to practise ivestigatio 56 What is a fitess to practise pael or committee? 56 What support will I get durig a fitess to practise ivestigatio? 57 Geeral Medical Coucil ad Medical Schools Coucil 03

6 Achievig good medical practice: guidace for medical studets What does this guidace cover? Maitaiig a high stadard of professioal behaviour Your studies will brig you ito cotact with patiets ad members of the public, who ca be physically ad emotioally vulerable. Because of this, ad the fact that you ll be joiig a trusted professio, we expect you to uderstad that there is a differece i the stadard of behaviour expected of studets o courses that brig them ito cotact with patiets ad the public. Specifically, your behaviour at all times, both i the cliical eviromet ad outside of your studies, must justify the trust that patiets ad the public place i you as a future member of the medical professio. We ad your medical school will support you i your jourey from studet to doctor, which icludes teachig ad assessmet o professioalism. As a medical graduate, you ll eed to register with the GMC ad get a licece to practise before you ca begi work as a doctor if you wish to work i the UK. The GMC wo t register medical graduates who are ot fit to practise medicie. I additio to this guidace, we ve also produced guidace for medical schools ad medical studets o maagig professioalism ad fitess to practise cocers. It outlies the processes that medical schools should follow if they re worried about a studet s professioalism or fitess to practise medicie. 04 Geeral Medical Coucil ad Medical Schools Coucil

7 Achievig good medical practice: guidace for medical studets Examples of the kids of behaviour that are a cause for cocer ad may lead to formal processes beig used are outlied i the Professioalism key areas of cocer sectio of this guidace (see pages 47 53). About Good medical practice Good medical practice describes what is expected of all doctors registered with the GMC. It is a doctor s resposibility to be familiar with Good medical practice ad the explaatory guidace that supports it, ad to follow the guidace they cotai. Doctors must use their judgemet i applyig the priciples to the various situatios they will face as a doctor whether or ot they hold a licece to practise, whatever field of medicie they work i, ad whether or ot they routiely see patiets. Doctors must be prepared to explai ad justify their decisios ad actios. Geeral Medical Coucil ad Medical Schools Coucil 05

8 Achievig good medical practice: guidace for medical studets Usig this guidace Patiets eed good doctors traiig to be a good doctor starts at medical school. Durig your studies, you ll lear the importace of professioalism ad the priciples ad values set out i the GMC s core guidace for doctors, Good medical practice, ad the explaatory guidace that supports it. I this guidace, the GMC ad the MSC (referred to as we throughout the guidace) show how the priciples ad values i Good medical practice apply to you as a medical studet, to help prepare you for your future role as a doctor. Much of this guidace is relevat specifically to your work o cliical placemets. But professioalism is broader tha this ad icludes all elemets of your academic study, as well as the eed to be trustworthy ad hoest. I this guidace, we use the terms you must ad you should i the followig ways. You must is used to highlight importat areas that are strogly liked to Good medical practice. You should is used whe we give a explaatio of how to meet requiremets, ad where there are exceptios to how the priciple might apply. Throughout this guidace, we also offer more detail ad practical tips o how you ca meet the requiremets we set out. You will fid these i the text boxes, outlied i gree. 06 Geeral Medical Coucil ad Medical Schools Coucil

9 Achievig good medical practice: guidace for medical studets Goig above ad beyod takig o the challege of professioal excellece This guidace explais the stadards of professioal behaviour expected of you durig your studies. True professioalism is about strivig for excellece to achieve this you ll eed to lear to: develop healthy ways to cope with stress ad challeges (resiliece) deal with doubt ad ucertaity apply ethical ad moral reasoig to your work work effectively i a team, icludig beig able to give costructive ad hoest feedback maage your ow learig ad developmet be resposive to feedback prioritise your time well ad esure a good work-life balace promote patiet safety ad be able, where appropriate, to raise cocers work collaboratively with patiets ad other professioals deal with ad mitigate agaist persoal bias. You may fid may of these difficult or challegig to do well but, as with all elemets of professioalism, your medical school will help you to develop these skills. Beig professioal meas you ll eed to make time to reflect o your experieces, to lear cotiually ad to apply your learig i practice. You will eed to seek out feedback, remai up to date with professioal ad ethical guidace ad be able to adapt to chagig circumstaces. Your teachers ad traiers wat you to develop ad become a excellet doctor, so you should look to them for guidace ad support. Geeral Medical Coucil ad Medical Schools Coucil 07

10 Achievig good medical practice: guidace for medical studets Domai 1: Kowledge, skills ad performace Develop ad maitai your professioal performace 1 As a registered doctor, you ll be expected to keep your skills ad kowledge up to date so you ca give your patiets the best stadard of care. 2 Registered doctors must be familiar with ad follow all laws ad regulatios relevat to their practice as well as ay guidace the GMC issues. This will protect patiets by makig sure they receive safe ad lawful treatmet ad will help doctors to provide the best care possible. 3 As a medical studet, you ll lear the basic skills ad kowledge you eed to treat patiets, but you are also developig your ability to lear ad acquire future skills. As you move through medical school ad ito postgraduate educatio ad traiig, you ll cotiue to build o what you have leart. For you, this aspect of good medical practice is about participatig fully i this learig process. 08 Geeral Medical Coucil ad Medical Schools Coucil

