The lack of time and support to make a reality of reflective practice is one of the biggest challenges of medical professionalism, doctors of all grades reveal.
A new GMC report examines medical professionalism and how challenges to its promotion can be tackled through collaboration and teamwork.
The Medical Professionalism Matters report is the culmination of 18 months of events and conversations with the medical profession, from GPs, consultants and trainees to royal colleges, training providers and employers.
As is widely acknowledged many doctors feel the current environment is the most challenging of their careers, as the pressures of day-to-day practice rise with the often conflicting demands of doctors’ employers and the patients they care for.
Among the most frequently raised issues were making a reality of reflective practice, problems around professional isolation, fragmentation of care for patients and poor communication.
One of the biggest complaints was about the yawning communication gap between primary and secondary care, which many felt had worsened in the last 20 years.
Meanwhile many felt that doctors in training were especially vulnerable because their constant rotations meant they never feel part of a team.
The GMC’s Chair, Professor Terence Stephenson, said: “We all know medicine is immensely challenging and sometimes issues can seem insurmountable. But throughout this series I have been incredibly heartened and encouraged by the amount of passion and determination participants showed towards finding collaborative solutions to the challenges the profession as a whole faces.
“It has been immensely gratifying to hear views and ideas from such a wide range of doctors, from across the profession and across the UK.”
The advisory group behind the report make a range of recommendations:
- The GMC and Medical Schools Council working with medical schools to make sure there is a stronger focus on understanding medical professionalism within the undergraduate curriculum. This would help students reflect on the realities of practice and the complex human interactions involved.
- Medical schools strengthening their efforts to prepare students for the transition to practice.
- Medical royal colleges and the GMC working together to reinvigorate continuing professional development, with an emphasis on reflection and changing practice rather than ticking boxes. This would include challenging areas of practice such as having difficult conversations and effective team working.
- The GMC, alongside other systems regulators and improvement bodies, intensifying their efforts to promote a culture of openness, learning and candour, recognising that the professional may be the ‘second victim’ when things go wrong in healthcare.
- All organisations doing more to recognise the intense pressure on the profession and make it more acceptable for people to ask for help when they are struggling. This would include the GMC continuing to implement its programme of reforms to take account of doctors’ mental health when facing fitness to practise procedures.
Stephenson continued: “I hope this report will provide us with the start of an important conversation about how we can work together to achieve positive change. In taking findings forward we also need to celebrate everything that is astounding and transformational about the profession.”
The themes will be discussed further at the GMC’s conference and the organisations involved through the advisory group have each committed to taking forward the learning through further conversations.