⭐ GMC GOOD MEDICAL PRACTICE — MSRA SJT EDITION

SJT Textbook: Good Medical Practice (GMC)

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🎯 THE CORE PRINCIPLE

Good Medical Practice (GMP) is the ethical backbone of the MSRA SJT. The exam tests whether your behaviour aligns with GMC duties — not your personality. Almost every scenario maps to safety, competence, communication, professional integrity, and fairness.

High-scoring answers prioritise immediate patient safety, early escalation, transparent communication, and objective, compassionate decision-making. Delaying action, guessing, or prioritising convenience over safety consistently scores poorly.

GMP groups expectations into four domains, each heavily represented in SJT scenarios. Understanding how each domain appears in exam questions gives you a predictable, high-scoring framework for decision-making.

Access the complete MSRA SJT revision textbook here → https://www.passthemsra.com/courses/msra-sjt-textbook/

GMC Good Medical Practice MSRA SJT – The Four Core Domains

🧩 THE FOUR DOMAINS (MSRA SJT Interpretation)

In the GMC Good Medical Practice MSRA SJT framework, working within competence and escalating early consistently produces top-scoring answers.

DOMAIN 1 — Knowledge, Skills & Performance

Core idea: Work safely within competence, recognise limits early, and continue improving.
What the SJT tests:

* Knowing when something is beyond your level
* Seeking senior help appropriately
* Clear, accurate documentation
* Avoiding guesswork or shortcuts
* Upholding safe practice even when busy or pressured

High-yield behaviours:
* “Work within your competence” always scores top-tier.
* Early escalation beats doing it yourself.
* Admitting uncertainty is safer than pretending.

Red flags:
* Proceeding unsupervised
* Ignoring knowledge gaps
* Hiding mistakes
* Attempting tasks beyond competence due to pressure or staffing gaps

DOMAIN 2 — Safety & Quality

Core idea: Escalate early, act quickly, and prioritise patient safety above all else.
What the SJT tests:

* Recognising risk and acting without delay
* Challenging unsafe colleagues
* Datix/incident reporting
* Following local policies
* Ensuring systems and environments remain safe

High-yield behaviours:
* Safety > convenience, embarrassment, loyalty, or hierarchy.
* “Escalate immediately” is the correct answer in most risk scenarios.
* Document + Datix + inform senior is the triad for harm events.

Red flags:
* Delayed escalation
* Downplaying harm
* Protecting colleagues instead of patients
* Trying to fix things quietly
* Ignoring unsafe conditions

DOMAIN 3 — Communication, Partnership & Teamwork

Core idea: Be clear, honest, respectful, and collaborative; enable shared decisions.
What the SJT tests:

* Active listening
* Using interpreters appropriately
* Giving space for emotions
* Checking understanding
* Working with the MDT
* High-quality handover

High-yield behaviours:
* Acknowledge feelings before giving facts.
* Interpreter for communication needs — never a family member.
* Shared decision-making wherever possible.

Red flags:
* Talking over patients
* Being dismissive or abrupt
* Poor handover
* Avoiding difficult conversations
* Using jargon
* Withholding information

DOMAIN 4 — Maintaining Trust

Core idea: Honesty, integrity, fairness, and transparency in all interactions.
What the SJT tests:

* Professional boundaries
* Avoiding discrimination
* Declaring conflicts of interest
* Maintaining dignity
* Apologising appropriately
* Acting impartially

High-yield behaviours:
* “Be open and honest” is exam gold.
* Apology + explain next steps > delaying or minimising.
* Declare conflicts immediately.

Red flags:
* Dishonesty (even small lies)
* Hiding conflicts of interest
* Shifting blame onto others
* Treating colleagues unfairly
* Unprofessional behaviour online or in person

⚡ HIGH-YIELD ACTIONS (What Scores Points)

1. Recognise your limits and escalate early.
2. Protect patient safety as the top priority.
3. Communicate clearly, respectfully, and without jargon.
4. Use professional interpreters for communication needs.
5. Be open and honest, especially after errors.
6. Declare conflicts of interest immediately.
7. Document clearly, factually, and promptly.
8. Report unsafe practice and incidents through correct channels.
9. Treat all individuals fairly and without bias.
10. Follow policies, guidelines, and governance processes.

