What is Good Medical Practice?
Good Medical Practice is the General Medical Council's core statement of the values, knowledge, skills and behaviours expected of every doctor on the UK medical register. It applies at every grade, in every specialty and setting, including non-clinical and management roles. The 2024 edition came into effect for doctors on 30 January 2024, replacing the 2013 edition. Since 13 December 2024 it has also applied to physician associates and anaesthesia associates registered with the GMC.
The standards use two kinds of wording. 'You must' marks an overriding duty. 'You should' describes what is expected in most circumstances, recognising that there may sometimes be a good reason to act differently. The GMC stresses that the standards describe good practice and are meant to be applied with professional judgement.
How the GMC uses it
- It is the framework for annual appraisal and five-yearly revalidation.
- It is the benchmark when the GMC decides whether a doctor's fitness to practise is impaired. Serious or persistent failure to follow it puts registration at risk.
- It is supported by more detailed guidance, for example on consent, confidentiality, prescribing, leadership and candour. Read Good Medical Practice for the principle, then the detailed guidance for how to apply it.
What are the four domains of Good Medical Practice 2024?
| Domain | What it covers | Everyday example |
|---|---|---|
| 1. Knowledge, skills and development | Good standard of practice, keeping up to date, limits of competence, records, safe prescribing, your own health | Asking a senior before doing a procedure you have not done independently |
| 2. Patients, partnership and communication | Kindness and respect, shared decision making, consent, confidentiality, clear communication, meeting patients' needs | Explaining all options, including no treatment, and respecting the patient's choice |
| 3. Colleagues, culture and safety | Respectful and fair culture, teamwork, raising concerns, patient safety, continuity of care, safe delegation | Speaking up when a colleague is belittled at handover |
| 4. Trust and professionalism | Honesty and integrity, openness when things go wrong, conflicts of interest, professional boundaries | Telling a patient promptly and honestly that an error has occurred |
The domains are equally important. Learn their names: they structure appraisal discussions and are often used in NHS interview questions.
What changed in Good Medical Practice 2024?
The GMC grouped the main changes under five themes that run across all four domains.
- Creating respectful, fair and compassionate workplaces: Doctors must treat colleagues with kindness and respect and must not act in a way that is, or could reasonably be seen as, bullying, harassment or sexual harassment.
- Promoting patient-centred care: A stronger focus on understanding what matters to patients and supporting them to make decisions.
- Helping to tackle discrimination: Doctors must not discriminate, and should act when they see discrimination against patients or colleagues.
- Championing fair and inclusive leadership: Every doctor has leadership responsibilities, whatever their role, including helping create supportive environments.
- Supporting continuity of care and safe delegation: Handover, delegation and referral must be safe, and the person you delegate to must be competent for the task.
Domain 1: Knowledge, skills and development in practice
You must be competent in all aspects of your work, keep up to date and work within your limits. That does not mean knowing everything; it means knowing when to ask for help and asking without delay. For doctors new to the NHS, gaps are often about systems rather than medicine: electronic records, local pathways, UK prescribing and the BNF, and laws such as the Mental Capacity Act 2005 in England and Wales.
- Keep clear, accurate, contemporaneous records, including decisions and reasons.
- Prescribe only with adequate knowledge of the patient's health and when satisfied the medicine meets their needs.
- Know the guidance your team uses: NICE in England and Wales, SIGN in Scotland, trust protocols and safety alerts.
- Take part in appraisal, reflect and act on feedback.
- Look after your own health and get help if it may affect patients.
Domain 2: Patients, partnership and communication in practice
The doctor-patient relationship in the UK is a partnership. Patients are entitled to the information they need to decide, including the risks, benefits and alternatives of each option and the option of doing nothing. The GMC's Decision making and consent guidance explains this dialogue. A paternalistic 'doctor decides' approach does not meet the standard.
- Capacity: assume an adult has capacity unless it is established otherwise. An unwise decision is not, on its own, evidence of incapacity. The law on capacity differs between the four UK nations.
- Confidentiality: share information with the care team for direct care, and disclose otherwise only with consent, when the law requires, or when justified in the public interest. Corridors, lifts and messaging groups are common sources of avoidable breaches.
- Equality: do not discriminate on any protected characteristic, and do not let personal beliefs affect the advice or treatment you give. If you have a conscientious objection, make sure the patient can still access care.
Domains 3 and 4: Colleagues, culture, safety, trust and professionalism
Domain 3 asks every doctor to help build a safe, respectful culture. You must raise concerns promptly if patient safety, dignity or comfort is compromised, whoever is involved, support colleagues who raise concerns and never victimise them. When you delegate, you must be satisfied the person can do the task safely, and you keep responsibility for the patient's overall management. Domain 4 is about trust: honesty in everything, including CVs, references, research, expenses and statements to employers or the GMC, and openness when things go wrong.
| Situation | What the standards expect |
|---|---|
| Your prescribing error causes minor harm | Tell the patient, apologise, put things right where possible, report it and reflect |
| A colleague asks you to sign for a procedure you did not observe | Refuse; do not sign documents you believe to be false or misleading |
| A company representative offers a gift | Do not accept gifts that could affect, or be seen to affect, your judgement; declare interests |
| A former patient sends you a friend request | Maintain professional boundaries |
Many international doctors come from systems where questioning a senior is unusual. In the NHS, raising a concern is a professional duty, not disloyalty. Start with the most local safe route (the person involved, your supervisor or the clinician in charge), then your organisation's process, which in England usually includes a Freedom to Speak Up Guardian, and the GMC or another regulator if serious concerns are not resolved. You need an honest, reasonable belief that something may be wrong, not proof. Keep a short factual note of what you saw and who you told.
