What Good Medical Practice actually is
Good Medical Practice is the General Medical Council’s core guidance for doctors. It is not a statute and not a syllabus: it is the standard a doctor’s conduct is measured against when someone raises a concern, and it sits behind a great deal of what UK medical schools say they are looking for at interview.
The GMC publishes a suite of ethical guidance — on consent, confidentiality, prescribing, social media, raising concerns — but Good Medical Practice sits above it. The updated edition took effect in January 2024, replacing a version that had stood since 2013, and it says considerably more about workplace behaviour than its predecessor: not bullying, harassing or discriminating against colleagues, and helping build a culture where people can speak up.
One caveat. Good Medical Practice governs doctors. Dentistry applicants should cite the General Dental Council’s Standards for the Dental Team, which covers the same territory — patients’ interests first, communication, consent, confidentiality, raising concerns, working within your knowledge and skills — under its own principles. The reasoning transfers; the citation should not.
The four domains, and what each is really asking
The current edition is organised into four domains. Learn them as questions rather than titles: a panel is testing whether you understand what each one demands of a person on a ward at four in the morning.
- Knowledge, skills and development — are you competent, and do you stay competent? Working within the limits of your competence, keeping current, and recognising that a doctor who stops learning becomes unsafe slowly rather than suddenly.
- Patients, partnership and communication — do you treat patients as partners rather than problems? Listening, sharing information they can use, supporting their decisions, treating them without discrimination, being straight about uncertainty.
- Colleagues, culture and safety — are you safe to work alongside? Safe systems, proper handover, raising concerns when a patient may be at risk, and treating colleagues fairly.
- Trust and professionalism — can you be trusted when nobody is checking? Honesty in your records, research, applications and finances; professional boundaries; openness when something goes wrong; and behaving, online included, so as not to damage confidence in the profession.
Only the first domain is about medicine in the textbook sense; three of the four are about behaviour. That ratio is not an accident, and it is the ratio to aim for when you describe a good doctor.
The domains are a marking scheme, not a reading list
Almost every generic professionalism question — what makes a good doctor, your greatest weakness, a time you worked in a team — can be answered by choosing two or three domains and evidencing each. Three done properly beats four listed. It is the same logic as the scoring domains in what interviews actually test.
The licence: registration, appraisal and revalidation
Good Medical Practice has teeth because it is attached to a licence, and the licence is checked continuously rather than once at qualification. Interviewers rarely ask about the machinery, but a candidate who understands it sounds like someone who has thought about the job rather than the degree.
- Registration with a licence to practise
- Being on the medical register is not enough on its own. The licence is what permits a doctor to practise in the UK, including prescribing and signing certain statutory documents.
- Appraisal
- An annual structured conversation about a doctor’s whole practice, built from evidence: professional development, quality improvement, significant events, and feedback from patients and colleagues.
- Revalidation
- The process, introduced in 2012, by which a licensed doctor periodically shows they remain fit to practise — normally five-yearly, on the recommendation of a senior doctor called the responsible officer, and drawing on the appraisals rather than an examination.
- Fitness to practise
- The regulator’s formal process for concerns serious enough to call a doctor’s registration or licence into question.
It starts earlier than applicants expect. Medical and dental schools run their own fitness to practise procedures for students, under guidance the GMC issues with the Medical Schools Council, and students have faced those procedures over dishonesty, plagiarism and what they posted online. The GMC also took on statutory regulation of physician associates and anaesthesia associates in December 2024, which is useful to know if a panel opens the scope of practice debate.
The duties applicants are actually asked about
Candour: being open when something goes wrong
The professional duty of candour requires a doctor to be open with a patient when something goes wrong with their care: say what happened, apologise, and explain what will be done to put it right. It is owed to the patient, not granted as a favour, and the duty exists precisely because the instinct to say nothing is human and strong.
Two refinements make an answer sound informed. A separate statutory duty of candour binds organisations rather than individuals, introduced in England after the failures at Mid Staffordshire, and the two run alongside each other. And in England and Wales the law is explicit that an apology does not of itself amount to an admission of negligence, which removes the commonest excuse for withholding one.
Raising concerns, and the whistleblowing tension
A doctor must act if they believe patient safety is or may be compromised, including when the problem is a rota or a system rather than a single error. The duty is to raise the concern, not to have proved it first. Record what you saw and when at every stage.
- Deal with it directly where that is safe — most concerns are resolved by speaking to the person involved or to whoever is running the shift.
- Escalate within the team: a clinical or educational supervisor, the consultant, the clinical director. As a student, your tutor or the medical school.
- Use the formal internal route: in NHS trusts in England that includes a Freedom to Speak Up guardian, a role recommended by Sir Robert Francis’s Freedom to Speak Up review.
- Go outside the organisation, to the regulator or another appropriate body, if the concern is serious and internal routes have failed.
Speaking up about a colleague
Why the duty is not negotiable
- Serious harm is rarely the work of one bad actor. NHS inquiries repeatedly find staff who had concerns and did not escalate them.
