Edited to be addressed in second person rather than third person. Changed “resident” to “doctor.” / Good Medical Practice (Proposed version June 2006, except “Duties of a Doctor” is from December draft)
Spelling Americanized. Sorted by paragraph into the taxonomy of the ACGME Competencies. Headers aggregated at the beginning of each related ACGME section; asterisk indicates secondary assignment of GMP header to more than one ACGME Competency. / Physician Accountability for Physician Competence Summit Work Group
Assigned to the ACGME Competency without regard to GMP matching / Global Minimum Essential Requirements
Institute for International Medical Education
Medical Education, 2002 / CANMEDS 2005
Only the competency statements have been inserted here. The definitions, elements, etc. can be found in the attached copy of CanMEDS. Items included here are highlighted in that copy.
The duties of a doctor registered with the General Medical Council [1]
Patients must be able to trust doctors with their lives and health. To justify that trust you must: [3-4]
You are personally accountable for your professional practice and must always be prepared to justify your actions and decisions. [35-36]
Duties and responsibilities of doctors [37]
The guidance which follows describes the principles of good medical practice and standards of competence, care and conduct expected of you in all aspects of your professional life.
Good Medical Practice is not exhaustive. It cannot cover all forms of professional practice or misconduct which may bring your registration into question. However, serious or persistent failure to follow this guidance will put your registration at risk. [39-45] / Public Statement of Definition
Physician competence is a measurable demonstration of skills, knowledge, and behaviors that meet professional standards, is in the best interest of the patient’s health while being empathetic to the patient’s wants in the context of society’s needs as a whole.
The assurance of competence of a physician is a shared responsibility of the individual physician, the entity that grants a legal privilege to practice medicine, the medical profession, and the public. [5-11]
*GMP Headers – Because the GMP headers are often used as “short-hand” for the detailed competencies, the headers have been listed opposite the ACGME Competency headers. Where content under GMP headers is divided across several ACGME Competencies, the GMP header is listed in each, but with an asterisk for all but the primary mapping.
ACGME Competencies Vers. 1.3 (9.28.99)Edited to be addressed in second person rather than third person. Changed “resident” to “doctor.” / Good Medical Practice (Proposed version June 2006, except “Duties of a Doctor” is from December draft)
Spelling Americanized. Sorted by paragraph into the taxonomy of the ACGME Competencies. Headers aggregated at the beginning of each related ACGME section; asterisk indicates secondary assignment of GMP header to more than one ACGME Competency. / Physician Accountability for Physician Competence Summit Work Group
Assigned to the ACGME Competency without regard to GMP matching / Global Minimum Essential Requirements
Institute for International Medical Education
Medical Education, 2002 / CANMEDS 2005
Only the competency statements have been inserted here. The definitions, elements, etc. can be found in the attached copy of CanMEDS. Items included here are highlighted in that copy.
PATIENT CARE
As a doctor, you must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. / Good clinical care [49]
Decisions about access to medical care [87]
Relatives, carers and partners [226]
Ending professional relationships with patients[278]
*Working with colleagues [295]
Arranging cover[346]
*Sharing information with colleagues [361]
Delegation and referral[379]
Make the care of your patient your first concern; [7]
Provide a good standard of practice and care; [8]
Good clinical care must include: [51] / Clinical Skills [110]
The graduates must diagnose and manage the care of patients in an effective and efficient way. In order to do so, he/she must be able to: [112-113] / MEDICAL EXPERT [4]
Demonstrate compassionate and patient-centered care [57]
You are expected to communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families / Respect each patient's dignity and individuality;
Treat every patient politely and considerately; [16-17]
You should treat relatives, carers, partners and others close to the patient considerately, and be sensitive and responsive in providing information and support, including after a patient has died, while following the guidance in Confidentiality: Protecting and Providing Information. [228-231]
You are expected to gather essential and accurate information about your patients / Adequately assessing the patient's conditions, taking account of the history (including the symptoms, psychological and social factors), the patient's own priorities, and where necessary examining the patient; [52-54] / Assessment [28] / take an appropriate history including social issues such as occupational health; [115]
perform a physical and mental status examination; [117] / Perform a complete and appropriate assessment of a patient; [40]
For the purposes of prevention and health promotion, diagnosis and ormanagement, elicit a history that is relevant, concise and accurate tocontext and preferences [73-74]
For the purposes of prevention and health promotion, diagnosis and/ormanagement, perform a focused physical examination that is relevantand accurate [75-76]
Select medically appropriate investigative methods in a resourceeffectiveand ethical manner [77]
Effectively facilitate a structured clinical encounter [172]
Accurately elicit and synthesize relevant information and perspectives of patients and families, colleagues, and other professionals [173-174]
Gather information about a disease, but also about a patient’s beliefs,concerns, expectations and illness experience [175-176]
Seek out and synthesize relevant information from other sources, such as apatient’s family, caregivers and other professionals [177-178]
You are expected to make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment / Respect patients' right to reach decisions with you about their treatment and care; [24-25]
The investigations or treatment you provide or arrange must be based on the assessment you and the patient make of their priorities, and your clinical judgment about the likely effectiveness of the treatment options. [89-91] / Diagnosis [29]
