Skills
S1: Demonstrate clinical responsibilities and role of the doctor
S2: Maintain confidentiality and respect patients’ dignity and privacy
S3: Manage their time and prioritise effectively
S4: Recognise and acknowledge their own personal and professional limits and seek help from colleagues and supervisors when necessary, including when they feel that patient safety may be compromised
S5: Protect patients from any risk posed by their own health including: • the risks to their health and to patient safety posed by self-prescribing medication and substance misuse• the risks to their health and to patient safety posed by fatigue – they must apply strategies to limit • the impact of fatigue on their health.
S6: Demonstrate person-centred care and include patients and, where appropriate, their relatives, carers or other advocates in decisions about their healthcare needs
S7: Seek patient consent, or the consent of the person who has parental responsibility in the case of children and young people, or seek the views of those with lasting power of attorney or independent mental capacity advocates
S8: Provide information about options for investigations, treatment and care in a way that enables patients to make decisions about their own care
S9: Assess the mental capacity of a patient to make a particular decision, including when the lack of capacity is temporary, knowing when and how to take action.
S10: Act appropriately, with an inclusive approach, towards patients and colleagues
S11: Raise and escalate concerns through informal communication with colleagues and through formal clinical governance and monitoring systems about:• patient safety and quality of care • bullying, harassment and undermining
S12: Demonstrate commitment to professional development and lifelong learning
S13: Mentor and teach other learners in the multi-professional team
S14: Access and analyse reliable sources of current clinical evidence and guidance and have established methods for making sure their practice is consistent with these
S15: Engage with revalidation, maintaining a professional development portfolio which includes evidence of reflection, achievements, learning needs and feedback from patients and colleagues
S16: Engage in induction and orientation activities, learn from experience and feedback, and respond constructively to the outcomes of appraisals, performance reviews and assessments.
S17: Adhere to the principles of the legal framework in which medicine is practised in the jurisdiction in which they are practising, and is aware of where further information on relevant legislation can be found
S18: Self-monitor, self-care and seek appropriate advice and support, including by being registered with a GP and engaging with them to maintain their own physical and mental health
S19: Manage the personal and emotional challenges of coping with work and workload, uncertainty and change
S20: Develop a range of coping strategies, such as reflection, debriefing, handing over to another colleague, peer support and asking for help, to recover from challenges and set-backs.
S21: Place patients’ needs and safety at the centre of the care process
S22: Promote and maintain health and safety in all care settings and escalate concerns to colleagues where appropriate, including when providing treatment and advice remotely
S23: Learn from their own and others’ errors to promote a culture of safety
S24: Apply measures to prevent the spread of infection, and apply the principles of infection prevention and control
S25: Apply quality improvement to improve practice and seek ways to continually improve the use and prioritisation of resources
S26: Adapt management proposals and strategies for dealing with health problems to take into consideration patients’ preferences, social needs, multiple morbidities, frailty and long term physical and mental conditions
S27: Work collaboratively with patients, their relatives, carers or other advocates, in planning their care, negotiating and sharing information appropriately and supporting patient self-care
S28: Work collaboratively with other health and care professionals and organisations when working with patients, particularly those with multiple morbidities, frailty and long term physical and mental conditions
S29: Recognise how treatment and care can place an additional burden on patients and make decisions to reduce this burden where appropriate, particularly where patients have multiple conditions or are approaching the end of life
S30: Manage the uncertainty of diagnosis and treatment success or failure and communicate this openly and sensitively with patients, their relatives, carers or other advocates
S31: Evaluate the clinical complexities, uncertainties and emotional challenges involved in caring for patients who are approaching the end of their lives and demonstrate the relevant communication techniques and strategies that can be used with the patient, their relatives, carers or other advocates.
S32: Safeguard children, young people, adults and older people, using appropriate systems for sharing information, recording and raising concerns, obtaining advice, making referrals and taking action
S33: Take a history that includes consideration of the patient’s autonomy, views and any associated vulnerability, and reflect this in the care plan and referrals
S34: Assess the needs of, and support required, for children, young people and adults and older people who are the victims of domestic, sexual or other abuse
S35: Assess the needs of, and support required, for people with a learning disability
S36: Assess the needs of, and support required, for people with mental health conditions
S37: Adhere to the professional responsibilities in relation to procedures performed for non-medical reasons, such as female genital mutilation and cosmetic interventions
S38: Take action by seeking advice from colleagues and making appropriate referrals where addiction (to drugs, alcohol, smoking or other substances), poor nutrition, self neglect, environmental exposure, or financial or social deprivation are contributing to ill health
S39: Maintain effective teamwork and interpersonal relationships with a clear shared purpose
S40: Demonstrate leadership and the ability to accept and support leadership by others
S41: Contribute to effective interdisciplinary team working with doctors from all care settings and specialties, and with other health and social care professionals for the provision of safe and high-quality care
S42: Work effectively with colleagues in ways that best serve the interests of patients.