Traps generally minimise risk, avoid escalation, hide concerns, or prioritise convenience.

💬 MODEL PHRASES (Use These in SJT Logic)

* “I should work within my competence and seek senior support.”
* “I will be open and honest about what occurred.”
* “I will escalate concerns immediately.”
* “I will use a professional interpreter to ensure safe communication.”
* “I will document clearly and objectively.”

P – Protect the patient
E – Ensure fairness
A – Act within competence
R – Respond honestly
L – Legal and ethical duties (capacity, consent, confidentiality)

📋 QUICK FAQ

Is GMP directly tested in the MSRA SJT?
Yes — almost every question maps to its principles.

What is the strongest principle to follow in uncertainty?
Safety > everything else.

Is apologising usually correct?
Yes — when something has gone wrong, apologise sincerely and outline next steps.

How do I balance autonomy and safety?
Autonomy matters, but safety takes priority when risk is high.

When should I escalate concerns about colleagues?
Immediately if safety is affected or there is risk of recurrence.

📚 GMC ANCHOR POINTS

* Knowledge, Skills & Performance (work within competence)
* Safety & Quality (escalation, reporting, policy)
* Communication, Partnership & Teamwork (clarity, respect, shared decisions)
* Maintaining Trust (honesty, integrity, fairness)
* Duty of candour (openness in error)
* Raising concerns (patient safety)
* Equality, diversity, fairness

💡 MINI PRACTICE SCENARIO

During a busy evening shift, you notice a colleague has prescribed a potentially dangerous dose of an anticoagulant. They appear flustered and ask you not to escalate the issue.

Best action: Correct the error, ensure patient safety, escalate to the senior, inform the colleague respectfully, document, and complete an incident report.
Why: This aligns with safety, candour, escalation, documentation, and learning — all core GMP duties.

🎯 KEY TAKEAWAYS

✓ Safety is always the top priority.
✓ Act within competence; ask early for help.
✓ Honesty and transparency score exceptionally well.
✓ Escalate risks immediately.
✓ Communicate clearly and respectfully.
✓ Treat everyone fairly and without bias.
✓ Document and follow appropriate governance processes.
✓ If unsure, choose the response that best protects the patient.

Mastery of the GMC Good Medical Practice MSRA SJT principles is one of the strongest predictors of consistent high SJT scores.

🔗 RELATED TOPICS

* → Duty of candour
* → Raising concerns about patient safety
* → Shared decision-making
* → Professional boundaries
* → Communication skills
* → Safeguarding principles

📖 FULL PRACTICE QUESTIONS

Example SJT — Best of 3 (8 options; choose three)

A junior colleague administers the wrong dose of a bronchodilator to a patient with severe asthma. The patient is stable but at increased risk of arrhythmia. The colleague admits the error privately and asks you not to escalate. You are busy with several unwell patients.

Options:
A. Correct the error immediately and review the patient
B. Reassure your colleague and keep the matter private
C. Escalate to the senior doctor on call
D. Document the incident clearly in the notes
E. Wait until the end of the shift to raise the concern
F. Allow the colleague to decide whether to report it
G. Complete an incident report (Datix)
H. Criticise the colleague in front of the team

Example SJT — Rank 5 (best → worst)

A patient with limited English needs to consent to emergency surgery. The team is short-staffed, and a relative offers to translate.

Options:
A. Arrange an urgent professional interpreter
B. Use simple phrases but delay consent until understanding is confirmed
C. Allow the relative to translate
D. Provide printed leaflets only
E. Proceed with consent despite limited understanding due to time pressure

FAQs

Q1: Are the Duties of a Doctor tested in the MSRA SJT?
A: Yes. Nearly every MSRA SJT scenario directly tests one or more of the GMC Duties of a Doctor.

Q2: What behaviours score highest in Duties of a Doctor questions?
A: Protecting patient safety, early escalation, honesty, fairness, working within competence, and respectful communication.

Q3: Should autonomy ever override patient safety in the MSRA SJT?
A: No. When risk is present, patient safety always takes priority over autonomy.

Q4: Is delay ever acceptable in escalation scenarios?
A: No. Delay is almost always a low-scoring response in the MSRA SJT.

⭐ GMC: DUTIES OF A DOCTOR — MSRA SJT EDITION

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