11 Achievig good medical practice: guidace for medical studets 4 You must: egage fully with your medical course by attedig educatioal activities, icludig lectures, semiars ad placemets, ad by completig coursework liste to the advice of your lecturers ad traiers comply fully with the regulatios ad other systems or structures provided by your medical school or uiversity i relatio to your studies respod costructively to verbal ad writte feedback from patiets, lecturers, cliicias ad members of the multidiscipliary team by critically reflectig o the feedback ad makig a actio pla to improve where ecessary reflect o what you have leart ad look at ways to improve your ow performace. Geeral Medical Coucil ad Medical Schools Coucil 09

12 Achievig good medical practice: guidace for medical studets What is reflectio? You will hear about the cocept of reflective practice throughout your time at medical school. At its core, reflectio is thikig about what you ve doe, what you did well ad what you could do better ext time. To do this, you eed to thik about what effect your actios have o yourself ad o others, icludig patiets ad colleagues, across all aspects of your educatio ad traiig. For example, if you have a iteractio with a patiet or a colleague that did t go as plaed, you should explore how you approached the situatio i a critical light to see if you ca lear from what happeed ad use that learig to improve the way you approach similar situatios i the future. Reflectio also meas respodig costructively to feedback from your teachers, traiers ad colleagues. Thik about what you have bee told you ca improve ad aim to put those improvemets ito actio. This is how medical studets ad registered doctors lear ad improve. 10 Geeral Medical Coucil ad Medical Schools Coucil

13 Achievig good medical practice: guidace for medical studets 5 As a medical studet, you ll lear about relevat laws ad professioal guidace, ad it s importat that you apply that learig whe you are o a cliical placemet. O a cliical placemet, it is your resposibility to kow, ad proactively fid out, about these policies ad procedures ad apply them i your work. This icludes followig the relevat laws ad guidace whe you are o a overseas placemet or elective. Apply kowledge ad experiece to practice 6 Registered doctors must recogise ad work withi the limits of their competece. 7 As a medical studet, this applies to you i relatio to the time you ll sped with patiets o a cliical placemet. It also meas you should oly treat patiets or give medical advice whe you are uder the supervisio of a registered healthcare practitioer. You must ot carry out procedures o frieds or your family. You must: recogise the limits of your competece ad ask for help whe ecessary make sure you clearly explai your level of competece to ayoe who supervises you o a placemet, so you are ot asked to do aythig you are ot traied to do make sure patiets, carers ad colleagues are aware that you are a medical studet ad ot a registered doctor Geeral Medical Coucil ad Medical Schools Coucil 11

14 Achievig good medical practice: guidace for medical studets take actio if you thik you re ot beig effectively supervised o a cliical placemet (see paragraph 9) egage i a timely fashio with routie evaluatio systems provided by your medical school or uiversity (for example, ed of placemet questioaires or staff-studet liaiso committees). Beig professioal o placemets practical steps Always itroduce yourself to patiets, lettig them kow your ame ad that you are a medical studet. Whe you meet a patiet for the first time, check if they have ay objectios to havig a studet preset. If your medical school or placemet provider has give you a ID badge or similar, make sure it is visible at all times. Dress smartly ad i lie with dress codes set out by your medical school or placemet provider. Arrive o time for your placemet ad do ot leave your placemet early uless you have agreed this with a relevat supervisor. Atted iductio sessios if they re offered. 12 Geeral Medical Coucil ad Medical Schools Coucil

15 Achievig good medical practice: guidace for medical studets Atted all madatory traiig arraged for you while o a placemet. Make sure you kow about ad follow the rules ad guidace specific to your placemet, icludig how you should raise ay cocers. If i doubt, make sure you ask if there is aythig i particular you should kow at the start of your placemet. Be hoest with patiets if you do t kow the aswer to their questios. Patiets appreciate that you are there to lear. Make sure you kow who is resposible for directly supervisig you o your placemet ad who has the overall resposibility for medical studets where you are workig. This will help you uderstad where to go if you eed help ad if you have ay cocers you eed to raise. Be aware that while o ay elective, i the UK or abroad, studets should still apply the advice i this guidace wherever possible. 8 If you are ot sure you are able to carry out a procedure competetly, you should ask for help from a more experieced colleague, such as a urse or qualified doctor. You should oly attempt practical procedures if you have bee traied to do so, ad oly uder supervisio that is appropriate to your level of competece. Geeral Medical Coucil ad Medical Schools Coucil 13

