Keeping up to date. GMC guidance on Continuing Professional Development

Introduction 

1.         High quality patient care depends on doctors making sure that they maintain and improve the standards of their practice of medicine. What doctors learn at medical school and in their postgraduate training needs to be updated throughout their careers to reflect changes in practice and changes in the needs and aspirations of patients.

2.         This is why all doctors have a professional responsibility to keep themselves up to date. The GMC requires of doctors that:

‘You must keep your knowledge and skills up to date throughout your working life.  In particular, you should take part regularly in educational activities which maintain and further develop your competence and performance.’[1]

It is also why, with the introduction of revalidation, all doctors will be required to demonstrate regularly that they are fulfilling this professional obligation. 

3.         This guidance is designed to help:

a.                  Doctors considering how best to maintain and improve their practice.

b.                  Professional colleagues involved in helping doctors maintain and improve their practice, for example through appraisal or mentoring.

c.                  Individuals and organisations who provide specific development opportunities such as courses or programmes.

d.                  Organisations who undertake the quality assurance of what individuals do to maintain and improve their practice.

What is CPD?

4.         For the purposes of this guidance, we define CPD as being a continuing process outside formal undergraduate and postgraduate training that allows individual doctors to maintain and improve standards of medical practice through the development of knowledge, skills, attitudes and behaviour.[2] CPD may also facilitate specific changes in practice. It may have a role to play in enabling doctors to keep up to date when not currently practising.

 Content of CPD activity

5.         Individual doctors need to keep themselves up to date in all the areas of Good Medical Practice:

·                    Good professional practice

·                    Maintaining good medical practice.

·                    Relationships with patients.

·                    Working with colleagues.

·                    Teaching and training

·                    Probity

·                    Health

7.         What doctors do in their CPD should be relevant to their practice.  It should therefore:

a.                  Be informed by reflection on their work and the identification of areas where further development is needed. 

b.                  Relate to the professional development of the individual doctor in the context of the organisation for which the doctor works.

c.                  Cover all areas of their medical practice, including non-clinical areas such as management, research and teaching.

d.                  Be informed by understanding the environment in which the doctor works.
 

e.                  Recognise the benefits of learning across professional boundaries.   

8.         Maintaining and improving one’s practice requires involvement in different types of activity. The approaches adopted by different doctors vary according to their specialty and field of practice. They should certainly not be restricted to attendance at formal off-site lectures which may play a part. Learning from peers and patients within the doctor’s workplace can be particularly effective.[3]

 The role of professional organisations

9.         Doctors may find it helpful to involve a professional organisation, such as a Royal College, in their CPD activities. This involvement can give doctors confidence in the value of the activities that they have been undertaking.  It would also be helpful to the doctor in relation to appraisal (at the doctor’s place of work) and revalidation of the doctor’s licence to practise (by the General Medical Council).

10.       There are a number of different ways in which professional organisations might be involved. These include the provision of specialty-specific guidance, the accreditation of courses and quality assurance.

11.       Specialty-specific guidance might be provided on areas such as:

a.                  The knowledge, skills and attitudes expected of a doctor.

b.         Ways to identify individuals’ areas of strength and weakness so they can make the best use of CPD

c.                  The commitment that it would be sensible to make to different aspects of CPD.

12.       In addition to offering specialty-specific guidance on CPD, professional organisations could consider the effectiveness of specific courses or activities, for example through a system of course accreditation.

13.       Professional organisations might also be able to certify the extent of doctors’ CPD activities. This certification could be audited in order to verify that claimed activities have been undertaken and are appropriate.[4]  

14.       The Academy of Medical Royal Colleges has published a helpful framework for the involvement of Royal Colleges in CPD.[5]

Principles for CPD activity

15.       The way in which individual doctors undertake CPD activity varies depending upon specialty, opportunity, priorities and personal learning styles. We encourage this diversity, since without it CPD activities would be less effective. 

16.       There are, however, certain principles that those involved in CPD may wish to bear in mind. 

a.                  The overall objective of CPD is to improve health care for patients.
 

b.                  CPD also helps doctors to improve their career opportunities and work satisfaction. 

c.         CPD should cover all aspects of Good Medical Practice and doctors should keep up-to-date in all areas of their medical practice. 

d.         Doctors should target much of their CPD activities at meeting specific needs and outcomes. These should be defined by the doctor, but should take account of the advice of relevant professional organisations and the needs of the service in which the doctor practises. A range of types of activities will normally be appropriate. 

e.         Public and patient involvement should be incorporated into CPD[6], in particular in the development of CPD schemes, standard setting and quality assurance. It is also essential that doctors are up-to-date in relation to the expectations of patients and the public.  

f.          All doctors should support medical and other colleagues who are undertaking CPD. This support might be direct or it might be recognition of the importance of providing opportunities for CPD to take place.

g.         Doctors should discuss and review their CPD with others as appropriate. Appraisal systems provide the main opportunity for ensuring that CPD is relevant to the doctor’s practice, bearing in mind the needs of the doctor and the organisation and any guidance available from professional organisations.
 

h.         Incorporating measures of assessment to allow doctors to be clear about how they are developing will help the individual doctor to judge his or her progress and might be helpful when doctors are required to demonstrate that they are up-to-date in the context of revalidation. Any such measures should be valid and reliable.