Development of a GMC aligned curriculum for internal medicine including a qualitative study of the acceptability of ‘capabilities in practice’ as a curriculum model

Abstract

The Shape of Training review and the General Medical Council (GMC) requirements in demonstrating generic professional capabilities were major drivers for the Joint Royal Colleges of Physicians Training Board (JRCPTB) to develop the new internal medicine curriculum. In particular, the GMC required progression to a more outcomes-based curriculum. The present curricula for physician training are based on demonstrating a large number of individual competencies that are assessed by a variety of different methods. It was felt that current system was overwhelming and had become a 'tick box' exercise. The new curriculum is based on a much smaller number of outcomes, called capabilities in practice, which reflect the key professional work activities of a fully trained physician. The aim is to re-emphasise the role of professional judgement in 'trusting' the work a trainee does and thus make assessment more realistic and meaningful for both trainees and trainers. The proof of concept study explored the feasibility of using this outcomes-based model of assessment in a UK NHS setting. The learning from the study has enabled us to make significant changes to the internal medicine curriculum. The GMC has recently approved the curriculum and the JRCPTB is implementing the programme from August 2019.