16 Achievig good medical practice: guidace for medical studets 9 If you thik you are ot beig properly supervised o a placemet, you should stop the work you are doig ad raise your cocers with the placemet provider ad your medical school. This wo t impact o your studies ad will show that you are a resposible studet actig i a professioal maer. We also expect you to take prompt actio if you have ay cocers about possible risks to patiets, as set out i paragraphs While you are at medical school, you ll lear how to make good cliical decisios ad how to be satisfied a patiet has give coset. You ll lear that the coset process is about shared decisio makig betwee a doctor ad a patiet, where the doctor uses their specialist kowledge ad experiece to help their patiet cosider their optios ad make a iformed decisio. * 11 Towards the ed of your studies, you may be resposible, uder supervisio, for explaiig to a patiet what will happe to them ad, i some cases, gettig their coset for a mior procedure, such as takig a blood sample or a blood pressure readig. I almost all other cases, you wo t be solely resposible for seekig coset. Whatever the circumstaces, you should always check with the patiet what they have already agreed to i terms of treatmet ad that they re happy for a studet to be ivolved i their care. * You ca fid out more about coset i the GMC s guidace for registered doctors, Coset: patiets ad doctors makig decisios together, available at 14 Geeral Medical Coucil ad Medical Schools Coucil

17 Achievig good medical practice: guidace for medical studets Coset thigs to remember Patiets eed to kow that you are a studet so they ca make a iformed decisio about whether they wat you to be ivolved i their care. Oce they kow you are studet, you ca ask if they re happy for you to talk to them about their health or carry out a procedure. Remember: if you have ay cocers about whether a patiet has give coset to you beig ivolved i their care or udertakig ay type of procedure, talk to your supervisor about your cocers. you should be aware that sometimes patiets might ot have the capacity to give coset. * you should ot carry out ay procedure o a patiet without their coset for that specific procedure. you must respect the decisio of patiets who do ot wat you to be ivolved i their care. * See Part 3 of Coset: patiets ad doctors makig decisios together for more iformatio o a patiet s capacity to coset, available at Geeral Medical Coucil ad Medical Schools Coucil 15

18 Achievig good medical practice: guidace for medical studets Record your work clearly, accurately ad legibly 12 Doctors must record their work clearly, accurately ad legibly. Records should iclude: relevat cliical fidigs decisios made ad actios agreed (ad show who they were made by) ay drugs prescribed or other ivestigatio or treatmet the iformatio give to the patiet. 13 This helps to esure effective team workig, safe hadover ad cotiuity of care. Therefore, the iformatio must make sure that ayoe readig those otes ca uderstad them ad rely o the fact that the iformatio is correct. This icludes patiets ad their relatives or carers. 14 As a medical studet, you must make sure that the otes you write are clear, accurate ad legible, eve whe made as part of the learig process, as this will help you develop the skills you ll eed as a doctor. 15 You should make sure all the documetatio you submit to your medical school is writte i a professioal way. This icludes the fidigs of activities, such as audit or research you carry out as part of your studies. 16 Geeral Medical Coucil ad Medical Schools Coucil

19 Achievig good medical practice: guidace for medical studets Recordig your work dos ad do ts Do: make it clear that you re a medical studet whe you add aythig to a patiet s otes you should put your ame ad year of study so what you write ca be checked by a registered health professioal make sure the otes you take are dated, clear, accurate ad legible eve if they re ot goig o a patiet s official record make sure your otes are recorded as soo as possible after your iteractio with a patiet get rid of your otes carefully especially whe they relate to patiets usig facilities desiged for the disposal of cofidetial material. Do t: write aythig you would ot wat to be made public i otes, logbooks or reports submit work that is difficult to read or poorly preseted store cofidetial material i places that are t secure this icludes digital ad paper files. Geeral Medical Coucil ad Medical Schools Coucil 17

20 Achievig good medical practice: guidace for medical studets Domai 2: Safety ad quality Cotribute to ad comply with systems to protect patiets 16 Registered doctors must ot oly comply with rules desiged to protect patiets, but also seek to improve the quality of the services they give to patiets both at a idividual ad at a systems level. 17 As a medical studet, you ll lear about quality improvemet ad quality assurace, ad will have the opportuity to take part i audits ad reviews. You ll also be i cliical settigs durig your studies ad you must tell your supervisor whe thigs go wrog ad whe these problems affect, or could affect, patiet care. 18 Durig your medical traiig, you may witess or be ivolved i somethig goig wrog with a patiet s care, ad you may be asked to cotribute to a iteral iquiry. Although your medical school will ormally be told about sigificat evets, you should cotact seior staff (for example, your year director or persoal tutor) at a early stage, so they ca arrage support for you. This will protect patiets ad allow the cliical team you are workig with to respod appropriately. 19 You must cotribute hoestly ad opely to the process. Opeess ad hoesty are key to beig a good medical studet ad a safe ad trustworthy doctor. You may hear this referred to as your professioal duty of cadour. * * The GMC ad the Nursig ad Midwifery Coucil have produced joit guidace for urses ad doctors, Opeess ad hoesty whe thigs go wrog: the professioal duty of cadour, available at 18 Geeral Medical Coucil ad Medical Schools Coucil

