Since 2011, we have published an annual report on the state of medical education and practice. It sets out what is happening in the education and practice of doctors and considers some of the current challenges facing the profession and the systems in which it works.

Here, Kirk Summerwill, Head of Intelligence and Insight at the GMC and project manager of the report, talks us through its production and the potential of the report to drive improvements for doctors working in the health service.

Why was the first state of medical education and practice report produced in 2011?

We have large volumes of data and there was a need to share it. Back in 2011, our then Chief Executive, Niall Dickson, realised we had an awful lot of data that other people in the healthcare sector would find useful.

This project is not just to do with our regulatory remit – it’s to do with the health of the profession and healthcare systems in general. That was the main driver.

This project is not just to do with our regulatory remit – it’s to do with the health of the profession and healthcare systems in general.

There were other smaller drivers as well, like getting better at making our data usable and making it clear who and what our data is and isn’t useful for. These are questions we didn’t have as mature answers to in 2011 as we do now.

Number of doctors on the medical register 2011-15
Number of doctors on the medical register, incl. non-licensed doctors 2011-15, The state of medical education and practice in the UK 2016, figure 9, p. 29.

What were the main themes that emerged in that first report in 2011 and what trends have been spotted in the past five years?

In 2011, we started out looking at a very wide range of issues – too many to list! Among other things, we considered the key role of education in maintaining high standards and the preparedness of medical graduates when they enter foundation training. We also looked at patterns in complaints about doctors, such as that older and male doctors were more likely to be complained about.

Our liaison teams across the UK have used these findings to help target and tailor the support they give to doctors and employers on the front line.

Over the years we’ve spotted a number of trends on topics like these, like which groups of doctors are more likely to be complained about by, say, the public, and what types of complaints the public make most often. Our liaison teams across the UK have used these findings to help target and tailor the support they give to doctors and employers on the front line.

Number of complaints and investigations received by the GMC during 2011-15
Number of complaints and investigations received by the GMC during 2011-15, The state of medical education and practice in the UK 2016, figure 35, p. 59

In the 2014 report, for the first time, we collected together all of the issues being raised to the GMC via our liaison teams and looked at what doctors were asking for our Standards team’s advice on. We investigated those issues and reported on them in chapter 4 that year. In 2015, we went further and in chapter 3 we looked at all enquiries made to every GMC team.

I think The state of medical education and practice report has prompted us to more deeply investigate issues that were directly reported by doctors and employers.

So, more than just picking up trends over the years I think The state of medical education and practice report has prompted us to more deeply investigate issues that were directly reported by doctors and employers.

Why does the GMC continue to produce the report every year?

We do regular evaluations of the report and we’ve got solid evidence that people in healthcare providers, think tanks and government departments are using the report to make decisions and to inform their research. That’s where its main value lies.

In The state of medical education and practice, we often publish emerging thinking about discussions that are still being had.

But we also know that doctors see the report and the issues raised resonate with them. They can see that we understand a more nuanced view of the health service. They can see that we consider these difficult problems that don’t have clear answers. In The state of medical education and practice, we often publish emerging thinking about discussions that are still being had.

How does the GMC decide which data is included in the report?

It’s difficult to predict which information will be useful for different doctors or for policymakers or for workforce planners, for example, so we divide our energy in two.

Half of it is saying ‘here is as much data as we think could possibly be useful’ and we publish that in reference tables. As far as I know, this is one of the largest transparency releases of usable, granular, fixed data by any regulator.

We always invite people to suggest what they want or need to know about the profession.

On the other half, we have the written content in the report itself. This is put together by our insight team, which is made up of contextual researchers, specialists in the healthcare sector and experts who have a deep understanding of how to analyse data and make sure it’s meaningfully interpreted.

Demographic characteristics of licensed doctors on the register and medical students in 2015
Demographic characteristics of licensed doctors on the register and medical students in 2015, The state of medical education and practice in the UK 2016, figure 1, p. 7

These people comb through all our data and pick out the most compelling, unusual or meaningful stories that we think people should be made aware of. For example, which doctors are being complained about and are they being complained about for any reason our data can help identify? Who refers doctors to the GMC and for what reason? These are all important questions that doctors and their employers would find useful to answer.

How do people from outside the GMC feed into the report?

We may not be the people who know what is useful for different groups in the health service. That’s why we always invite people to suggest what they want or need to know about the profession.

One of the main considerations when compiling the report is which issues doctors have raised with us.

As I mentioned earlier, one of the main considerations when compiling the report is which issues doctors have raised with us. We look at what doctors have been asking our contact centre team about and what types of ethical queries our Standards team has received.

Questions might also come from doctors who attend a workshop with one of our liaison advisers in England, Scotland, Wales or Northern Ireland. This helps us identify where there are country or region specific issues. Our employer liaison advisers keep us up to date on the issues affecting those who employ doctors across the UK.

We have external reviewers from all levels of the health sector who give us feedback on the insight they’d like to know more about.

We also gather insight from a range of specialist teams, such as our equality and diversity team, who collaborate with individuals and organisations from across the health sector. And we have external reviewers from all levels of the health sector who give us feedback on the insight they’d like to know more about.

We combine all this intelligence to inform what we include in the report. Since this project began in 2011, we’ve been pushing to improve how we gather this intelligence and to increase our capacity to analyse it in a way that helps doctors and the public. We’ve come a long way but there is a lot more to come.

Medical students and doctors at each stage of medical education in 2015
Medical students and doctors at each stage of medical education in 2015, The state of medical education and practice in the UK 2016, figure 27, p. 47

How does the insight shared in the report influence the GMC’s work?

We can’t include everything in The state of medical education and practice, but some of the issues that come to light during the process might feed into our wider research programme or they might be considered by our policy teams. For example, insight captured in this report informed our ongoing programme of work to improve doctors’ experiences of the fitness to practise process.

This project also advances our understanding of the data we hold and helps us make sure others use our data correctly and meaningfully when they’re making decisions that might impact on doctors’ working lives.

I would want the people who train and manage doctors to reflect on the types of problems doctors have, to see whether they can intervene to improve these situations – that would be the best possible result of this work.

How do you want other health organisations to use the report?

I’d like to think that this report can help people make better decisions about their doctors, their workforce or how they organise their service. I’d like them to reflect on the types of issues the report highlights and come to us with questions if we can help them make decisions or interpret the data better or change the product to be more useful to doctors and decision-makers.

I would want the people who train and manage doctors and design doctors’ workplaces to reflect on the types of problems doctors have, to see whether they can intervene to improve these situations – that would be the best possible result of this work.

Related posts

Read the full 2016 The state of medical education and practice in the UK report

View our Flickr album to see the key charts and graphs from The state of medical education and practice 2016 report