scholarly journals The far-reaching implications of Montgomery for risk disclosure in practice

2018 ◽  
Vol 24 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Sarah Devaney ◽  
Craig Purshouse ◽  
Emma Cave ◽  
Rob Heywood ◽  
José Miola ◽  
...  
Keyword(s):  
Informed Consent ◽  
Patient Autonomy ◽  
Service Providers ◽  
General Medical Council ◽  
Medical Council ◽  
Court Decisions ◽  
Risk Disclosure ◽  
Risks And Benefits ◽  
Uk Supreme Court ◽  
The Uk

The UK Supreme Court held in Montgomery v Lanarkshire HB (2015) that practitioners must take reasonable care to ensure patients are aware of any material risks involved in treatment. We reviewed all court decisions since Montgomery which deal with the case, to establish how this judgment is being interpreted by the courts and the implications of this for risk disclosure in practice. We found that Montgomery’s application has been expanded in a number of ways: information about reasonable alternatives includes the provision of information about their risks and benefits; Montgomery applies to post- as well as pre-operative disclosure; and the timing of discussion with patients about risks is important. Conversely, there is evidence that the parameters of Montgomery are being curtailed, giving rise to questions about judicial commitment to patient autonomy. In some cases there is focus on the objective risks of procedures as opposed to patients’ subjective concerns; in others, causation of injury is sometimes a factor that will defeat claims. There are also further questions about whether patients now should accept more responsibility for the outcome of decisions they make. We conclude that practitioners engaged in discussions about the risks of proposed treatments and their alternatives have been left in a position of uncertainty by the courts in relation to the obtaining of informed consent in practice. It is now critical that updated guidance is provided by the UK General Medical Council to give practitioners and service providers confidence that they are adhering to the law.

The Duties of Doctors In Medical Education: A Letter To The Editor (Preprint)

2019 ◽  
Author(s):  
Sneha Barai
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Role Models ◽  
Role Model ◽  
General Medical Council ◽  
Future Generations ◽  
Medical Council ◽  
Positive Role ◽  
The Uk ◽  
And Training

UNSTRUCTURED The UK General Medical Council (GMC) explicitly states doctors have a duty to ‘contribute to teaching and training…by acting as a positive role model’. However, recent studies suggest some are not fulfilling this, which is impacting medical students' experiences and attitudes during their training. As such, doctors have a duty to act as role models and teachers, as specified by the GMC, which it seems are not currently being fulfilled. This would improve the medical students’ learning experiences and demonstrate good professional values for them to emulate. Therefore, these duties should be as important as patient care, since this will influence future generations.

scholarly journals Medical Students’ Experience of Mindfulness Training in the UK: Well-Being, Coping Reserve, and Professional Development

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Alice Malpass ◽  
Kate Binnie ◽  
Lauren Robson
Keyword(s):  
Medical Education ◽  
Mental Health Problems ◽  
Qualitative Interviews ◽  
General Medical Council ◽  
Well Being ◽  
Mindfulness Training ◽  
The Body ◽  
Free Text ◽  
Medical Council ◽  
The Uk

Medical school can be a stressful experience for students, resulting in stress-related mental health problems. Policy recommendations from the General Medical Council (GMC), the body responsible for improving medical education in the UK, recommend the use of mindfulness training to increase well-being and resilience to stress. Students participating in an eight-week mindfulness training between Autumn 2011 and Spring 2015 were invited to complete a free text survey at the end of their mindfulness course. In addition, six qualitative interviews were conducted lasting between 60 and 90 minutes. Interviews used a topic guide and were recorded and transcribed verbatim. We used the framework approach to analyse the data. Students reported a new relationship to their thoughts and feelings which gave a greater sense of control and resiliency, an ability to manage their workload better, and more acceptance of their limitations as learners. The small group context was important. Students described improved empathy and communication skills through building inner awareness of thoughts and feelings, noticing judgments, and developing attentive observation. The findings show how resiliency and coping reserve can be developed within medical education and the role of mindfulness in this process. We present a conceptual model of a learnt cycle of specific vulnerability and describe how MBCT intercepts at various junctures in this self-reinforcing cycle through the development of new coping strategies that embrace an “allowed vulnerability.”

The constitutional influence of the Judicial Committee of the Privy Council on the UK apex court: institutional proximity and jurisprudential divergence?