21 Achievig good medical practice: guidace for medical studets Respod to risks to safety 20 Patiet safety is the resposibility of the whole team, which could iclude cliical ad o-cliical members. This is why registered doctors must take actio to raise cocers ad support others to raise cocers about patiet safety. 21 This applies to everyoe workig i a healthcare settig icludig medical studets o cliical placemets. Patiet safety does ot just relate to the cliical treatmet patiets get it also icludes raisig cocers whe a patiet s digity or comfort is compromised. * 22 You must: raise ay cocers you have about patiet safety, digity or comfort promptly follow your medical school s policy o raisig cocers, wherever possible. * The GMC has produced guidace o Raisig ad actig o cocers about patiet safety ad a decisio-makig tool that will help registered doctors kow what to do if they have a cocer about patiet safety. See Geeral Medical Coucil ad Medical Schools Coucil 19

22 Achievig good medical practice: guidace for medical studets How to raise a patiet safety cocer 23 We recogise that raisig cocers about patiet care ca be difficult. As a medical studet, you may ot feel comfortable raisig issues with supervisors who may be resposible for makig assessmets of your performace o the placemet. You may also feel ucomfortable raisig cocers with seior cliicias. This is why you should, wherever possible, follow your medical school s formal policy o raisig cocers, which will help you uderstad how to deal with difficult issues like these. 24 I exceptioal circumstaces, you may ot feel comfortable followig the medical school s policy (for example, because the perso causig the cocer is the perso you have to raise it with), but you must still fid aother way to raise your cocer. For example, you ca talk to a member of staff with whom you have a ogoig relatioship, such as your persoal tutor, who ca support you. If the cocer arises while you are o a placemet, you may also fid it helpful to refer to the placemet provider s raisig cocers policy. 25 It ca be difficult for orgaisatios to deal with aoymous cocers, because it s more difficult to ivestigate the situatio if they do t kow who made the complait. Therefore, you should avoid raisig cocers aoymously wherever possible. Remember that, although your medical school will kow who raised the cocer, they wo t ecessarily eed to ame you as the source of cocer whe they ivestigate. 20 Geeral Medical Coucil ad Medical Schools Coucil

23 Achievig good medical practice: guidace for medical studets What if my cocer is about my frieds or peers? It ca be difficult to raise cocers about fellow studets, who may be people you work with o projects or placemets or your frieds. But as a studet choosig to joi a regulated professio, it is your duty to put patiets first ad this icludes patiets you see o placemets ad those treated by your fellow studets i the future. You might be cocered about the behaviour of a fellow studet, for example if they are: rude to a patiet does ot cotribute to group work you ve bee assiged posts iappropriate cotet o social media (see the Social media dos ad do ts box o pages 36 37) is itoxicated whe attedig a placemet, lecture or semiar. It ca be eve harder to raise cocers about a peer s health, but you must brig this to the attetio of your medical school if you are worried about their safety or wellbeig. You should ever attempt to treat a fellow studet s health coditio ad whe you raise your cocers it s importat to remember that this will eable your medical school to give them help ad support. Geeral Medical Coucil ad Medical Schools Coucil 21

24 Achievig good medical practice: guidace for medical studets 26 If you re ot sure whether you should raise a cocer formally, you should ask your medical school or a experieced healthcare professioal for advice. GMC guidace to doctors o raisig cocers ackowledges issues like this, icludig, for example, if the perso causig cocer is part of the problem or the doctor does t have cofidece that the cocer will be addressed adequately based o previous experieces. You may therefore fid this guidace helpful. * What should I do if I have a cocer about a member of staff at my medical school or o a cliical placemet? 27 It s just as importat to raise cocers you have about the staff you work with. For example, a doctor, urse or other healthcare professioal who is or may be: actig outside his or her competece failig to see cocers about their health or ot followig advice o these cocers. 28 You may also have cocers about the lecturers ad staff at your medical school. Ad while they may ot be a immediate risk to patiets, your medical school will still wat to kow if you are cocered about someoe s health or wellbeig. They ca the take steps to eable the idividual to get the support they eed. You must always raise cocers i a cofidetial, o-judgemetal way. * See the Steps to raise a cocer sectio of the GMC s guidace Raisig ad actig o cocers about patiet safety, available at guidace/ethical_guidace/11867.asp. 22 Geeral Medical Coucil ad Medical Schools Coucil

