Upholding GMC Standards

Upholding GMC Standards MSRA SJT

This upholding GMC standards MSRA SJT guide explains how Good Medical Practice duties on safety, honesty, competence, and escalation are tested in high-scoring SJT scenarios.

🎥 Video Lesson (YouTube)

🎧 Podcast Lesson (Spotify / Apple / Amazon)

🎯 THE CORE PRINCIPLE

Upholding GMC standards means consistently applying Good Medical Practice (2024) to daily clinical decisions. The SJT tests whether you refuse unsafe or dishonest actions, escalate concerns appropriately, and protect patients even when under pressure. Safety, honesty, competence, and documentation always outrank convenience or hierarchy.

⚡ HIGH-YIELD ACTIONS (What Scores Points)

1. Identify the relevant GMC duty (safety, honesty, competence, fairness).
2. Decline unsafe or dishonest requests (no backdating, no unsafe discharge).
3. Escalate early to an appropriate senior or governance route.
4. Put immediate safety measures in place while seeking senior review.
5. Document facts, rationale, discussions, and agreed plans.
6. Use formal raising-concerns mechanisms when needed.
7. Work within competence and request supervision promptly.
8. Maintain accurate, contemporaneous records.
9. Communicate clearly with the team to ensure continuity.

Always reject anything that hides, delays, or dilutes standards — these score poorly.

💬 MODEL PHRASES (Use These in SJT Logic)

* “I can’t do that — it wouldn’t meet GMC standards. I’ll record accurately and involve the senior.”
* “I’m concerned this plan is unsafe; I’ll arrange urgent senior review and interim safety steps.”
* “I’ve documented the facts, advice received, and actions agreed.”
* “If concerns continue, I’ll escalate through the formal route to protect the patient.”

Standards first • Tell/decline breach • Escalate • Act now • Document

📋 QUICK FAQ

What if local policy conflicts with GMC guidance?
Follow GMC guidance. Raise the conflict formally and record actions.

Must I follow an unsafe instruction from a senior?
No. Decline respectfully, reference guidance, escalate, and protect the patient.

What if I’m unsure which duty applies?
Prioritise safety and honesty first; ask senior advice.

Do near misses need reporting?
Generally yes — record, escalate, and follow incident-reporting systems.

How do I delegate safely?
Work within competence, clarify tasks, check understanding, and supervise appropriately.

📚 GMC ANCHOR POINTS

• Make the care of patients your first concern; act with honesty (GMP paras 1–5).
• Raise concerns and take prompt action for safety (Raising and acting on concerns).
• Work within competence, seek supervision, and delegate safely (Delegation and referral).
• Maintain accurate records and ensure continuity (GMP continuity and handover).
• Be open and honest when things go wrong (Candour).

💡 MINI PRACTICE SCENARIO

A registrar asks you to backdate a review note to match the expected ward-round time.
Best action: Decline, document accurately, and inform them you will escalate if needed.
Why: Accuracy and honesty are core GMC duties; falsifying records is unsafe and unprofessional.

🎯 KEY TAKEAWAYS

✓ GMC standards always outrank convenience or hierarchy
✓ Decline unsafe or dishonest actions
✓ Escalate early and formally if concerns persist
✓ Protect the patient with immediate safety steps
✓ Document objectively and accurately

🔗 RELATED TOPICS

* → Duty of Candour
* → Speaking Up / Whistleblowing
* → Delegation and Supervision
* → Unsafe Discharge Decisions
* → Professional Boundaries

📖 FULL PRACTICE QUESTIONS

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

Scenario: Your registrar asks you to backdate a note to show they reviewed a patient earlier. The entry would not be accurate.

Options A–H
A. Backdate the note to keep the team harmonious
B. Decline to backdate and explain records must be accurate
C. Document truthfully what occurred, including times
D. Escalate respectfully to the consultant if pressure continues
E. Edit wording to make it “close enough”
F. Leave it for now and fix later
G. Ask the group chat what others do
H. Email the patient to tell them your registrar is dishonest

Example SJT — Rank 5 (best → worst)

Scenario: Bed pressures are high. A frail patient with hypotension and new confusion is being pushed for discharge to free a bed.

Options A–E
A. Explain discharge is unsafe; escalate to on-call consultant and site manager
B. Discharge now with advice and GP follow-up
C. Keep the patient in, document concerns, and arrange urgent senior review
D. Ask the nurse to “keep an eye” and discharge if observations improve
E. Discharge now but ask family to monitor closely