Worked example: applying the standards
Six months into her first NHS post, Leila sees a consultant repeatedly mock a foundation doctor's accent and call her slow at morning handover. Later the foundation doctor tells Leila she is thinking of leaving medicine. Leila also notices a patient was discharged with an incorrect medication list, written by the foundation doctor under pressure.
It is not my place to challenge a consultant, so I said nothing. I told the foundation doctor this is how surgery is. The discharge letter was not my error, so I left it for her.
I contacted the patient and GP to correct the medication list and reported the error so the team could learn. I spoke privately with the foundation doctor, listened, and signposted her to her educational supervisor and wellbeing support. I recognised the consultant's comments were not acceptable under Good Medical Practice, took advice from my clinical supervisor and, with the foundation doctor's agreement, raised the concern through the trust's process. Next time I will try to speak up in the moment, for example by calmly bringing the discussion back to the clinical facts.
The strong response puts the patient first, is open about the error, supports a colleague and uses proper channels. It does not require an aggressive confrontation; it requires not staying silent or normalising the behaviour.
How do I use Good Medical Practice in appraisal and revalidation?
You have an appraisal every year, and the GMC decides on revalidation of your licence roughly every five years. Reflect on your supporting information (CPD, quality improvement, significant events, colleague and patient feedback, compliments and complaints) against the standards.
I made a prescribing error. It was not serious. I will be more careful next time. Domain: Knowledge, skills and development.
On a busy ward round I prescribed a standard antibiotic dose for a patient with reduced kidney function; the pharmacist caught it before any dose was given. I had relied on memory under time pressure. I reviewed BNF guidance on renal dose adjustment and our antimicrobial guideline. I now check the latest renal function and the guideline before every antibiotic prescription, and I reported the near miss so others could learn. Standards: Knowledge, skills and development (safe prescribing); Colleagues, culture and safety (learning from incidents).
The GMC has said it will not ask doctors for their reflective notes to investigate a concern, but these notes are not legally privileged. Write honest, factual, anonymised reflections focused on learning. If you are the subject of a complaint or investigation, speak to your medical defence organisation or the BMA before sharing reflections.
This is a summary only; read the full Good Medical Practice 2024 on the GMC website. Our course Good Medical Practice: Professional Standards for Doctors works through each domain with clinical scenarios and a structured reflection for your appraisal portfolio. GMC Registration Routes for International Doctors and Adapting to UK Clinical Practice and NHS Culture may help if you are new to UK practice.
Frequently asked questions
When did Good Medical Practice 2024 come into force?
It came into effect for doctors on 30 January 2024, replacing the 2013 edition. It has also applied to physician associates and anaesthesia associates registered with the GMC since 13 December 2024. If you are preparing for an interview, appraisal or exam, make sure you are using the 2024 edition and its four domains.
What are the four domains of Good Medical Practice?
Knowledge, skills and development; patients, partnership and communication; colleagues, culture and safety; and trust and professionalism. Each contains standards that describe what patients and colleagues can expect from a doctor. They are equally important and are used to structure appraisal and many NHS interview questions.
What is the difference between 'must' and 'should' in Good Medical Practice?
'Must' describes an overriding duty that applies in all circumstances. 'Should' describes what you are expected to do in most situations, while recognising that you may not always be able to, or there may be a good reason to act differently. If you depart from a 'should', be ready to explain your reasoning.
Does Good Medical Practice apply outside work?
Yes, in part. The standards on trust and professionalism cover conduct that could affect public confidence in doctors, including behaviour online, honesty in financial and legal matters, and how you treat colleagues outside clinical settings. The GMC can act on serious misconduct outside work if it raises questions about a doctor's fitness to practise.
Is Good Medical Practice the same as the GMC's other guidance?
No. Good Medical Practice sets the core standards. The GMC also publishes more detailed guidance on specific topics, such as decision making and consent, confidentiality, prescribing, leadership and the duty of candour. Doctors are expected to follow both; the detailed guidance explains how to apply the core principles.
How is Good Medical Practice used in GMC fitness to practise cases?
It is the benchmark the GMC uses when deciding whether a doctor's fitness to practise is impaired. A serious or persistent failure to meet the standards can lead to warnings, conditions, suspension or erasure. If you are the subject of a concern, contact your medical defence organisation or the BMA for advice early.
What do the 2024 changes mean for international doctors?
The values will feel familiar, but some expectations may be stronger than in your previous system: shared decision making with patients, speaking up regardless of seniority, and active responsibility for a respectful, non-discriminatory workplace. The 2024 edition also makes clear that every doctor has leadership responsibilities and must ensure delegation and handover are safe.
Related courses
Good Medical Practice: Professional Standards for Doctors
This course explains the GMC's Good Medical Practice (2024), the core standards every doctor registered in the UK must follow. It works through the…
GMC Registration Routes for International Doctors
This course explains how an international medical graduate can gain full registration with a licence to practise from the General Medical Council. It…
Adapting to UK Clinical Practice and NHS Culture
This course prepares internationally trained doctors and allied health professionals for the everyday realities of working in the NHS. It covers team…
Sources and further reading
- Good medical practice (2024). General Medical Council.
- Key changes to Good medical practice 2024. General Medical Council.
- Get to know Good medical practice 2024. General Medical Council.
- Decision making and consent. General Medical Council.
- Confidentiality: good practice in handling patient information. General Medical Council.
- Openness and honesty when things go wrong: the professional duty of candour. General Medical Council and Nursing and Midwifery Council.
Practitioner Insight is an independent education provider. It is not affiliated with or endorsed by the GMC, MPTS, NMC, HCPC, GPhC or any NHS organisation, and this information is not legal advice. If you have been referred to a regulator, speak to your defence organisation, trade union or legal representative.
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