The General Medical Council (GMC) ensures high standards of medical practice and will provide a helpful source of professional guidance throughout your medical career. In this section, we give a brief account of the functions of the GMC and its role in medical education.

How does the GMC concern students?

For many doctors, it is probably fair to say that mention of the GMC conjures up the unwelcome spectre of patient complaints and fitness to practise procedures.

In reality, the GMC has a wide role in ensuring the highest standards of medical practice and the wellbeing of patients and this begins in undergraduate medicine. The GMC can also provide a helpful source of professional guidance throughout a medical career.

What is the GMC and what does it do?

The role of the GMC is to 'protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine'. The GMC does not itself set clinical standards – this is more properly the remit of the medical royal colleges – but professional and ethical standards.

It does this in the following ways:

• fostering good medical practice; 
• promoting high standards of medical education and training; 
• dealing with doctors whose fitness to practise may be in doubt; and
• keeping a list of registered medical practitioners.

In setting ethical standards in medicine, the GMC publishes guidance on good practice that both medical students and doctors are expected to adhere to and against which their fitness to practise can, if necessary, be judged.

Promoting excellence

In its key document, Promoting excellence, the GMC sets out the medical skills, knowledge and professional behaviour that students must learn before graduating. In addition to setting standards for medical schools, NHS bodies and doctors involved in teaching, Promoting excellence places a number of basic obligations on students, including:

• taking responsibility for their own learning, including achieving all the outcomes set out in Outcome for graduates, whatever their personal preferences or religious beliefs; 
• ensuring patient safety by working within the limits of their competence, training and status as medical students; 
• raising any concerns about patient safety, or any aspect of the conduct of others which is inconsistent with good professional practice; and
• keeping to the guidance 'Medical students: professional values and fitness to practise' developed by the GMC and the Medical Schools Council.

Fitness to practise

Undergraduate medical students are not registered with the GMC and are therefore not subject to GMC fitness to practise proceedings. Student fitness to practise is a matter for individual medical schools, but is based on the standards laid down by the GMC and the Medical Schools Council. In essence, a student’s fitness to practise will be in question where 'their behaviour or health raises a serious or persistent cause for concern about their ability to continue on a medical course, or to practise as a doctor after registration'.

Behaviour that might call into question a student’s fitness to practise can include:

• harming patients or putting patients at risk of harm; 
• showing a deliberate or reckless disregard of professional and clinical responsibilities towards patients or colleagues; 
• compromising patient safety through failure to properly manage health conditions or impairments; 
• abusing a patient’s trust or violating a patient’s autonomy or other fundamental rights; and
• behaving dishonestly, fraudulently or in a way designed to mislead or harm others.

The GMC and ethical decision making

Doctors are bound by the standards laid out by the GMC in its good practice guidance. It is therefore essential that doctors are familiar with this guidance in order to be able to take it into account as part of their decision-making procedures when confronted by ethical dilemmas.

Looking after yourself, looking after your colleagues

At the heart of the work of the GMC lies a professional contract between doctors and patients. Maintaining high standards of professionalism is straightforwardly good for both doctors and patients, and a medical education is where knowledge of these standards starts to develop.

Medicine is a demanding profession and, in addition to developing appropriate skills, you need to develop mechanisms to ensure your own wellbeing. Although this involves practical things such as looking after personal health by ensuring you are registered with your own GP and seeking independent medical advice where necessary, it also extends to developing positive and supportive professional relationships with colleagues.

Medical students and doctors in training who work in supportive professional networks, who share experiences and ideas, and who look out for each other, are frequently better placed to manage the stresses that medicine can bring.