2020 ◽  
Vol 71 (2) ◽  
pp. 285-302
Author(s):  
Roger Masterman
Keyword(s):  
Supreme Court ◽  
Ad Hoc ◽  
Court Decisions ◽  
Privy Council ◽  
House Of Lords ◽  
Uk Supreme Court ◽  
Proportionality Test ◽  
The Uk ◽  
The Relationship

It is often claimed that the constitutional role of the UK’s apex court is enriched as a result of the experiences of the Judicial Committee of the Privy Council as interpreter of constitutions within its overseas jurisdiction. This paper considers the relationship between the House of Lords/UK Supreme Court and the Judicial Committee and its effect on the importation of external influences into the UK’s legal system(s), further seeking to assess how far the jurisprudence of the Judicial Committee has influenced constitutional decision-making in the UK apex court. While ad hoc citation of Privy Council authorities in House of Lords/Supreme Court decisions is relatively commonplace, a post-1998 enthusiasm for reliance on Judicial Committee authority – relating to (i) a ‘generous and purposive’ approach to constitutional interpretation and (ii) supporting the developing domestic test for proportionality – quickly faded. Both areas are illustrative of a diminishing reliance on Judicial Committee authority, but reveal divergent approaches to constitutional borrowing as the UK apex court has incrementally mapped the contours of an autochthonous constitutionalism while simultaneously recognising the trans-jurisdictional qualities of the proportionality test.

scholarly journals Mandating doctors to attend counter-terrorism workshops is medically unethical

2016 ◽  
Vol 40 (2) ◽  
pp. 87-88 ◽  
Author(s):  
Derek Summerfield
Keyword(s):  
Medical Association ◽  
Ethical Leadership ◽  
Ethical Issues ◽  
Civil Liberties ◽  
General Medical Council ◽  
British Medical Association ◽  
Medical Council ◽  
Counter Terrorism ◽  
Mandatory Training ◽  
The Uk

SummaryThis is a brief exploration of the ethical issues raised for psychiatrists, and for universities, schools and wider society, by the demand that they attend mandatory training as part of the UK government's Prevent counter-terrorism strategy. The silence on this matter to date on the part of the General Medical Council, medical Royal Colleges, and the British Medical Association is a failure of ethical leadership. There is also a civil liberties issue, reminiscent of the McCarthyism of 1950s USA. We should refuse to attend.

scholarly journals A survey of communication skills teaching at medical school

2006 ◽  
Vol 88 (3) ◽  
pp. 84-86 ◽  
Author(s):  
Andrew Raftery ◽  
Particia Scowen
Keyword(s):  
Informed Consent ◽  
Medical Students ◽  
Medical School ◽  
Communication Skills ◽  
Undergraduate Education ◽  
General Medical Council ◽  
Skills Assessment ◽  
Medical Council ◽  
Surgical Practice ◽  
Essential Component

Communication is an essential component of surgical practice. Awareness of its importance is increasing among surgeons due to both the association between litigation and poor communication and recent requirements for obtaining informed consent. The General Medical Council has stated that medical students should have acquired and demonstrated their proficiency in communication by the end of their undergraduate education. Furthermore, communication skills assessment is now a pass/fail component of the intercollegiate MRCS examination of the surgical royal colleges.

Mentoring for urologists

2018 ◽  
Vol 12 (2) ◽  
pp. 158-162 ◽  
Author(s):  
Tim Terry ◽  
Nancy Redfern ◽  
Gordon French
Keyword(s):  
Systematic Review ◽  
Case Series ◽  
General Medical Council ◽  
Cross Sectional Study ◽  
Medical Council ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Trained Staff ◽  
The Uk ◽  
Based Medicine

Trainee and established urologists are familiar with ‘generic mentoring’ as a potpourri of helping aids that include supervision, coaching, buddying, career advice, counselling and patronage to enable mentees to develop professionally. However, most are unfamiliar with ‘developmental mentoring’ as a highly specific learnt technique through which mentors help mentees, by interactive dialogue, to choose their own agendas and arrive at their own solutions to career/professional/personal opportunities or difficulties as distinct from the paternalistic mentor approach typified by the downward flow of information generated by ‘generic mentoring’. This paper is a systematic review of developmental mentoring as pertains to urologists in the UK, and reports outcomes of 1-hour taster sessions between Egan-trained mentors and urologists offered at British Association of Urological Surgeons (BAUS) annual general meetings since 2013. Both the General Medical Council and the Royal College of Surgeons of England imply that ‘mentoring’ is mandatory for both trainees and trained urologists, but fail to clarify what they mean by a ‘mentor’, which potentially creates a void in providing ‘developmental mentoring’ since the later requires specific training and is costly to provide. Currently, most ‘developmental mentoring’ is performed by trained staff in Local Education and Training Boards or National Health Service Trusts. BAUS has an opportunity to offer ‘developmental mentoring’ through a portal on its website to manage opportunities and difficulties experienced by its members. Level of evidence: This paper is a systematic review as pertains to the place of mentoring in current urological practice. By its nature, it has reviewed previous narrative reviews and its highest level of evidence is a contemporary paper from 2016, which was a comparative cross-sectional study; other case series were reviewed. Overall, this amounts to level 4 with a recommendation of C as per the Oxford Centre for Evidence-based Medicine Levels of Evidence.