25 Achievig good medical practice: guidace for medical studets Raisig cocers a legal or a moral duty? Medical studets are ot registered with the GMC ad are ot employees of their placemet providers. This meas that either the GMC or placemet providers ca legally require studets to raise cocers. However, studets do have a formal relatioship with their medical school, which will expect them to raise cocers. Medical studets also have a moral resposibility to raise cocers about patiet safety, digity ad comfort. Professioalism is ot about doig the miimum it is about doig what is ecessary to protect patiets. Geeral Medical Coucil ad Medical Schools Coucil 23

26 Achievig good medical practice: guidace for medical studets Protect patiets ad colleagues from ay risk posed by your health 29 Registered doctors must protect patiets from ay risk posed by their health. To do this, they must ask for help from a suitable colleague ad follow their advice about ay chages to their practice the colleague cosiders ecessary. 30 You ll have sigificat cotact with patiets while o cliical placemets. Ay health issues you have may affect them, as well as your fellow studets ad teachers. 31 If you kow or suspect that you have a coditio that could be passed o to colleagues or patiets, you must follow your medical school s guidace about this. 32 As a medical studet, both durig study ad o a placemet, you re likely to experiece situatios that will have a emotioal impact o you. At times, you may experiece stress ad axiety. This is completely ormal ad your medical school will support you with safe ways to share ad reflect o difficult experieces. But if you are cocered about your levels of axiety, you should seek help from your geeral practitioer (GP) ad other appropriate sources (for example, helplies) to address ay issues at a early stage. This may iclude makig adjustmets to your traiig or practice, if ecessary. 24 Geeral Medical Coucil ad Medical Schools Coucil

27 Achievig good medical practice: guidace for medical studets 33 You should be aware that some coditios that are usually mior such as the commo cold may have a disproportioate impact o some patiets, for example those with compromised immue systems. You eed to bear this i mid whe you decide whether to go to a placemet if you are uwell. 34 You must comply with the occupatioal health policies ad procedures of your medical school or uiversity (for example, immuisatio agaist commo, serious commuicable diseases). 35 You must egage with the occupatioal health referral process if your health has deteriorated, or if there are cocers that your health may have a impact o your ability to study. 36 You do t eed to perform exposure proe procedures * (EPPs) to achieve the outcomes of udergraduate medical educatio. Studets with blood-bore viruses ca study medicie, but they may ot be able to perform EPPs ad may have restrictios o their cliical placemets. They must also complete the recommeded health screeig before they carry out ay EPPs ad must limit their medical practice whe they graduate. You ca fid further iformatio ad guidace at BBV.aspx. * EPPs are those where there is a risk that ijury to the worker may result i exposure of the patiet s ope tissues to the blood of the worker. These procedures iclude those where the worker s gloved hads may be i cotact with sharp istrumets, eedle tips or sharp tissues (spicules of boe or teeth) iside a patiet s ope body cavity, woud or cofied aatomical space where the hads or figertips may ot be completely visible at all times. Geeral Medical Coucil ad Medical Schools Coucil 25

28 Achievig good medical practice: guidace for medical studets Gettig idepedet medical advice 37 Doctors should, wherever possible, avoid treatig themselves or providig medical care to ayoe with whom they have a close persoal relatioship. They must seek idepedet medical advice o issues relatig to their ow health. 38 As a medical studet, you also eed to seek idepedet ad objective advice from a GP or other appropriately qualified healthcare professioal ad ot rely o what you have leart as a medical studet or the views of other studets, medically qualified family members or frieds. It is importat that you have access to idepedet advice ad you should register with a GP who is local to your medical school. 26 Geeral Medical Coucil ad Medical Schools Coucil

29 Achievig good medical practice: guidace for medical studets Your health dos ad do ts Do: tell your medical school if you have a health coditio or you experiece sigificat chages to a stable health coditio get appropriate support all medical schools have support systems i place to help you, so take advatage of these register with a GP local to your medical school seek idepedet advice if you have a health coditio or thik your health or persoal circumstaces may be affectig your studies or traiig make sure you follow ay treatmet pla you are give, ad do t make chages to your treatmet without cosultig your treatig physicia. Do t: hide it your medical school will wat to help you diagose or treat yourself seek treatmet from frieds, family or those close to you. Geeral Medical Coucil ad Medical Schools Coucil 27

30 Achievig good medical practice: guidace for medical studets Iformig your medical school 39 Doctors must declare ay health coditios which might affect their fitess to practise to the GMC so that it ca take ay ecessary actio to protect patiets ad help the doctor get the support they eed. 40 As a medical studet, you must tell your medical school about ay serious health problems, or ay aspect of your health or persoal circumstaces that could affect your traiig (especially your placemets) or your relatioship with colleagues. This is so that your medical school ca support you, ad it ca oly do this if it kows that you have a problem. Tellig your medical school shows you have isight ito the impact your coditio may have o patiets, your fellow studets ad yourself. This is a crucial factor that medical schools cosider i relatio to health ad fitess to practise. 41 We have produced guidace for medical studets ad medical schools o dealig with metal health coditios, Supportig medical studets with metal health coditios. * There is also guidace that gives practical suggestios to medical schools to help them make medicie more accessible to disabled studets i Gateways to the professios. * See See 28 Geeral Medical Coucil ad Medical Schools Coucil

