About the core content
About the core content of learning
What are the aims of the core content?
It provides a necessary core of knowledge, skills, attitudes and behaviours in medical ethics and law for doctors of tomorrow.
The ethics component of the core has two main complementary purposes:
- Creating ‘virtuous doctors’
- Providing them with a skill set for analyzing and resolving ethical problems (though these are sometimes seen as being in tension with each other).
The topics are expressed as learning outcomes for which students should be able to demonstrate a critically reflective understanding (that includes the requisite knowledge) and appropriate attitudes and practical skills. We also wish to combat the ‘silent curriculum’.
Who decided what is ‘necessary’?
In March 2006 the IME, BMA and the HEA held a conference on learning, teaching and assessing medical ethics and law.
Participants agreed that the 1998 consensus statement was now ‘ripe for reconsideration’ because some of the topics and emphasis were dated; issues could now be addressed that had not previously been considered in sufficient detail and some subjects might be more appropriate for postgraduate rather than undergraduate study.
They also considered that the form and quality of assessment were currently greatly constrained by resources (particularly staff) and some assessment tools were inappropriate and applied uncritically. Concern was expressed about the possible marginalisation of ethics and law within the curriculum.
In 2007 the IME initiated a project to promote good practice in the teaching, learning and assessment of medical ethics and law across the UK’s by now 32 medical schools.
The extensive consultation process to update the core content of learning for medical ethics and law began at the 2009 IME conference
Participants (medical practitioners, teachers of ethics and law in medical schools, other healthcare professionals and medical students) reviewed the 1998 Consensus Statement, the UNESCO Bioethics Core Curriculum and a revised set of aims of teaching medical ethics and law.
A subsequent consultation document was also informed inter alia by guidelines from the GMC and other relevant authorities. It was placed on the IME website to which a wide range of individuals and interested bodies were invited to respond. In addition to individual responses, comments were received on behalf of most medical schools, the GMC, the Postgraduate Medical Education Training Board (subsequently merged with the GMC), several medical Royal Colleges and a medical defence organisation.
The core content was produced after several iterations by the project Steering Group and published as:
Stirrat GM, Johnston C, Gillon R, Boyd K. Medical ethics and law for doctors of tomorrow: the 1998 consensus statement updated. J Med Ethics 2010;36:55-60
Assumptions on which the core content of learning is based
A foundation in medical ethics and law:
- Is essential for students to become good doctors (as set out in the GMC’s ‘Good Medical Practice’).
- Is a necessary part of all clinical encounters and medical and public health interventions.
- Serves as a framework for understanding duties and responsibilities required for good medical practice.
- Underscores and explores the key importance in good medical practice of benefitting the health of individuals and populations whilst minimising harm in ways that respect autonomy and are just.
- Enables identification of ethical or legal issues in practice.
- Facilitates reflective and critical thinking on the practical application of the core content
What authority does it have?
One of its main strengths is its comprehensiveness. We sought and listened to the views of doctors, ethicists and lawyers involved in teaching medical ethics and law as well as students, lay people and the GMC and other bodies with responsibilities for, or interests in, medical education.
Crucially the GMC and BMA have confirmed that the revised core content of learning is consistent with their guidance on undergraduate education.
Since the GMC requires that educational facilities and infrastructure be appropriate to deliver the curriculum it suggests that each Medical School must provide adequate teaching time and resources to achieve the aims of the core.
We would go so far as to say that the core content should now be considered as a standard against which teaching, learning and assessment of medical ethics and law can be judged.
View the full core content of learning - on the JME website