S43: Safely pass on information using clear and appropriate spoken, written and electronic communication: • at handover in a hospital setting and when handing over and maintaining continuity of care in primary, community and social care settings • when referring to colleagues for investigations or advice • when things go wrong, for example when errors happen questioning colleagues during handover where appropriate • working collaboratively and supportively with colleagues to share experiences and challenges that encourage learning • responding appropriately to requests from colleagues to attend patients • applying flexibility, adaptability and a problem-solving approach to shared decision making with colleagues
S44: Recognise and show respect for the roles and expertise of other health and social care professionals and doctors from all specialties and care settings in the context of working and learning as a multi- professional team.
S45: Communicate clearly, sensitively and effectively with patients, their relatives, carers or other advocates, and colleagues from medical and other professions, by: • listening, sharing and responding• demonstrating empathy and compassion• demonstrating effective verbal and non-verbal interpersonal skills• making adjustments to their communication approach if needed, for example for people who communicate differently due to a disability or who speak a different first language• seeking support from colleagues for assistance with communication if needed
S46: Communicate by spoken, written and electronic methods (including in medical records) clearly, sensitively and effectively with patients, their relatives, carers or other advocates, and colleagues from medical and other professions. This includes, but is not limited to, the following situations: • where there is conflict or disagreement • when sharing news about a patient’s condition that may be emotionally challenging for the patient and those close to them • when sharing news about a patient’s death with relatives and carers or other advocates • when discussing issues that may be sensitive for the patient, such as alcohol consumption, smoking, diet and weight management or sexual behaviour • when communicating with people who lack insight into their illness or are ambivalent about treatment • when communicating with children and young people • when communicating with people who have impaired hearing, language, speech or sight • when communicating with people who have cognitive impairment • when communicating with people who have learning disabilities • when English is not the patient’s first language – by using an interpreter, translation service or other online methods of translation • when the patient lacks capacity to reach or communicate a decision on their care needs • when advocating for patients’ needs • when making referrals to colleagues from medical and other professions • when providing care remotely, such as carrying out consultations using telecommunications.
S47: Use methods of communication used by patients and colleagues such as technology-enabled communication platforms, respecting confidentiality and maintaining professional standards of behaviour.
S48: Elicit and accurately record a patient’s medical history, including family and social history, working with parents and carers or other advocates when the patient is a child or young person or an adult who requires the support of a carer or other advocate
S49: Encourage patients’ questions, discuss their understanding of their condition and treatment options, and take into account their ideas concerns, expectations, values and preferences
S50: Acknowledge and discuss information patients have gathered about their conditions and symptoms, taking a collaborative approach
S51: Provide explanation, advice and support that matches patients’ level of understanding and needs, making reasonable adjustments to facilitate patients’ understanding if necessary
S52: Assess a patient’s capacity to understand and retain information and to make a particular decision, making reasonable adjustments to support their decision making if necessary, in accordance with legal requirements in the relevant jurisdiction and the GMC’s ethical guidance as appropriate
S53: Work with patients, or their legal advocates, to agree how they want to be involved in decision making about their care and treatment
S54: Apply scientific principles, methods and knowledge to medical practice and integrate these into patient care.