31 Domai 3: Commuicatio, partership ad teamwork Achievig good medical practice: guidace for medical studets Commuicate effectively 42 Doctors must work i partership with patiets ad good commuicatio is vital if they are to do this successfully. Workig i partership is about supportig patiets to make decisios about their treatmet ad care, by listeig to ad respectig their views about their health. Workig i partership is also about sharig iformatio patiets wat or eed, i a way that is tailored to their eeds. 43 As a medical studet, you ll lear how to commuicate effectively i a variety of cliical, simulated ad o-cliical settigs ad it is importat that you apply your learig i your iteractios with patiets. 44 Whe commuicatig with patiets you must: be hoest whe you do t kow somethig. As a studet, you re ot expected to kow the aswers to all questios a patiet may have, but you are expected to liste to them ad respect their views. You should do your best to fid out the aswers to the patiet s questios yourself, or pass the query o to someoe who will be able to help take ito accout the patiet s laguage ad commuicatio eeds ad other potetial barriers to effective commuicatio (for example, pai or axiety) ad ask for support to help you commuicate effectively if ecessary * * You ca fid more iformatio ad iteractive resources aimed at helpig doctors provide good care for people with a learig disability o the GMC s learig disabilities website. See Geeral Medical Coucil ad Medical Schools Coucil 29

32 Achievig good medical practice: guidace for medical studets be polite ad cosiderate to ayoe close to the patiet, such as relatives, carers ad frieds at all times ot just durig a cosultatio. Work collaboratively with colleagues to maitai or improve patiet care 45 Doctors must work collaboratively with other doctors ad healthcare professioals to make sure patiets are treated effectively. 46 Whe o cliical placemets, you must be aware of ad cotribute fully to the work of the healthcare team. You must cotribute effectively to ay team you are part of i your o-cliical traiig. 47 You must treat your colleagues with respect. This icludes your fellow studets, cliical ad o-cliical teachers, ad those resposible for the admiistratio of your course. You ll also lear with studets from other health professios, which is importat to help you develop a better uderstadig of the roles that differet professios play i a multidiscipliary healthcare team. 48 You must: work collaboratively with your teachers, traiers, admiistrative or support staff ad fellow studets, icludig those from other healthcare professios 30 Geeral Medical Coucil ad Medical Schools Coucil

33 Achievig good medical practice: guidace for medical studets treat all peers ad colleagues fairly ad with respect uderstad that your ow behaviour ca ifluece how well a team works ad be prepared to adapt your behaviour to achieve the goals of the team. Teachig, traiig, supportig ad assessig 49 Every member of the medical professio is resposible for supportig less experieced members. This meas doctors should be prepared to cotribute to teachig ad traiig other doctors ad studets, ad should be willig to take o metorig roles. The GMC also expects doctors to take part i the assessmet of doctors i traiig ad to give feedback for the appraisals of colleagues. They must complete these activities i a ope ad hoest way. 50 As a medical studet, you may be expected to metor other studets or be asked to give feedback about your peers. If you are asked to do this, you must do so i a hoest, costructive, ope ad fair way. 51 As a medical studet, you ll be asked to give feedback o the quality of your placemets ad teachig. You must give this feedback whe asked, as it will help your medical school to improve the overall quality of the educatio it provides. You must be fair, costructive ad professioal i your feedback ad make commets based o your ow experiece. You should try to highlight areas of good practice as well as idetifyig areas where improvemets could be made. Geeral Medical Coucil ad Medical Schools Coucil 31

34 Achievig good medical practice: guidace for medical studets Cotiuity ad coordiatio of care 52 Registered doctors must cotribute to the safe trasfer of patiets betwee differet doctors, teams ad health ad social care settigs. This meas they must make sure they share relevat iformatio about the patiet with the colleague or team that is takig over their care. They must be satisfied that whe they had over or delegate care, it is to someoe with the appropriate qualificatios, skills ad experiece to provide safe care for the patiet. 53 As a seior medical studet, it is likely you ll be expected to look after patiets, uder supervisio. Whe you are trasferrig the care of a patiet, you must make sure you trasfer care to a appropriate perso ad that you share relevat iformatio with them. If you have ay cocers about this process, you should ask a seior colleague for help. Establish ad maitai parterships with patiets 54 All registered doctors must establish ad maitai parterships with patiets. This meas beig polite ad cosiderate ad treatig patiets as idividuals. It also meas respectig their digity ad privacy ad treatig patiets fairly ad with respect, whatever their life choices ad beliefs. 32 Geeral Medical Coucil ad Medical Schools Coucil