Do junior doctors practise to the UK General Medical Council standards?

2010 ◽  
Vol 7 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Robert Palmer ◽  
Robert Cragg ◽  
David Wall
Keyword(s):  
General Medical Council ◽  
Junior Doctors ◽  
Medical Council ◽  
The Uk

scholarly journals Individual appraisal for senior medical staff

2001 ◽  
Vol 25 (5) ◽  
pp. 166-169 ◽  
Author(s):  
Salwa Khalil ◽  
Elizabeth Parry ◽  
Nick Brown ◽  
Femi Oyebode
Keyword(s):  
Medical Staff ◽  
Clinical Care ◽  
General Medical Council ◽  
Component Part ◽  
Medical Council ◽  
Appraisal System ◽  
Public Attention ◽  
Medical Interventions ◽  
The Us ◽  
The Uk

There is public concern about medical errors. In Britain, the Bristol Inquiry is the paradigmatic example that focuses professional and public attention on the safety of medical interventions. In the US the Institute of Medicine's recent report To Err is Human: Building a Safer Health System (1999) was widely seen on both sides of the Atlantic as confirming what most already feared, that medical interventions were accompanied by unacceptably high levels of preventable harms (Barach & Small, 2000). The response to these public concerns has been multifold. In the UK clinical governance was introduced in April 1999, principally to focus attention on continuously improving the quality of clinical care. At the same time, the arrangements for the registration of doctors by the General Medical Council (GMC) was under review and there was an expectation that NHS trusts would bring consultants, who hitherto had been regarded as independent practitioners outside any supervisory system or arrangement, within an appraisal system. It has become clear that this appraisal system will be a component part of the GMC's revalidation of doctors (GMC, 2000). What is clear is that these varying systems are designed to restore public trust by providing an open process, which has the confidence of the profession, management and public alike. In this paper we aim to discuss the historical development of appraisal as a system for reviewing the performance of individual practitioners, suggest a method for appraising senior medical staff and finally to discuss the limitations and problems inherent in the introduction of such a system.

scholarly journals Comparing international postgraduate training and healthcare context with the UK to streamline overseas GP recruitment: four case studies

BJGP Open ◽  
2020 ◽  
Vol 4 (3) ◽  
pp. bjgpopen20X101034
Author(s):  
Emily Fletcher ◽  
John Campbell ◽  
Emma Pitchforth ◽  
Adrian Freeman ◽  
Leon Poltawski ◽  
...  
Keyword(s):  
South Africa ◽  
General Practice ◽  
New Zealand ◽  
Continuing Professional Development ◽  
General Medical Council ◽  
Rapid Review ◽  
Medical Council ◽  
European Economic Area ◽  
The Uk ◽  
Gp Training

BackgroundThere are ambitious overseas recruitment targets to alleviate current GP shortages in the UK. GP training in European Economic Area (EEA) countries is recognised by the General Medical Council (GMC) as equivalent UK training; non-EEA GPs must obtain a Certificate of Eligibility for General Practice Registration (CEGPR), demonstrating equivalence to UK-trained GPs. The CEGPR may be a barrier to recruiting GPs from non-EEA countries. It is important to facilitate the most streamlined route into UK general practice while maintaining registration standards and patient safety.AimTo apply a previously published mapping methodology to four non-EEA countries: South Africa, US, Canada, and New Zealand.Design & settingDesk-based research was undertaken. This was supplemented with stakeholder interviews.MethodThe method consisted of: (1) a rapid review of 13 non-EEA countries using a structured mapping framework, and publicly available website content and country-based informant interviews; (2) mapping of five ‘domains’ of comparison between four overseas countries and the UK (healthcare context, training pathway, curriculum, assessment, and continuing professional development (CPD) and revalidation). Mapping of the domains involved desk-based research. A red, amber, or green (RAG) rating was applied to indicate the degree of alignment with the UK.ResultsAll four countries were rated ‘green’. Areas of differences that should be considered by regulatory authorities when designing streamlined CEGPR processes for these countries include: healthcare context (South Africa and US), CPD and revalidation (US, Canada, and South Africa), and assessments (New Zealand).ConclusionMapping these four non-EEA countries to the UK provides evidence of utility of the systematic method for comparing GP training between countries, and may support the UK’s ambitions to recruit more GPs to alleviate UK GP workforce pressures.

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