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Overview of the Education & Training Section

The framework

High quality medical education and training lays the foundation for a doctor’s career and provides a platform for lifelong learning. It is a core factor in determining the quality of patient care. This is reflected in the object of the Medical Council, set out in the Medical Practitioners Act 2007; “...to protect the public by promoting and better ensuring high standards of...professional education, training and competence...”

Part 10 of the Medical Practitioners Act 2007, “Education and Training”, gives the Medical Council an explicit and expanded role in education and training. This spans the spectrum of medical education and training; from entry into medical school, through internship, basic and higher specialist training, into independent practice. The scope and complexity of the work to be done is striking. However, the focus is clear: it is quality assurance, i.e. the setting of standards and the assessing and monitoring of their implementation. Council’s Professional Development Committee is the focal point for this activity. Much of it is work in progress.

Setting standards

The Council is very conscious of the need to strike the right balance between having the robust standards required in the Act and being overly prescriptive or inflexible. Council recognises that there are a variety of ways of developing competence & a number of different pathways to the same objective and the emphasis of the Council standards is on outcomes.

Principles and values of good medical practice can be broadly categorised into a number of categories or domains, and these are being used as the framework for development. These domains – which incorporate the core elements of patient safety, professionalism, clinical skills, relating to patients, communication, collaboration and teamwork, management (including self-management) and scholarship, are applicable to all stages of education, training and professional competence.

Guidelines on the curriculum and content of undergraduate programmes; on medical education and training for interns; and on specialist medical education and training will also reflect this approach.

The ethical standards and behaviour for medical students guidelines will reflect the need for medical students, as “apprentice” medical practitioners who have contact with patients and their relatives, to maintain appropriate standards. The medical schools have indicated that they would welcome this guidance.

Monitoring standards

The Council also has to ensure that the standards it is developing are delivered by medical schools, training sites, and postgraduate training bodies; that there is adherence to the criteria, the guidelines and the standards.

Council continues its long-standing role in evaluating undergraduate medical programmes and schools, and all nine undergraduate medical programmes in Ireland are either fully accredited or provisionally accredited pending the graduation of the first students. This monitoring, which assesses teaching and learning on campus and on training sites, reveals continuing evolution, from six to five year programmes for school leavers, to four year programmes for graduate entrants, early exposure to clinical experience, emphasis on interactive learning, student involvement in curriculum development, effective use of technology, some impressive new facilities, and greater use of primary and community care sites for clinical teaching.

Applications to Council requesting recognition as a postgraduate specialty will be evaluated. In its assessment, Council will, among other things, seek evidence of a demonstrable need for those specialist medical services, and confirmation that recognition is in the best interests of the community in Ireland.

Council undertook inspections of clinical training sites under the previous acts, and it is required to do so under the 2007 Act. However, it is conscious of the need to avoid over-inspection and duplication of effort, and will be looking to minimise this.

Perhaps the biggest challenge in this area is the approval of postgraduate training bodies. 13 are currently approved, and a timetable will be drawn up for their assessment and the evaluation of any aspirant bodies.

The Pre-Registration Examination System has succeeded the Temporary Registration Assessment Scheme as the assessment for non-EU doctors who wish to come and practice in Ireland and who are not otherwise exempt. Review and revision of the PRES will continue to take place as part the Council’s key role of ensuring the competency of registrants.

Transparency and accountability

There is an emphasis in the 2007 Act on transparency, e.g. in the requirement to publish the reports of inspections, and this approach is shared by Council. A period of public consultation on the draft Education and Training Rules recently took place, and the Council will take responses into account.

Quality education and training requires dialogue and partnership between Council and stakeholders. These include patients, the wider public, medical students, trainees and the medical profession in general, medical schools and universities, postgraduate training bodies, training sites, the Heath Service Executive, and the Departments of Health & Children and Education & Science. There will be open channels of communication as Council undertakes its role in ensuring the quality of the education and training for the next generation of doctors, and the development and maintenance of competence among current registrants.