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Just how prepared can we expect new medical graduates to be?
  1. Emma Salisbury,
  2. Andrew Frankel
  1. Renal Department, Imperial College Healthcare NHS Trust, London, UK
  1. Correspondence to Dr Emma Salisbury, 1 Atalanta Street, London SW6 6TU, UK; emmasalisbury{at}

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The problem

In December 2010, The Lancet published the findings of a global independent commission of 20 professional and academic leaders who came together to develop a shared vision and a common strategy for education in medicine.1 Their problem statement was damning, “….fresh health challenges loom.….Professional education has not kept pace with these challenges, largely because of fragmented, outdated and static curricula that produce ill-equipped graduates.”1 They urged ‘concerned stakeholders’ to join them in ‘rethinking for reforms of professional education’ and in response, in 2011 the General Medical Council (GMC) published the first edition of a report entitled ‘The state of medical education and practice in the UK’.2 The GMC is ultimately responsible for determining and assuring quality of the outcomes of medical education and training in the UK, and sets out the standards for undergraduate education in the document ‘Tomorrow's Doctors 2009’.3

The ‘fresh health challenges’ referred to by The Lancet report describe the advance of modern medicine seen by industrialised nations such as the UK, combined with better hygiene, vaccination programmes and greater relative affluence. People are living longer, but with a growing burden of chronic disease. The public has also become better educated and more informed, assisted by the information technology revolution.2 These factors have placed increasing demands on the healthcare service, as well as contributing to an altered doctor–patient relationship with a new emphasis on partnership and negotiated care.2 As pressure on the healthcare service has mounted, tensions have grown between service delivery and protected time for medical education and training.2

The knowledge, skills and behaviour that undergraduates need to learn at UK medical schools are set out by the GMC which stipulates that newly graduated doctors, ‘must be able to …

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