S55: Select appropriate forms of management for common diseases, and ways of preventing common diseases their modes of action and their risks from first principles
S56: Illustrate, by professional experience, the principles for the identification, safe management and referral of patients with mental health conditions
S57: Conduct appropriate critical appraisal and analysis of clinical data
S58: Interpret and communicate research evidence in a meaningful way for patients to support them in making informed decisions about treatment and management
S59: Apply epidemiological data to manage healthcare for the individual and the community and evaluate the clinical and cost effectiveness of interventions
S60: Apply the basic principles of communicable disease control in hospital and community settings, including disease surveillance
S61: Assess, by taking a history, the environmental, social, psychological, behavioural and cultural factors influencing a patient’s presentation, and identify options to address these, including advocacy for those who are disempowered
S62: Apply social science principles, methods and knowledge to medical practice and integrate these into patient care
S63: Apply the principles, methods and knowledge of population health and the improvement of health and sustainable healthcare to medical practice
S64: Assess, by taking a history, the environmental, social, psychological, behavioural and cultural factors influencing a patient’s presentation, and identify options to address these, including advocacy for those who are disempowered
S65: Apply the principles of primary, secondary and tertiary prevention of disease, including immunisation and screening
S66: Propose an assessment of a patient’s clinical presentation, integrating biological, psychological and social factors, agree this with colleagues and use it to direct and prioritise investigations and care
S67: Safely and sensitively undertake: • an appropriate physical examination (with a chaperone present if appropriate) a mental and cognitive state examination, including establishing if the patient is a risk to themselves or others, seeking support and making referrals if necessary• a developmental examination for children and young people
S68: Interpret findings from history, physical and mental state examinations
S69: Propose a holistic clinical summary, including a prioritised differential diagnosis/diagnoses and problem list
S70: Propose options for investigation, taking into account potential risks, benefits, cost effectiveness and possible side effects and agree in collaboration with colleagues if necessary, which investigations to select
S71: Interpret the results of investigations and diagnostic procedures, in collaboration with colleagues if necessary
S72: Synthesise findings from the history, physical and mental state examinations and investigations, in collaboration with colleagues if necessary, and make proposals about underlying causes or pathology
S73: Make clinical judgements and decisions with a patient, based on the available evidence, in collaboration with colleagues and as appropriate for their level of training and experience, and understand that this may include situations of uncertainty
S74: Take account of patients’ concerns, beliefs, choices and preferences, and respect the rights of patients to reach decisions with their doctor about their treatment and care and to refuse or limit treatment
S75: Seek informed consent for any recommended or preferred options for treatment and care
S76: Propose a plan of management including prevention, treatment, management and discharge or continuing community care, according to established principles and best evidence, in collaboration with other health professionals if necessary
S77: Support and motivate the patient’s self-care by helping them to recognise the benefits of a healthy lifestyle and motivating behaviour change to improve health and include prevention in the patient’s management plan
S78: Make appropriate clinical judgements when considering or providing compassionate interventions or support for patients who are nearing or at the end of life, understanding the need to involve patients, their relatives, carers or other advocates in management decisions, making referrals and seeking advice from colleagues as appropriate
S79: Provide immediate care to adults, children and young people in medical and psychiatric emergencies and seek support from colleagues if necessary
S80: Recognise when a patient is deteriorating and take appropriate action
S81: Assess and determine the severity of a clinical presentation and the need for immediate emergency care
S82: Diagnose and manage acute medical and psychiatric emergencies, escalating appropriately to colleagues for assistance and advice
S83: Perform the core set of practical skills and procedures (defined by the GMC) safely and effectively, and identify, according to own level of skill and experience, the procedures for which they need supervision to ensure patient safety
S84: Provide immediate life support (GMC Practical Skills and Procedures)
S85: Provide cardiopulmonary resuscitation (GMC Practical Skills and Procedures)
S86: Establish an accurate medication history, covering both prescribed medication and other drugs or supplements, and establish medication allergies and the types of medication interactions that patients experience
S87: Carry out an assessment of benefit and risk for the patient of starting a new medication taking into account the medication history and potential medication interactions in collaboration with the patient and, if appropriate, their relatives, carers or other advocates
S88: Provide patients, their relatives, carers or other advocates, with appropriate information about their medications in a way that enables patients to make decisions about the medications they take
S89: Agree a medication plan with the patient that they are willing and able to follow
S90: Access reliable information about medications and be able to use the different technologies used to support prescribing
S91: Calculate safe and appropriate medication doses and record the outcome accurately
S92: Write a safe and legal prescription, tailored to the specific needs of individual patients, using either paper or electronic systems and using decision support tools where necessary
S93: Prescribe in consultation with clinical pharmacologists and pharmacists and other colleagues as appropriate
S94: Communicate appropriate information to patients about what their medication is for, when and for how long to take it, what benefits to expect, any important adverse effects that may occur and what follow-up will be required
S95: Detect and report adverse medication reactions and therapeutic interactions and react appropriately by stopping or changing medication
S96: Monitor the efficacy and effects of medication and with appropriate advice from colleagues, reacting appropriately by adjusting medication, including stopping medication with due support, care and attention if it proves ineffective, is no longer needed or the patient wishes to stop taking it
S97: Respect patient choices about the use of complementary therapies
S98: Make effective use of decision making and diagnostic technologies
S99: Apply the requirements of confidentiality and data protection legislation and comply with local information governance and storage procedures when recording and coding patient information
S100: Apply the principles of health informatics applied to medical practice
S101: Interpret common statistical tests used in medical research publications
S102: Critically appraise research information, including study design, the results of relevant diagnostic, prognostic and treatment trials, and other qualitative and quantitative studies as reported in the medical and scientific literature
S103: Formulate simple relevant research questions in biomedical science, psychosocial science or population science, and design appropriate studies or experiments to address the questions
S104: Evidence from large scale public health reviews and other sources of public health data to
inform decisions about the care of individual patients