- The threshold is a reasonable belief that patients may be at risk, not proof. Waiting for certainty is itself a decision.
- Raising something early is usually kinder than letting a pattern build until it becomes a regulatory matter.
- UK law protects workers who make qualifying disclosures in the public interest, though that protection is built around workers rather than students on placement.
Why it stays hard in practice
- Doctors who spoke up have described isolation, damaged references and stalled careers. Protection on paper is not always protection in practice.
- Juniors raise concerns about seniors who write their references and sign off their training. That asymmetry is real, not squeamishness.
- A concern raised clumsily can be unjust to a colleague who is unwell, exhausted or carrying something you cannot see.
- Reviews of NHS culture keep concluding the problem is systemic, which suggests individual courage is necessary but not sufficient.
Probity, boundaries and the version of you that is online
Probity means being honest in everything professional: accurate records, accurate research, an accurate application, no undeclared financial interest. Interviewers test it with small scenarios — a friend asks you to sign the register for them, a colleague inflates an audit — because probity usually fails in small, deniable increments rather than in one dramatic act.
Social media catches students most often. Confidentiality does not weaken because an account is private, details you consider anonymised are often identifiable to the patient and their family, and a post rarely stays where it was put. Boundaries apply online too: accepting a patient’s friend request is a boundary question, not a question of manners. Offline, doctors must not pursue sexual or improper emotional relationships with patients, and should avoid treating or prescribing for themselves and those close to them, because judgement is compromised in ways they cannot detect from the inside.
Competence, and how you treat colleagues
Recognising and working within the limits of your competence is the shortest useful idea in the document. It is what makes “I would ask for help” a strong answer rather than a weak one, and it is what an interviewer listens for when a station is pitched deliberately beyond a school leaver’s knowledge.
The current edition is firmer about how doctors treat each other, addressing bullying, harassment and discrimination directly. Connect that to the multidisciplinary team — a team where a nurse or pharmacist feels able to challenge a doctor is a safer team — and you are making the argument the guidance itself makes.
Fitness to practise and the public confidence test
When a concern is serious enough it becomes a fitness to practise matter. The GMC investigates; hearings are run by the Medical Practitioners Tribunal Service, which sits within the GMC but operates separately, so that the body bringing a case is not the body deciding it. Outcomes range from a warning, through undertakings and conditions on practice, to suspension and erasure from the register.
The part applicants miss is the standard applied. A tribunal is not only asking whether a patient was harmed; it asks whether the conduct would undermine public confidence in the profession and falls below what the public is entitled to expect. That is why doctors face sanctions for dishonesty, for convictions with no clinical dimension, and for behaviour well outside the hospital.
That test is the cleanest justification for why a medical school cares what you post and how you behave on placement. It is not moralising: the profession borrows its authority from public trust, and trust is a shared asset any member of it can spend.
The reflex answer that costs marks
Asked about a colleague who might be unsafe, weaker candidates jump straight to “I would report them to the GMC.” The regulator is the top of a ladder, not the first rung, and starting there sounds memorised rather than thought through. The opposite reflex — “I would not want to get them into trouble” — is just as costly, because it puts a friendship above a patient. Show the ladder, and say plainly that patient safety decides how far up it you go.
Using the domains in the room
What makes a good doctor?
Do not answer with adjectives. Choose three of the four domains and evidence each with something you have genuinely seen. Competence and its limits: the registrar who phoned a colleague rather than guessing at an ECG. Partnership: the GP who spent two minutes checking what the patient had understood, not what she had said. Trust: the consultant who told a family, in front of you, that a delay had been the team’s fault. Then close on whichever matters most to you, and say why.
A fellow student arrives at a hospital placement smelling of alcohol. What do you do?
Start with the patient rather than the person: someone who may be impaired should not be in contact with patients, so the first move is making sure they do not go onto the ward. Then speak to them privately and without accusation — you may be wrong, and they may tell you something that changes the picture. Then escalate to the supervising clinician the same day, telling your colleague you are doing it rather than going behind them. Finish humanely: dependence among health professionals is an illness with treatment pathways, and raising it early is more likely to get someone help than to end their career. If the examiner adds that your colleague swears it is a one-off, hold the line.
You see a friend from your course post a photo taken on a ward, with a patient visible in the background. What do you do?
Name the breach precisely: that is identifiable patient information published without consent, and a private account or a small following changes nothing. Speak to your friend first and ask them to take it down — proportionate, and it may well be the whole answer. Then be explicit that you would not let it go if they refused, because the patient’s interest outranks the friendship. Further credit sits in noting that a deleted post is not necessarily gone, so the school may need to know regardless.
Every one of those answers is a small ethics answer wearing professional clothes. The domains tell you what a doctor owes; they do not tell you how to choose when two of those debts conflict. That is the next thing to learn — the four pillars of medical ethics turn the standards here into a method you can run live in a station. Read this alongside the six NHS core values, which say something strikingly similar from the employer’s side rather than the regulator’s.