F1 Behaviours

• Communicates with patients sensitively and compassionately to assess their physical, psychological and social needs.
• Understands that presentation, including some physical signs, will vary in patients of different backgrounds at different ages and sometimes between men and women.
• Uses collateral history and alternative sources of information when appropriate.
• Examines the physical and mental state of patients sensitively, with a chaperone where necessary, eliciting and interpreting clinical signs including those elicited by the mental state examination.
• Recognises vulnerable individuals including those at risk of abuse or exploitation, and demonstrates appropriate consideration of safeguarding issues.

F2 Behaviours

• Is confident in patient interactions in acute, non-acute and community settings.
• Appropriately instigates a range of standardised assessments routinely (e.g. mental state, suicide risk scores, confusion assessments, pain scores, continence, VTE, nutritional assessments etc.).
• Actively seeks symptoms and clinical signs that confirm or refute diagnostic possibilities.
• Demonstrates focused assessments in an appropriate context and in a safe manner.

Generic professional capabilities (GPCs): 1, 2, 4, 7

F1 Behaviours

• Recognises the need for urgent intervention to treat both mental and physical health problems.*
• Demonstrates the skills needed to initiate immediate management in the critically ill patient.*
• Knows when seek advice and/or physical support as required.
• Provides comfort and support to the dying patient.

*To complete F1, the FD must demonstrate the following in the simulated environment:
– identify the causes and promote the prevention of cardiopulmonary arrest;
– recognise and treat the deteriorating patient using the ABCDE approach;
– undertake the skills of quality CPR and defibrillation (manual and/or AED) and
simple airway manoeuvres;
– utilise non-technical skills to facilitate initial leadership and effective team membership.

F2 Behaviours

• Takes responsibility for initial management of critically ill patients, seeking advice and/or physical support as required.*
• Demonstrates the knowledge and skills required to manage a variety of common urgent care scenarios, including mental health presentations and the ability to take a leading role in these situations.
• Recognises ‘the dying patient’ and ensures comfort and support.

*To complete F2, the FD must demonstrate the following in the simulated environment:
– recognise and treat the deteriorating patient using a structured ABCDE approach;
– deliver standardised CPR in adults;
– manage a cardiac arrest by working with a multidisciplinary team in an emergency situation;
– utilise non-technical skills to facilitate strong team leadership and effective team membership;
– communicate with and manage a disturbed or challenging patient with a mental health condition.

Note: Where an FD is not able to perform certain skills, it may be appropriate to allow reasonable adjustments to be made, including affording the opportunity to describe rather than demonstrate the skill.

GPCs: 1, 2, 3, 5, 6

F1 Behaviours

• Clearly communicates the findings of the physical, psychological and social assessment, including any uncertainties, to more senior doctors and the wider multiprofessional team.
• Recognises the importance of coexisting conditions, including mental health conditions, in assessment and management and understands that many patients are experts on their own condition(s).
• Recognises the patient who is likely to die within hours or days.
• Obtains consent for investigation and, where appropriate, intervention based on an understanding of the principles of capacity, and knows how to act when this is not present.
• Undertakes investigations appropriately and safely; interprets the results of these investigations and acts accordingly.
• Synthesises information to formulate a diagnosis and management plan based on professional knowledge, established guidelines, and legislative requirements and individual patient needs, where necessary in the context of diagnostic uncertainty.

F2 Behaviours

• Shows initiative in providing patient care and an increasing ability to make diagnostic and management decisions.
• Makes rational use of investigations and is confident enough to omit them or wait if appropriate.
• Understands the importance of coexisting conditions and their impact on the patient’s general wellbeing and adapts plans of care to accommodate these, including consideration of the burdens and benefits of treatment.
• Recognises patterns of presentation in different settings, makes rational use of guidelines in treatment, and recognises when patients fall outside them, bringing this to the attention of more senior doctors.
• Shows confidence in the face of uncertainty and prioritises care in a logical and considerate manner.

GPCs: 1, 2, 4, 7

F1 Behaviours

• Delivers care, including humane interventions*, in an appropriate and safe manner, including physical interventions, procedures**, safe prescribing***, blood transfusion, and use of medical devices.
• Uses available technology and medical devices to facilitate care.
• Shows an understanding of the importance of non-pharmacological therapies.
• Communicates diagnosis and potential treatment plans to patients and their carers, where necessary explaining uncertainty; communicates prognosis with an understanding of the impact this may have on the patient and their carers; establishes a shared approach where possible that is sensitive to the patient’s beliefs and background; educates patients in management of their condition and provides health promotion advice (e.g. making every contact count).

