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Hot topic: Approved practice settings

MPS Medicolegal Adviser Dr Jonathan Bernstein highlights the Hot-topicconsequences of not notifying the GMC when you finish your F2

It is an inevitable part of being a doctor that your opinion will be sought on medical matters outside professional practice settings, eg, with friends at dinner parties. While obvious issues arise from these encounters, such as record keeping, treating relatives and informing their GP, for foundation doctors, there are wider issues that throw up more immediate concerns.

Most F1 doctors recognise that their status as “provisionally” registered doctors restricts their ability to practise and prescribe medicines, but F2 doctors, some international medical graduates (IMG) and doctors returning to medicine after a career break, are also prohibited from working as doctors outside “approved practice settings”.

An approved practice setting, which includes primary and secondary care training centres, must satisfy the GMC that they have:

  • appraisal systems
  • systems for clinical governance
  • risk management policies
  • supervision arrangements
  • procedures to identify and act on performance concerns
  • procedures to act on and learn from complaints
  • procedures to ensure that medical practice is non-discriminatory
  • procedures to ensure and facilitate conformity with the GMC’s guidance in Good Medical Practice.

On successful completion of the F1 year, F2 doctors (IMGs, etc) who are now fully registered, are still required to practise in approved practice settings. When a doctor completes F1, from the doctor’s perspective, there is an automatic process by which the GMC is informed of their successful completion of that year and they are awarded full registration on the medical register.

The GMC requires notification that F2s have successfully completed the year in an approved practice setting – there is no automatic process

For doctors completing F2 it is slightly different, as the GMC requires notification that they have successfully completed the year in an approved practice setting – there is no automatic process. The onus is on the doctor and this can be done electronically through the GMC website.

Although this regulation came into force in 2007, most doctors are still unaware of this requirement. MPS has assisted doctors who issued private prescriptions believing that they were permitted to do so as they were well beyond their F2 year.

However, they were reported to the GMC by the pharmacists processing the prescriptions because when they checked the doctors’ registration on the GMC website they found that the record indicated that the doctors could only prescribe in approved practice settings. For most doctors this issue is likely to arise once they qualify as GPs or hospital specialists and start to prescribe outside approved practice settings for the first time.

Avoid the stress and trauma of a GMC investigation. Notify the GMC when you successfully complete your F2 year, or you could get bitten later on.