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The General Medical Council instructs doctors not to allow their personal beliefs to interfere with their practice. But if attitudes can threaten to impact negatively on a doctor's practice then the question arises: should doctors ever be professionally required to change their attitudes? In this paper I suggest that doctors should be required to amend their attitudes if two conditions are met, namely: (1) the doctor has an attitude that if neglected by the doctor will (or is very likely to) compromise his or her fitness to practise; and (2) the only way in which the doctor can prevent that attitude from compromising his or her fitness to practise is by changing the attitude. I also answer three objections that might be raised against the position that I advance. [ABSTRACT FROM AUTHOR]

In their first year of work, newly qualified doctors will care for patients who have palliative care needs or who are dying, and they will need the skills to do this throughout their medical career. The General Medical Council in the United Kingdom has given clear recommendations that all medical students should receive core teaching on relieving pain and distress together with caring for the terminally ill. However, medical schools provide variable amounts of this teaching; some are able to deliver comprehensive programmes whilst others deliver very little. This paper presents the results of a mixed methods study which explored the structure and content of palliative care teaching in different UK medical schools, and revealed what coordinators are trying to achieve with this teaching. Nationally, coordinators are aiming to help medical students overcome the same fears held by the lay public about death, dying and hospices, to convey that the palliative care approach is applicable to many patients and is part of every doctors' role, whatever their specialty. Although facts and knowledge were thought to be important, coordinators were more concerned with attitudes and helping individuals with the transition from medical student to foundation doctor, providing an awareness of palliative medicine as a specialty and how to access it for their future patients. [ABSTRACT FROM AUTHOR]

The General Medical Council's call to modernize medical education prompted the University of Liverpool Medical School to develop a new undergraduate programme, integrating palliative medicine as 'core' curricula. Following successful piloting, the palliative medicine training programme was further developed and expanded. This paper examines whether the additional investment produces improved outcomes. In 1999, fourth year undergraduate medical students (Cohort 1, n=217) undertook a 2-week pilot education programme in palliative medicine. Subsequently, the training programme was refined and extended, incorporating advanced communication skills training, an ethics project and individual case presentations (Cohort 2, n=443). Congruent with the study's theoretical driver of self-efficacy, both cohorts were surveyed pre- and post-programme with validated measures of: (i) self-efficacy in palliative care scale; (ii) thanatophobia scale. No significant differences between cohorts' pre-programme scores were identified. Within each cohort, statistically and educationally significant post-education improvements were recorded in both scales. Further post-education analysis indicated that the extended programme produces significantly greater improvements in all domains of the self-efficacy in palliative care scale (communication, t=-7.28, patient management, t=-5.96, multidisciplinary team-working t=-3.77 at p<0.000), but not thanatophobia. Although improvements were recorded in both cohorts, participation in the extended education programme resulted in further statistically significant gains. Interpreted through the theoretical model employed, improved self-efficacy and outcome expectancies will result in behavioural change that leads to improved practice and better patient care. [ABSTRACT FROM AUTHOR]

Current General Medical Council (GMC) guidelines state that any doctor who does not wish to carry out a non-therapeutic circumcision (NTC) on a boy must invoke conscientious objection. This paper argues that this is illogical, as it is clear that an ethical doctor will object to conducting a clinically unnecessary operation on a child who cannot consent simply because of the parents' religious beliefs. Comparison of the GMC guidelines with the more sensible British Medical Association guidance reveals that both are biased in favour of NTC and subvert standard consent procedures. It is further argued that any doctor who does participate in NTC of a minor may be guilty of negligence and in breach of the Human Rights Act. In fact, the GMC guidance implies that doctors must claim conscientious objection if they do not wish to be negligent. Both sets of guidelines should be changed to ensure an objective consent process and avoid confusion over the ethics of NTC. [ABSTRACT FROM AUTHOR]

As the General Medical Council (GMC) is currently in the process of reviewing its ethical guidance onconfidentiality, it is a prescient time to consider the legal and ethical issues inherent in it. This paper examines the question of anonymized data, and highlights the fact that the legal position regarding whether it should be classed as confidential is unclear, with the possibility of a change in the law being very real. Indeed, the article argues that the notion that anonymized data is not confidential can be challenged on both legal and ethical grounds, and thus that the GMC should take this into account in its new guidance. Although identifying the fact that this might have implications for epidemiological research, the article highlights an alternative approach that would allow the conduct of such research while not infringing patients' legally protected human rights. [ABSTRACT FROM AUTHOR]

