Exploring the perceived medical ethics and law training needs of UK foundation doctors

Abstract

Foundation doctors (FDs) encounter a wide range of ethical and legal issues during their first two years of work. Despite ethics being a key part of most modern undergraduate curricula, FDs can struggle with the issues they see. This study is based on results from an on-line survey answered by 479 UK FDs regarding their medical law and ethics learning needs, and their undergraduate training in this area. Over two-thirds stated they would wish to receive MEL training as an FD on self-discharge against medical advice (∼71%), sedating patients (∼70%), decision making in emergency medicine (∼67%), and withholding and withdrawing treatment (∼66%). Over half of all respondents want MEL training during their Foundation Programme on DNACPR orders (∼63%), dealing with patients with suicidal intent (∼59%), Mental Health Act (∼55%), Deprivation of Liberty Safeguards (∼54%), and end of life care (∼53%). We therefore propose a minimum curriculum for ethics and law training for FDs based on these topics, as well as cases brought by the FDs themselves.

Disclosure statement

The authors have no declarations of interests to report.

Glossary

A Foundation Doctor: is a junior doctor in the UK in the first 2 years after qualifying from medical school. The foundation programme is a 2 year work based training programme in which the two years are referred to as FY1 (foundation year one) and FY2 (foundation year two). Successful completion of FY1 allows the junior doctor to gain full registration with the General Medical Council (registration is provisional throughout the FY1 year). Successful completion of FY2 allows the doctor to apply for further training, either in a speciality or in general practice.

The British Medical Association www.bma.org.uk

Additional information

Notes on contributors

L. L. Machin

L. L. Machin, PhD, is a Senior Lecturer in Medical Ethics at Lancaster University. She is the Curriculum Lead for Professional Practice, Values and Ethics at Lancaster Medical School, and is a member of the Institute of Medical Ethics Education Committee.

N. Latcham

N. Latcham, MBChB, is currently undertaking GP Specialty Training at the University Hospitals of Morecambe Bay NHS Foundation Trust.

C. Lavelle

C. Lavelle, MBChB Hons, is a General Practitioner Trainee on the Wirral.

R. A. Williams

R. A. Williams, PhD, is a Senior Lecturer in Management Science at Lancaster University, with a research specialism in Operational Research of Health Systems. He is a Fellow of the Royal Society of Arts and a Guardian of their Health, Care and Wellbeing Network.

L. Corfield

L. Corfield, MBBS; MA Medical Law and Ethics; PGCME, is a Consultant Vascular Surgeon at the University Hospital of North Midlands NHS Trust and the Lead for Healthcare Law and Ethics at Keele Medical School. She is a member of the Institute of Medical Ethics Education Committee.