The GMC defines these as: nutrition, hydration, symptom control, pain control, end of life care, and CPR if and when appropriate.
** Note: Reasonable adaptations may be appropriate for the doctor who has difficulty with physical care.
*** By completion of FY1 must have passed the Prescribing Safety Assessment.

F2 Behaviours

• Actively seeks opportunities for health promotion and/or demonstrates a commitment to improving population health/resolving health inequality.
• When initiating treatment, routinely seeks to involve the patient as an equal partner in their care pathway.
• Demonstrates confidence in the use of nonpharmacological therapies including, where appropriate, re-enablement; counselling; physical, occupational and psychological therapy; and social prescribing.
• Prescribes anticipatory medications for the last days of life.
• Demonstrates an understanding of guidance around consent and, where appropriate, obtains consent for more complex procedures and, if appropriate, for research purposes.
• Shows ability to initiate and undertake procedures in more challenging settings and/or develops capabilities in more complex procedures.
• Communicates effectively in more challenging situations, such as the communication of poor or uncertain prognosis, in a manner that provides support for patients and their carers; initiation of DNAR discussions; situations where an error has occurred or conflict has arisen and/or where communication is more difficult, e.g. because of physical impairment, lack of capacity, immaturity, learning disability or language barriers, and uses an interpreter or other professional including IMCA or IMHA as appropriate.
• Demonstrates an ability to prescribe that is consistent with the standard required to pass the PSA.

GPCs: 1, 2, 3, 4, 6, 7, 8, 9

F1 Behaviours

• Prioritises tasks and takes responsibility for their completion, seeking help if required.
• Demonstrates an understanding of the processes to ensure correct patient identification.
• Ensures continuing care in an appropriate, safe environment which may include acute admission, arranging safe discharge, organising further contact, and onward or specialty referral including mental health or palliative care.
• Hands over care effectively both verbally and in writing, and with due respect for confidentiality.
• Conducts patient reviews in a timely manner.
• Escalates concerns to more senior doctors (or other appropriate healthcare professionals) as needed.
• Keeps clear contemporaneous records.

***By completion of FY1, must have passed the Prescribing Safety Assessment.

F2 Behaviours

• Works to facilitate patient flow in the context of the healthcare environment in which they work.
• Takes appropriate responsibility for care when under indirect supervision.
• Directs less experienced doctors in their work.
• Demonstrates an ability to direct/lead handover, showing some ability to anticipate problems that may arise and plan solutions to them.
• Is competent in written communication when making referrals and in summarising consultations, for example in creating letters in the outpatient setting and/or referring for admission.

GPCs: 1, 2, 5, 6, 7, 8

F1 Behaviours

• Demonstrates an understanding of personal values and the effect that personal behaviour and attitude has on others.
• Works as part of a team by showing an understanding of the role of a doctor:
managing time effectively, communicating clearly with team members, accepting the leadership of others and challenging this where appropriate.
• Understands and respects the differing roles of individual team members and care groups, and develops skills to interact with them effectively.
• Values diversity and understands the risks posed by unconscious bias.
• Clearly communicates the findings of the biopsychosocial assessment, including any uncertainties, to the wider multiprofessional team.
• Liaises with agencies outside the employing organisation and, where necessary, outside healthcare to ensure biopsychosocial needs are met, including the safeguarding of vulnerable patients.

F2 Behaviours

• Acts in a way that shows honesty and integrity and supports a just, open and transparent culture that fosters learning and critical enquiry.
• Demonstrates the ability to understand and influence the actions of others in an appropriate manner, and recognises that different professionals may prioritise work in a different way.
• Leads the multiprofessional team when appropriate (e.g. directs FY1s in day-today work, prioritises care tasks for self and team).
• Provides support to colleagues (including mentoring FY1s as necessary) and seeks to mitigate the effects of differential attainment on the performance of others.
• Recognises when others are not performing and offers support/seeks advice appropriately.

