where evident Domain 1- Knowledge, Skills Clinical performance, knowledge and skills and Performance Domain 2 Safety and (please provide specific examples) – Quality Identified concerns with one or more aspects of the Apply knowledge and consultation process. experience to practice These may include concerns with history taking, clinical Ensure that all examination, diagnostic skills and decision making, documentation (including developing/implementing management plans and clinical records) formally documentation, written and electronic. recording your work is clear, Concerns should be related to the expected level of accurate and legible achievement for the stage of training Not responding effectively in emergency situations. Apply knowledge and This may also be reflected if the trainee is frequently experience to practice unavailable/ does not respond to bleeps The trainee may show a lack of situational awareness, especially when under pressure Clinical complaints or critical incidents that have Contribute to and involved the trainee comply with systems to The trainee should have the opportunity to have a protect patients debrief following critical incidents in order to reflect and Respond to risks to identify learning opportunities safety Treat patients and colleagues fairly and without discrimination Repeated exam failure Maintain your This should be related to expected achievement at level professional of training, and may reflect a number of the key areas performance Identified concerns with technical skills, particularly Apply knowledge and in craft specialties experience to practice Concerns should be related to expected standard for current level of training Area of Concern Concern Supporting and specific evidence must Y/N GMC be provided Good Medical Practice Comment/Cross-over with other areas Framework domain Excellence should also be identified
where evident Clinical performance, knowledge and skills (please provide specific examples) Domain 1- Knowledge, Skills and Performance Domain 2 – Safety and Quality Identified concerns with one or more aspects of the consultation process. These may include concerns with history taking, clinical examination, diagnostic skills and decision making, developing/implementing management plans and documentation, written and electronic. Concerns should be related to the expected level of achievement for the stage of training Apply knowledge and experience to practice Ensure that all documentation (including clinical records) formally recording your work is clear, accurate and legible Not responding effectively in emergency situations. This may also be reflected if the trainee is frequently unavailable/ does not respond to bleeps The trainee may show a lack of situational awareness, especially when under pressure Apply knowledge and experience to practice Clinical complaints or critical incidents that have involved the trainee The trainee should have the opportunity to have a debrief following critical incidents in order to reflect and identify learning opportunities Contribute to and comply with systems to protect patients Respond to risks to safety Treat patients and colleagues fairly and without discrimination Repeated exam failure This should be related to expected achievement at level of training, and may reflect a number of the key areas Maintain your professional performance Identified concerns with technical skills, particularly in craft specialties Concerns should be related to expected standard for current level of training Apply knowledge and experience to practice Area of Concern Concern Y/N Supporting and specific evidence must be provided Comment/Cross-over with other areas Excellence should also be identified GMC Good Medical Practice Framework domain
final_combined_referral_forms_professional_support_for_doctors_in_training_-v1_.docx