An Introduction to Professional Competence Schemes

The Law and Professional Competence

The 2007 Medical Practitioners Act provides a new legal framework under which the Medical Council must ensure that all doctors maintain their professional competence.  This law places an obligation on doctors to participate in the Council’s Professional Competence Schemes.  Since the 2007 Act was passed into law, the government has ‘commenced’ it in stages.   The only part of the Act which has yet to be commenced (Part 11) relates to Professional Competence. 

In December 2009, the Medical Council indicated to government that it had completed its preparation for the introduction of Professional Competence Schemes and formally asked the Minister for Health & Children to commence Part 11 of the Medical Practitioners Act.  Once commenced, participating doctors must be formally enrolled in Professional Competence Schemes within a twelve-month period.

Professional Competence applies to all 10,000 registered doctors who are in practice in Ireland, other than those in approved post-graduate training posts.  It applies to those on the general as well as on the specialist register.  It applies to the self-employed, to those working in the private sector and to those in the public sector.  It applies to NCHDs who are not in approved post-graduate training posts.  It applies to those who work part-time and to those who are not currently in clinical practice. 

In short, it almost certainly applies to you. 

The Medical Council has devolved responsibility for the day-to-day administration of Professional Competence Schemes to the 13 recognised Postgraduate Training Bodies.  However, in accordance with the law, the Medical Council will maintain ultimate responsibility for all aspects of Professional Competence.  It will monitor the compliance of doctors and will introduce structures to deal with those who fail to comply. 

What Professional Competence Schemes will involve

The Medical Council fully accepts that the vast majority of doctors maintain their professional competence (i.e. their knowledge and skills) as a matter of course.  For such doctors, the introduction of Professional Competence Schemes will involve little more than a minor administrative task – i.e. formally documenting their on-going educational activities.  In the development of Professional Competence Schemes, the Medical Council is keen to build on what was already in place.  However, it is perhaps inevitable that future changes in medical practice will cause Professional Competence Schemes to evolve over time. 

To begin with, there will be two elements to Professional Competence Schemes:

•Continuing Professional Development

•Clinical Audit

Continuing Professional Development (CPD)

The Medical Council has allowed each of the 13 Postgraduate Training Bodies some flexibility in deciding what exactly it expects of those doctors who are aligned to it for Professional Competence.  However, all doctors will be expected to accumulate a minimum of 50 CPD credits over a 12-month period.  As a rule of thumb, an hour of CPD activity will generate one CPD credit, though some Training Bodies may weight certain CPD activities so that they generate higher credits.  In addition, credits must relate to a range of different activities, for example to educational activities that happen in the normal work-place as well as those that involve attendance at regional, national or international meetings.  Each doctor will need to check with the relevant Postgraduate Training Body to find out what exactly will be expected of him or her in relation to CPD. 

Clinical Audit

Clinical audit is a structured process with identifiable steps:

•A doctor identifies a specific area of clinical practice on which to focus

•Relevant data is collected and ideally, this is compared with an existing and accepted standard

•The doctor reflects on what has been learnt and when indicated, modifies his or her practice accordingly

As part of the Medical Council’s Professional Competence Schemes all doctors will be obliged to participate in Clinical Audit.  Initially, there will be a requirement to take part in just one Audit exercise annually, though it is probable that this demand will increase over time.  It is envisaged that doctors will initially need to devote something like one hour per month (i.e. 12 hours per year) to Audit activities.  As with CPD activities, the relevant Postgraduate Training Body will be able to provide individual doctors with practical advice on the conduct of Clinical Audit. 

The further development of Professional Competence Schemes

In introducing its Professional Competence Schemes, the Medical Council has made every effort to ensure that the new demands being placed on doctors, on employers, on the Postgraduate Training Bodies and on the Irish health care system are both realistic and likely to enhance the delivery of clinical care.  The Schemes will be closely monitored and if necessary, will be modified in the light of experience.  There is particular interest in the potential role of Multi-Source Feedback (MSF) as an element of Professional Competence Schemes.  Currently, the Medical Council is conducting the second of two pilot projects on MSF that should help to clarify its future role.  

What you need to do

Once the Minister for Health & Children commences Part 11 of the Medical Practitioners Act (and assuming that you are not currently in an approved postgraduate training post), you need to contact your Postgraduate Training Body to enrol in its Professional Competence Scheme. 

If you are not aligned to any Postgraduate Training Body, you should contact that Training Body which is most relevant to your area of clinical practice.  You need not necessarily be a member of a Training Body to participate in its Professional Competence Scheme.  If you have any difficulty in aligning with a Postgraduate Training Body we would urge you to contact the Professional Competence Section of the Medical Council without delay at 01-498-3136 or pc@mcirl.ie.