The new general practice curriculum—Being a General Practitioner
Chairman of Council, RCGP
The general practice curriculum was granted unconditional approval by the Postgraduate Medical Education and Training Board (PMETB) in 2006. It is the first nationally approved curriculum for training general practitioners in the UK. It provides a new system for education, training and assessment, replacing the outdated Vocational Training Regulations and the dual assessment system of summative assessment as the licensing exam and the old college examination.
The curriculum is designed as a guide for the period of postgraduate medical education for general practice from the end of the foundation programme to completion of specialist training. Those who successfully complete their training and achieve the required standard in their assessments will be awarded the PMETB's Certificate of Completion of Training which in turn gives the successful doctor eligibility for entry on to the General Medical Council's General Practitioner Register.
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The curriculum work began in 2001. The RCGP's Education Network established two working groups, one to deal with teaching and learning and the other with assessment. Each group brought together experts in education, training and assessment, from the college, deaneries and universities across the UK. They included patient, public and GP trainee representation as well as management input from the NHS.
A literature review was commissioned from the Centre for Research into Medical and Dental Education at the University of Birmingham and an extensive consultation exercise was carried out. This involved a national questionnaire survey of the views of trainees and GP educators on training for general practice, meetings with lay representatives and GP trainees and focus groups and presentations at national and international conferences to share findings and explore perspectives on them.
Following the consultation period the core curriculum statement, ‘Being a General Practitioner’1, was written together with more detailed supplementary statementsQ1: I think it would be useful to put the full list of statements in a box – this short paper acts as an introduction to the curriculum – so the list would help the reader's understanding. The statements were circulated widely in draft form to more stakeholders, lay and trainee representatives as well as specialist interest groups within the RCGP and posted on the RCGP website. There followed a further period of even wider formal consultation prior to submission of the curriculum to PMETB for approval. It was approved unconditionally in 2006; a testimony to the hard work and extensive consultation exercise.
Being a General Practitioner is the ‘core’ statement. It is essential reading because it specifies the generic professional competences required for UK general practice. Specific clinical areas of application are dealt with in the other curriculum statements but the ‘core’ statement underpins them all.
‘Being a General Practitioner’ provides the framework for the structured educational programmes, which are delivered in, deaneries across the country. While the design of the programmes vary according to local requirements, the knowledge, competences, clinical and communication skills and profession attitudes remain the same irrespective of whether the Specialty Registrar is based in an inner city practice or in a rural environment in any of the four countries of the UK.
This is because the curriculum has been the subject of intense research and consultation and draws explicitly upon The European Definition of General Practice/Family Medicine as set out by the European Academy of Teachers in General Practice (EURACT)2 and has been mapped against Good Medical Practice, the General Medical Council's guidance on the duties of a doctor registered with the General Medical Council.3
The European Definition of General Practice/Family Medicine contains six domains of core competence described on a background of three essential features fundamental to a person-centred scientific discipline. From these the RCGP developed generic competences of the general practitioner, and also subject specific competences.
These six domains of competence are:
- Primary care management
- Person-centred care
- Specific problem-solving skills
- A comprehensive approach
- Community orientation
- A holistic approach
The three essential features fundamental to a person-centred scientific discipline are:
- Contextual: using the context of the person, the family, the community and their culture
- Attitudinal: based on the doctor's professional capabilities, values and ethics
- Scientific: adopting a critical and research based approach to practice and maintaining this through continuing learning and quality improvement
The framework is set within a pedagogical approach that supports the preparation of lifelong learners. This is a necessary prerequisite for doctors to sustain their capacity to practice effectively in an environment of changing expectations about appropriate practice. This approach recognizes that individuals learn at different rates and use different styles. It also is explicit in recognizing that learning is enhanced when individuals are actively involved in identifying their needs and contributes to planning, implementing and evaluating their programme of learning.
The curriculum has been developed with three principal audiences in mind: trainees, educators and assessors. For trainees, it contains the elements of knowledge, skills and attitudes that will assist them in reaching and demonstrating required competences. For educators with responsibilities as facilitators or managers of learning, it is a framework which, shaped by professional practice, is a basis for their dialogues with trainees as learners. For assessors, it is a resource that enables them to interpret learning outcomes into valid and reliable tests of those competences.
All three audiences require a deep understanding of the ‘core’ statement ‘Being a General Practitioner‘ and over the years ahead, InnovAiT will help guide the way.
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1 Royal College of General Practitioners Being a General Practitioner London: RCGP; 2007
2 WONCA Europe The European Definition of General Practice/Family Medicine London: WONCA Europe; 2005
3 General Medical Council Good Medical Practice, 3rd edition. London: GMC; 2001
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