GPCs: 1, 2, 3, 4, 5, 6, 7, 8, 9

F1 Behaviours

• Recognises the importance of personal wellbeing for safe patient care (e.g. takes breaks appropriately, understands ‘sleep hygiene’ if working shifts, registers with a GP, understands how to seek help for personal issues if needed).

F2 Behaviours

• Recognises the importance of protecting patients and colleagues from risks posed by personal and health issues.
• Understands personal wellbeing in the context of planning a future career.

GPCs: 1, 3, 4, 5, 6

F1 Behaviours

• Takes responsibility for own actions.
• Demonstrates an understanding of the need for 24-hour care in the acute setting, including the need to ensure safe cover in unexpected situations and the concept of scheduling planned care to facilitate safe and efficient use of resources.
• Works within their healthcare organisation, conforming to values, policies, training requirements etc.
• Demonstrates by application an understanding of the principles of the national healthcare system in which they practice, including conforming to legislative requirements.
• Notices and reports failures in care or situations where care is substandard.

F2 Behaviours

• Takes a proactive approach with employing organisation to ensure clear cover arrangements, effective personnel management, booking leave etc.
• Recognises and reports failures in care, understands causes of medical error and contributes to the systems that prevent/ rectify systematic errors.

GPCs: 1, 3, 4, 5, 6, 7, 8

F1 Behaviours

• Engages with QI initiatives through activities such as collecting data for audit purposes, attending QI meetings, and following recommendations to improve the quality of care.

F2 Behaviours

• Takes an active part in ongoing QI work, including active involvement with QI processes and encouragement of others to follow recommendations to improve the quality of care.
• Where appropriate, instigates and carries out QI project within framework of employing organisation.
• Adopts new patterns of working, including the use of new technologies (e.g. virtual consulting, genomics) and philosophies (e.g. a sustainable healthcare approach) to enhance patient care.

GPCs: 1, 2, 3, 5, 6, 8, 9

F1 Behaviours

• Provides clear explanations in the clinical setting, including the ability to educate patients about their conditions and therapies.
• Plans and delivers a formal teaching session using an appropriate teaching method.

F2 Behaviours

• Delivers teaching in the clinical setting to students or less experienced doctors, other healthcare professionals and/or trainees.
• Provides appropriate feedback to students, FY1s and/or other healthcare workers on performance.
• Expands teaching repertoire by teaching/ presenting in other settings and/or using other techniques.

GPCs: 1, 2, 4, 5, 6, 8, 9

F1 Behaviours

• Regularly develops and maintains a portfolio of evidence that demonstrates practice in line with the requirements of the foundation curriculum that can be used to show the FD’s readiness to progress to further training, apply for full GMC registration and move on to undertake more independent practice.
• Demonstrates initiative.
• Participates in quality assurance of training programmes, including national and local surveys.

F2 Behaviours

• Develops and maintains a portfolio of evidence that demonstrates practice in line with the requirements of the foundation curriculum that can be used to show the FD’s readiness to practise with indirect supervision and move on to further training.
• Actively seeks learning opportunities and proactively develops portfolio to demonstrate skills in line with career expectations and/or future professional development.

GPCs: 1, 3, 4, 5, 6, 8, 9

F1 Behaviours

• Demonstrates an ability to appraise new knowledge and knows how to incorporate any findings into practice.
• Learns from experience, seeks out feedback, both positive and negative; and demonstrates an ability to understand criticism and, where necessary, adapts practice appropriately.
• Actively engages with foundation training, completes curriculum requirements, and participates in core foundation and departmental teaching programmes.

F2 Behaviours

• Keeps practice up to date.
• Actively engages with foundation training.
• Demonstrates an ability to understand criticism and, where necessary, adapts practice appropriately.
• Demonstrates an ability to seek out and appraise new knowledge and, where appropriate, recruits for and/or conducts original research and incorporates any findings into practice.

GPCs: 1, 2, 3, 8, 9

F1 Behaviours

• Demonstrates an exploration of the breadth of medical practice to broaden knowledge and understand the variety of care available to the patient, and to inform career development.
• Understands the impact of personal values on career selection.

F2 Behaviours

• Demonstrates an understanding of a variety of different healthcare environments.
• Demonstrates an understanding of career options available.

GPCs: 1, 2, 3, 4, 5, 6, 7, 8, 9