35 Achievig good medical practice: guidace for medical studets 55 As a medical studet, you ll lear how to develop a partership with patiets. Therefore you must: be polite ad cosiderate at all times liste ad respod to patiets views ad cocers respect patiets digity, cofidetiality ad privacy treat patiets fairly ad with respect, o matter what your ow thoughts are about their life choices or beliefs be clear with patiets about the role you ll take i their care. Maitaiig patiet cofidetiality 56 All patiets have a right to expect that their doctors will hold iformatio about them i cofidece. Cofidetiality is cetral to trust betwee doctors ad patiets. 57 However, cofidetiality is ot absolute, ad appropriate iformatio sharig is essetial to the efficiet provisio of safe, effective care. You ll lear about this at medical school, but you eed to be aware that you must ever share cofidetial iformatio about a patiet with ayoe who is ot directly ivolved i their care without the patiet s permissio. Geeral Medical Coucil ad Medical Schools Coucil 33

36 Achievig good medical practice: guidace for medical studets 58 May improper disclosures are uitetioal. You must ot share idetifiable iformatio about a patiet where you ca be overheard, such as i a public place or o social media, or iclude it i ay work or logbooks you submit. You must be clear about what cofidetial iformatio a patiet has agreed ca be shared with frieds ad family before you discuss their care. You ca fid more iformatio about whe ad how you ca disclose persoal iformatio about patiets with their coset, where the law requires it ad i the public iterest i the GMC s guidace, Cofidetiality. 59 You must also follow ay policies of your medical school, uiversity or placemet provider to make sure persoal iformatio is stored ad disposed of securely. 34 Geeral Medical Coucil ad Medical Schools Coucil

37 Achievig good medical practice: guidace for medical studets How does cofidetiality apply to my placemets? It s ormal to wat to talk about thigs you have see o cliical placemets with colleagues or frieds. You ll see uusual medical coditios ad may be put i situatios where patiets experiece adverse outcomes. But you must ever disclose patiet idetifiable iformatio without a patiet s coset. * If you re ot sure what to share if you re asked to provide iformatio for a iquiry or logbook, you should ask for advice before you disclose ay iformatio. You should also make sure you ever discuss patiets i a public place or o social media. Eve if you do t metio a patiet by ame, there s a chace that someoe earby (or olie, if you re o social media) might kow whom you are talkig about. If you do wat to talk to a colleague, fried or supervisor about what you have see o a placemet, you should oly do that i a private place. Ad you should t metio the patiet by ame, except to a cliicia directly ivolved i their care. For more iformatio, see the GMC s guidace for registered doctors, Good medical practice, Cofidetiality ad Doctors use of social media. You ca fid these at * For more iformatio o this, see paragraphs 8 9 of the GMC s guidace Coset: patiets ad doctors workig together. Available at Geeral Medical Coucil ad Medical Schools Coucil 35

38 Achievig good medical practice: guidace for medical studets Social media dos ad do ts Do: check your privacy settigs so you kow who ca see what o the platforms you use. But remember that social media sites caot guaratee cofidetiality whatever privacy settigs you use remember that the apps you use may lik to your social media profile ad that iformatio from that site may be see by users of the app maitai boudaries by ot egagig with patiets or others about a patiet s care through your persoal social media profiles or platforms. Istead, if appropriate, use a separate professioal platform or profile to respod remember that oce iformatio is published o social media sites you may ot be able to cotrol how it is used by others ad it ca be difficult to remove it from the iteret or the site it was origially posted o use social media to express your views, but do t behave i a derogatory maer to other users ad do t post discrimiatory cotet thik carefully about how others, particularly patiets both preset ad future, might perceive your cotet. 36 Geeral Medical Coucil ad Medical Schools Coucil

39 Achievig good medical practice: guidace for medical studets Do t: share iformatio about patiets or post iformatio that could idetify a patiet misrepreset your skills or level of traiig to others post complaits about your placemet providers, medical school, teachers or traiers. Makig a coscietious objectio 60 Doctors may choose to opt out of providig certai types of treatmet because of their persoal beliefs ad values, as log as this does ot result i discrimiatio agaist idividuals or groups of patiets. If a doctor has a coscietious objectio to arragig or providig a particular procedure, they must explai this to the patiet, tell them about their right to see aother doctor ad make sure they have the iformatio to do so. Doctors must ot express disapproval of the patiet s lifestyle, choices or beliefs i doig this. You ca fid more iformatio i the GMC s guidace Persoal beliefs ad medical practice. * * See Geeral Medical Coucil ad Medical Schools Coucil 37

40 Achievig good medical practice: guidace for medical studets 61 Medical schools have a obligatio to make adjustmets for cultural or religious beliefs, but they must balace these adjustmets agaist practical cosideratios. For example, they may eed to schedule cliical placemets or assessmets durig certai religious festivals or at times of religious observace. 62 As a medical studet, you also have the right to hold a coscietious objectio to some types of treatmet ad you should discuss this with your medical school. However, you must meet the GMC s outcomes for graduates (origially published i Tomorrow s Doctors) * ad ca t be exempted from ay of these outcomes. * See outcomes.asp. 38 Geeral Medical Coucil ad Medical Schools Coucil