Treatment [30] / apply basic diagnostic and technical procedures, to analyze and interpret findings, and to define the nature of a problem; [119-120]
perform appropriate diagnostic and therapeutic strategies with the focus on life-saving procedures and applying principles of best evidence medicine; [122-123]
identify, formulate and solve patients' problems using scientific thinking and based on obtained and correlated information from different sources; [218-219]
formulate hypotheses, collect and critically evaluate data, for the solution of problems. [223] / Effectively identify and explore issues to be addressed in a patientencounter, including the patient’s context and preferences [71-72]
Use preventive and therapeutic interventions effectively; [41]
Demonstrate effective, appropriate, and timely application of preventiveand therapeutic interventions relevant to the physician’s practice [83-84]
Effectively identify and explore problems to be addressed from a patientencounter, including the patient’s context, responses, concerns, andpreferences [186-188]
You are expected to develop and carry out patient management plans / Providing or arranging advice, investigations or treatment where necessary; [55-56]
Prescribe drugs or treatment, including repeat prescriptions, only where you have adequate knowledge of the patient's health and are satisfied that they serve the patient's needs; [62-64] / personal responsibility for the care of individual patients. [43]
exercise clinical judgment to establish diagnoses and therapies; [125] / Effectively perform a consultation, including the presentation of welldocumentedassessments and recommendations in written and/or verbalform in response to a request from another health care professional [50-52]
Demonstrate effective clinical problem solving and judgment to addresspatient problems, including interpreting available data and integratinginformation to generate differential diagnoses and management plans [78-80]
Implement an effective management plan in collaboration with a patientand their family [82]
Engage patients, families, and relevant health professionals in shareddecision-making to develop a plan of care [192-193]
You are expected to counsel and educate patients and their families / Accurately convey relevant information and explanations to patients and families, colleagues and other professionals [179-180]
You are expected to use information technology to support patient care decisions and patient education / retrieve patient-specific information from a clinical data system; [192]
use information and communication technology to assist in diagnostic, therapeutic and preventive measures, and for surveillance and monitoring health status; [194-195]
understand the application and limitations of information technology; [197] / Employ information technology appropriately for patient care [339]
You are expected to perform competently all medical and invasive procedures considered essential for the area of your practice / Specialty principles & practice
Osteopathic principles [33-34]
Competency in procedures [38] / Demonstrate proficient and appropriate use of procedural skills, both diagnosticand therapeutic; [42-43]
Demonstrate effective, appropriate, and timely performance of diagnosticprocedures relevant to their practice [89-90]
Demonstrate effective, appropriate, and timely performance of therapeuticprocedures relevant to their practice [91-92]
You are expected to provide health care services aimed at preventing health problems or maintaining health / You should encourage patients and the public to understand and take action to improve their health. This may include the effects of their life choices on their health and well-being and the outcomes of their treatments. [97-99] / manage patients in an effective, efficient and ethical manner including health promotion and disease prevention; [131-132] / Respond to individual patient health needs and issues as part of patient care 387]
Identify the health needs of an individual patient [388]
Identify opportunities for advocacy, health promotion and disease preventionwith individuals to whom they provide care [389-390]
Promote the health of individual patients, communities, and populations [402]
You are expected to work with health care professionals, including those from other disciplines, to provide patient-focused care / Co-operate with colleagues; [11]
Referring the patient to another practitioner, when this is in their best interests. [57-58]
Respect the patient’s right to seek a second opinion; [67]
Consult and take advice from colleagues, where appropriate; [73]
You must be satisfied that, when you are off duty, suitable arrangements have been made for your patients' medical care. These arrangements should include effective handover procedures, involving clear communication with healthcare colleagues. If arrangements are not satisfactory, you should take steps to safeguard patient care and follow the guidance in paragraph 4 (see under “System Based Practice”). [348-352]
Sharing information with other healthcare professionals is important for safe and effective patient care. [363-364]
Delegation involves asking a colleague to provide treatment or care on your behalf. You will still be responsible for the overall management of the patient, and accountable for your decision to delegate. When you delegate care or treatment you must be satisfied that the person to whom you delegate has the qualifications, experience, knowledge and skills to perform the duties which they will be required to carry out. You must always pass on enough information about the patient and the treatment needed. [381-387]
Referral involves transferring some or all of the responsibility for the patient's care, usually temporarily and for a particular purpose, such as additional investigation, care or treatment, which falls outside your competence. You must be satisfied that any health care professional to whom you refer a patient is accountable to a statutory regulatory body. If this is not the case, the transfer of care should be regarded as delegation, and you will remain responsible for the overall management of the patient, and accountable for your decision to delegate. [389-395] / Effective Referral [31] / Seek appropriate consultation from other health professionals, recognizing thelimits of their expertise. [44-45]