Confidentiality and disclosure of information in the public interest present difficult dilemmas for healthcare practitioners and call for clear legal and regulatory guidance. The common law duty of confidence, and established exceptions to it, are shaped by medical practice and detailed guidance produced by the General Medical Council. Guidance issued by other healthcare regulators in a highly fragmented environment is at best unclear and at worst inaccurate. This article assembles and justifies a framework of evaluation against which regulators' guidance can be assessed, focussing on the specific issue of when the duty of confidentiality can be set aside in the public interest. Comparison of statutory regulators' guidance reveals wide variation which creates uncertainty for practitioners confused by inconsistency between guidance documents. The results of this analysis raise questions about the relationship between common law and regulatory guidance, in particular, whether it is appropriate to recognise different standards for different healthcare professions. This article argues that there is an opportunity to correct this anomaly and ensure appropriate consistency as part of a wider review of healthcare professional regulation. [ABSTRACT FROM AUTHOR]

The author reflects on the threat of explicitly identifying the patient's identity for medical research. He said that the guideline of the General Medical Council in Great Britain that requires explicit consent from the patient is impractical and could deprive the improvement of medical services. However, he stated that the new statutory body formed to advise the government on the present condition of medical research would provide opportunity to set things right.

The author reflects on the importance of information confidentiality in dealing with cancer research. He admires the work of epidemiologists in researching for treatments of cancer, however, the latest ruling of the General Medical Council in Great Britain orders the need for the patient's consent and identity. He added that confidentiality protects the patient from untoward disclosure of information that might be used against the patient.

In response to slow progress regarding technological innovations to manage type 1 diabetes, some patients have created unregulated do-it-yourself artificial pancreas systems (DIY APS). Yet both in the United Kingdom (UK) and internationally, there is an almost complete lack of specific guidance – legal, regulatory, or ethical – for clinicians caring for DIY APS users. Uncertainty regarding their professional obligations has led to them being cautious about discussing DIY APS with patients, let alone recommending or prescribing them. In this article, we argue that this approach threatens to undermine trust and transparency. Analysing the professional guidance from the UK regulator – the General Medical Council – we demonstrate that nothing within it ought to be interpreted as precluding clinicians from initiating discussions about DIY APS. Moreover, in some circumstances, it may require that clinicians do so. We also argue that the guidance does not preclude clinicians from prescribing such unapproved medical devices. [ABSTRACT FROM AUTHOR]

Background This study explores the importance of various factors upon the overall satisfaction of Core Medical Trainees (CMTs) in the Yorkshire and Humber Deanery to aid targeting of improvement efforts. Methods Responses for all CMTs in Yorkshire and the Humber to all questions and domains from the UK National Training Survey 2017 were correlated with a marker of overall trainee satisfaction. Questions with high and low degrees of correlation were identifled, as well as recurrent themes. Results Clinical supervision appears to be closely related to overall trainee satisfaction, frequently correlating well, whereas educational supervision does not. Almost all themes with high correlation were regarding day-to-day experience, whereas those correlating poorly were regarding infrastructure issues. Conclusions Assuming similar costs, to improve overall trainee experience the most limited resources are probably best targeted at those factors influencing day-to-day experience, such as freeing consultant time for clinical supervision rather than developing one-off trainee experiences. [ABSTRACT FROM AUTHOR]

In April 2014, the Law Commission published its report, Regulation of Health Care Professionals and Regulation of Social Care Professionals in England. This provides a timely reminder that medical regulation remains potentially problematic and contentious. In this article, I review the origins of the so-called state–medical profession bargain created in 1858, the history of its effectiveness, or lack of effectiveness, and the extent to which recent regulatory developments and the Law Commission proposals constitute significant renegotiation of the bargain. I conclude by considering whether the proposal may even represent the beginnings of state imposition of a new bargain, in which other health-care professions might significantly challenge the traditional dominance of doctors. [ABSTRACT FROM PUBLISHER]

This article describes how to use the RCGP curriculum for learning and teaching in general practice, explaining why the revised curriculum is designed the way it is and how you can get the most out of it during your training and beyond. [ABSTRACT FROM AUTHOR]

The article discusses General Medical Council (GMC) guidance on scenario encountered by physicians in primary care where patient's relative, friend or other acquaintance approaches a physician expressing concern about the health or wellbeing of a patient. It informs that input of family and friends can be beneficial as they may act to safeguard a patient's interests. It suggests the need for guidance for doctors to define the limits of exchanges with a third party.