41 Achievig good medical practice: guidace for medical studets Domai 4: Maitaiig trust Show respect for patiets 63 Doctors must ot use their professioal positio to pursue a sexual or improper emotioal relatioship with patiets or those close to them. 64 Whe somethig goes wrog with a patiet s treatmet, doctors must be ope ad hoest with patiets ad carers. 65 As a medical studet, your studies will brig you ito cotact with patiets ad members of the public, who ca be physically ad emotioally vulerable. Because of this, ad the fact that you ll be joiig a trusted professio, you must ot use your positio to pursue a sexual or improper emotioal relatioship with them. This icludes situatios where a patiet or someoe close to them tries to iitiate a relatioship with you. 66 Treatig patiets with respect icludes ot expressig your persoal beliefs to patiets i ways that exploit their vulerability or would cause them distress. 67 As a medical studet, you wo t be directly resposible for patiet care because this resposibility will lie with your supervisor. But if you thik ay aspect of care that you are ivolved i has goe wrog, you should tell your supervisor as soo as possible. Your supervisor will support you, ad if ecessary will help you to put thigs right, which may iclude explaiig to the patiet what has happeed ad offerig a apology. Geeral Medical Coucil ad Medical Schools Coucil 39

42 Achievig good medical practice: guidace for medical studets Treat patiets ad colleagues fairly ad without discrimiatio 68 Doctors must provide or arrage ivestigatios ad treatmet based o: the assessmet that they ad their patiet make of the patiet s eeds ad priorities ad their cliical judgemet about the likely effectiveess of the treatmet optios. Doctors must ot refuse or delay treatmet because they believe a patiet s actios or lifestyle have cotributed to their coditio. 69 As a medical studet, you wo t be expected to make decisios about treatmet optios. But you must t let your ow opiios or views affect the way you treat patiets ad others or the iformatio you give them. 70 Medical studets must treat their colleagues with respect. I your case, colleagues iclude fellow medical ad other healthcare studets, the cliicias ad other staff you work with o cliical placemets, ad the staff at your medical school. 71 You must ot ufairly discrimiate agaist patiets or colleagues o the basis of their lifestyle, culture, or social or ecoomic status. This icludes characteristics protected by legislatio, which are: 40 Geeral Medical Coucil ad Medical Schools Coucil

43 Achievig good medical practice: guidace for medical studets age disability geder reassigmet race pregacy ad materity religio or belief sex sexual orietatio. How ca I hadle ucoscious bias? Ucoscious biases are the beliefs, attitudes or stereotypes that affect your uderstadig, actios or decisios i a way you are ot cosciously aware of. Ofte these biases affect the immediate decisios we make about people ad situatios. Reflective practice ivolves tryig to idetify your persoal biases ad how they ifluece your thikig ad the way you respod to people or situatios. Developig this skill is fudametal to makig good decisios as a professioal. Geeral Medical Coucil ad Medical Schools Coucil 41

44 Achievig good medical practice: guidace for medical studets Act with hoesty ad itegrity Hoesty 72 Doctors hold a trusted positio i society ad must make sure their coduct both professioally ad persoally justifies their patiets trust i them ad the public s trust i the professio. 73 As a studet aimig to joi a trusted professio, you have to meet a higher stadard of behaviour tha other studets, who are o courses that do t directly lead to joiig a professio. How ca I demostrate hoesty? You must behave hoestly from the poit that you apply to medical school, durig your studies ad whe you start workig as a doctor. Here are some practical thigs you must do to demostrate you are hoest i your work as a medical studet. Do t pass off the work of others as your ow. This is plagiarism. Do t self-plagiarise by submittig your ow previously assessed work. 42 Geeral Medical Coucil ad Medical Schools Coucil

45 Achievig good medical practice: guidace for medical studets Be hoest about your experiece ad qualificatios. This meas you must ot give your supervisors or teachers ay misleadig or false iformatio about your qualificatios or experiece, or iclude such iformatio i documets such as CVs ad job applicatios. Whe you carry out research, make sure you report fidigs accurately ad truthfully. Be hoest ad trustworthy i all your commuicatios with patiets ad colleagues. This meas you must make clear the extet of your kowledge ad check that the iformatio you provide is correct. Be ope ad truthful about your health ad make use of the processes put i place by your medical school to support you. Be hoest i the work you submit as part of your course. This meas you must ot claim to have doe somethig, like a practical procedure o a cliical placemet, if you have ot. Do t say you have atteded teachig sessios if you have t. Ad do t ask aother studet to sig i for you. Be hoest ad ope i ay fiacial ad commercial dealigs with employers, isurers ad other orgaisatios ad idividuals. Geeral Medical Coucil ad Medical Schools Coucil 43