Demonstrate effective, appropriate, and timely consultation of anotherhealth professional as needed for optimal patient care [100-101]
Effectively work with other health professionals to prevent, negotiate, and resolveinterprofessional conflict. [245-246]Participate effectively and appropriately in an interprofessional healthcare team [249-250]
Work with others to assess, plan, provide and integrate care forindividual patients (or groups of patients) [255-256]
Enter into interdependent relationships with other professions for theprovision of quality care 260]
Patient Care orphans / Recognize and work within your professional competence; [9]
Recognize and work within the limits of your professional competence; [61]
Take steps to alleviate pain and distress whether or not curative treatment is possible; [65-66]
Keep clear, accurate, legible and contemporaneous records, reporting the relevant clinical findings, the decisions made, the information given to patients and any drugs prescribed or other investigation or treatment provided; [68-71]
You must give priority to the investigation and treatment of patients on the basis of clinical need, when such decisions are within your power. If inadequate resources, policies or systems prevent you from doing this and patient safety is or may be compromised, you must follow the guidance at paragraph 4 (see under “Practice Based Learning) [109-112]
All patients are entitled to care and treatment to meet their clinical needs. You must not refuse treatment to patients because their medical condition may put you at risk. Where a patient poses a risk to your health or safety, you should take all available steps to minimize the risk, before providing treatment or making suitable alternative arrangements for treatment. [114-118]
Rarely, there may be circumstances in which the trust between you and a patient has broken down and you find it necessary to end your professional relationship with them. For example, this may occur if a patient has been violent to you or a colleague, has stolen from the premises, or has persistently acted inconsiderately or unreasonably. In such circumstances, you must be satisfied that your decision is fair and does not contravene the guidance in paragraph 5 (see under “Professionalism”). You must be prepared to justify your decision. You should not end relationships with patients solely because they have made a complaint about you or your team, or because of the resource implications of their care or treatment. If you charge fees, you may refuse further treatment for patients unable or unwilling to pay for services already provided. You must follow the guidance in paragraphs 5-8 (see under “Professionalism” and “Patient Care”). [280-288]
You should inform the patient, orally or in writing, of your decision and the reasons for ending the professional relationship. You must also take steps to ensure that arrangements are made promptly for the continuing care of the patient, and hand over records to the patient's new doctors without delay. [290-293] / Record Keeping [32]
Access [35]
Treatment in emergencies [36]
Pain management [40]
Timeliness [37]
Effective use of resources [39]
End of life care [41] / recognition of the moral obligation to provide end-of-life care, including palliation of symptoms; [35]
recognize immediate life-threatening conditions; [127]
manage common medical emergencies; [129] / Effectively and appropriately prioritize professional duties when facedwith multiple patients and problems [55-56]
Ensure patients receive appropriate end-of-life care [86]
Appropriately document and disseminate information related to proceduresperformed and their outcomes [94-95]
Ensure adequate follow-up is arranged for procedures performed [96]
Arrange appropriate follow-up care services for a patient and their family [102]
Maintain clear, accurate, and appropriate records (e.g., written or electronic)of clinical encounters and plans [198-199]
Demonstrate a commitment to delivering the highest quality care andmaintenance of competence [541-542]
ACGME Competencies Vers. 1.3 (9.28.99)
Edited to be addressed in second person rather than third person. Changed “resident” to “doctor.” / Good Medical Practice (Proposed version June 2006, except “Duties of a Doctor” is from December draft)
Spelling Americanized. Sorted by paragraph into the taxonomy of the ACGME Competencies. Headers aggregated at the beginning of each related ACGME section; asterisk indicates secondary assignment of GMP header to more than one ACGME Competency. / Physician Accountability for Physician Competence Summit Work Group
Assigned to the ACGME Competency without regard to GMP matching / Global Minimum Essential Requirements
Institute for International Medical Education
Medical Education, 2002 / CANMEDS 2005
Only the competency statements have been inserted here. The definitions, elements, etc. can be found in the attached copy of CanMEDS. Items included here are highlighted in that copy.
MEDICAL KNOWLEDGE
As a doctor, you must demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care. / *Maintaining good medical practice [125]
Keeping up to date[127]
Keep your professional knowledge and skills up to date; [10]
You must keep your knowledge and skills up to date throughout your working life. You should be familiar with relevant guidelines and developments that affect your work. [129-131] / Scientific Foundation of Medicine [46]
The graduate must possess the knowledge required for the solid scientific foundation of medicine and be able to apply this knowledge to solve medical problems. The graduate must understand the principles underlying medical decisions and actions, and be able to adapt to change with time and the context of his/her practice. In order to achieve these outcomes, the graduate must demonstrate a knowledge and understanding of: [48-52] / *SCHOLAR [415]
Establish and maintain clinical knowledge, skills and attitudes appropriate to theirpractice; [39]
You are expected to demonstrate an investigatory and analytic thinking approach to clinical situations / Accessing and evaluating information [19]
You are expected to know and apply the basic and clinically supportive sciences which are appropriate to your discipline / Mastery of practice specific body of knowledge
How: Continuous certification [20-21] / the normal structure and function of the body as a complex of adaptive biological system;