Buying the equipment for your medical bag is an important—and potentially expensive—necessity for your career in general practice. In this article we outline some of the things to consider to ensure that your kit is reliable and cost-effective. Being prepared will enable you to react to the more common medical scenarios that you will face outside your practice and stay within the guidance of the General Medical Council. [ABSTRACT FROM PUBLISHER]

This article considers the nature of Mr Burke's concerns in bringing his action and the practical implications of similar situations. When artificial nutrition and hydration is provided, practical issues arise regarding future, potentially long-term care. This in turn raises concerns about place of care, provision of carers and funding, which may not easily be resolved. The GMC guidance exists to provide direction and help for practitioners when difficult decisions have to be made about future treatment with the intention that the patients' wishes and benefit of any potential treatment will be central to the discussions. Nevertheless, the reality of having these conversations, raising emotive issues with the patient and/or carers, and the implications of the final decision, may be very different in practice. [ABSTRACT FROM AUTHOR]

This article explores the recent ferment surrounding professional self-regulation in medicine and other health professions. It reviews the academic literature and sets out an agenda for research. The first section considers definitions, acknowledging the particularly complex regulatory maze in UK health care at present, in which professional self-regulation is only one part. The second section reviews academic writing, currently dispersed among the disciplines. 'The logic of light touch regulation', a feature of the 19th century establishment of the General Medical Council, can perhaps shed light on present debates. Alongside the intense political spotlight on regulation in the wake of the Bristol case, consumer-led research and consumer pressure to rethink the principles of regulation has emerged. This is examined in the third section. Finally, themes for research are advanced. First, there is a need to explore the changing relationship between the state and professions and implications, not only for the professions but for health care more broadly. Second, calls for a new professionalism need to be given clearer content. Third, the moves towards more lay involvement in regulatory bodies need study. Fourth, questions of human rights and professional registers must be explored. Fundamental questions of what professional self-regulation can hope to achieve and where it fits in relation to government ambitions as a whole, remain unresolved. Alongside the work programme of the new overarching regulator, there may well be scope for a new style of public enquiry covering the whole territory of regulation. [ABSTRACT FROM AUTHOR]

Information about a patient's health is recorded in order to provide for that patient's care. Most patients will not think about the other uses for their data and many assume that the information they provide will go no further than the health care professionals who have been caring for them. Information collected about patients is essential for developments in our understanding of health and health care. Most patients will be happy to allow their data to be used for these purposes, once this has been explained. Health care professionals have an obligation to ensure that patients know when identifiable data about them are to be used and to get their agreement about making disclosures. We know that this is not easily achieved; doctors, nurses and others providing care are already over-stretched. Patients may be anxious about their condition and treatment. They may not, for a variety of reasons, read leaflets or letters sent or given to them. This does not mean our obligations to respect patients by keeping them informed and seeking their agreement can be ignored. Openness about how health care professionals work and partnership with patients are essential to the continued trust of the public in the professions. The challenge is not to answer the question whether we need consent but rather how we can best obtain it. [ABSTRACT FROM AUTHOR]

The article offers views on the potential effects of the procedure in which some of the medical complaints in Great Britain will be referred to the local health service of primary trust rather than the General Medical Council. It infers that such procedure will expose a patient's complaint to doubts about the objectivity of a decision made by a trust employee as well as undermine its validity.

The author reflects on the effort of the General Medical Council (GMC) health committee in helping mentally sick doctors in Great Britain. According to the author, the health procedure of the GMC has been in the process of development in terms of the physical fitness of doctors. Furthermore, the procedure is designed to confront the sick doctor with his problem, to provide him with insight into it.