Speciality Specific Guidance

Speciality Specific Guidance

The Faculty of Occupational Medicine of the Royal College of Physicians

3rd Floor, New Derwent House, 69-73 Theobald’s Road, London, WC1X 8TA Tel: 020 72428698

For the Award of Membership of the Faculty of Occupational Medicine under regulation M1 (C)
The Faculty of Occupational Medicine, December 2009

Guidance for Applications for Membership under Regulation M1(c)

Good Medical Practice

MFOM holders must be judgement-safe and competent in their practice of occupational medicine. The MFOM holder will offer choices to patients[1], share decisions with them with sensitivity and provide education and support for self-care. They must be able to demonstrate the qualities and abilities to manage a clinical unit or team, ensuring high standards of professional care and effective working relationships with colleagues across professional disciplines. The MFOM holder will be able to monitor plans and initiatives, to evaluate them and ensure that modifications are made where appropriate. The MFOM holder may take on a leadership role within teams and organisations and will have the vision and foresight to develop new ways of working and the commitment to see projects and teams through to the end. The MFOM holder will demonstrate the personal capacity and qualities to respond positively to feedback from colleagues and patients, to take and accept responsibility for clinical decisions, and to manage and respond to complaints from families of patients and fellow professionals in a professional manner. They must support teaching and training programmes for trainees, departments and staff under their supervision. MFOM holders must demonstrate a commitment to the highest standards of care and ethical and professional behaviour within their speciality and within the medical profession as a whole.

1 Good clinical care

Providing a good standard of practice and care

MFOM holders must take and accept responsibility for the patient’s care in all OM contexts. They will maintain high standards in OM clinical practice and will be able to demonstrate strong analytic skills and insight in the clinical and management decisions they make about the treatment and care of patients. MFOM holders practise safely and acknowledge when cases go beyond their expertise and when they should refer to other specialists for advice. MFOM holders ensure that they and their colleagues work within current legal and ethical guidelines in their field. They monitor clinical practice and evaluate and modify protocols in the light of evidence-based research and audit findings. MFOM holders will ensure clear and effective systems for sharing information, record-keeping and report-writing in a timely fashion.

Generic criteria / MFOM holder standards / Examples of evidence
MFOM holders will;
1.1 Have the breadth of knowledge and skills to take responsibility for safe clinical decisions / Applicants will be measured against the CCT curriculum requirements for Occupational Medicine. Essentially an MFOM holder will:
Make an adequate OH assessment of the patient’s health, based on the clinical and occupational history and clinical signs, an understanding of the work, and if necessary, an appropriate examination of the patient, and any relevant medical reports and tests.
Assess competently the interaction between workers and their jobs- including occupational factors that may adversely affect their health and safety, or that of others; and factors in the individual that may pose special difficulties in the safe, effective conduct of their duties and fitness for work.
Organise investigations important to the assessment of occupational risks or fitness for work.
Provide specific occupational interventions where indicated.
Take suitable and prompt action when necessary.
Provide patients with the information they need to protect themselves against
occupational risks.
Apprise the patient of other sources of help and advice.
Refer the patient to their general practitioner when indicated.
Collect enough information to make a competent assessment of the risks from work, including information on groups of workers.
Visit the workplace where appropriate, in order to gain an understanding of the work environment, the nature and demands of the work and the risks to health.
Advise on the measures required to control the health and safety risks arising from work activities, especially any obligations which are statutory.
Advise health surveillance where indicated and interpret the findings.
Assess competently the patient’s capability for work and the options for rehabilitation or redeployment in cases considered for ill health retirement.
Encourage employers to accommodate workers with illness or disability and advise
employers and employees on any statutory requirements and sources of assistance relating to disability.
Encourage employers not to discriminate unfairly against employees with health problems. / Qualifications
-evidence of qualifications relevant to OM , e.g. Associateship of the Faculty of Occupational Medicine of the Royal College of Physicians of London or Diploma in Occupational Medicine.
-for overseas qualifications, authenticated evidence, details of curriculum/assessments.
-evidence of training posts and programmes followed e.g. curriculum details.
-training log books/portfolios.
-evidence that training was recognised by relevant authorities.
-detailed curriculum vitae.
-employment records with duration/level of responsibility/exposure to OM curricular elements/detailed description of duties/number of cases and activity levels.
-evidence from recent practice (five years)
-reports from supervisors or colleagues.
-appraisals/other formative assessment information.
-revalidation portfolios.
-clinical audit/case discussion group/continuous improvement activities.
-examples of written reports/assessment of workplaces/health surveillance or investigation of cases of occupational illness.
1.2 Have the self-awareness to acknowledge where the limits of their competence lie, and when it is appropriate to refer to other senior colleagues for advice / Recognise and work within the limits of their professional competence.
Be willing to consult colleagues and seek specialist advice or supervision, where appropriate.
1.3 Have the ability to take responsibility for clinical governance activities, risk management and audit in order to improve the quality of service provision / Work with colleagues to monitor and maintain their awareness of the quality of the service they provide, and be open and honest with the results.
Take part in regular and systematic medical and clinical audit.
Respond constructively to the outcome of reviews, assessment and appraisals, of their performance.
Demonstrate an understanding of the context, meaning, and implementation of clinical governance.

2. Relationships with patients

MFOM holders will demonstrate the capacity to build trust and to develop and maintain effective relationships with patients. They will be good listeners and show respect and understanding for patients’ perspectives on their illnesses or conditions. They must demonstrate a commitment to the principles and practice of consent and confidentiality.

Generic Criteria / MFOM holder standards / Examples of evidence
MFOM holders will:
2.1 Be skilled in building relationships of trust with patients and their families/supporters, through effective interpretation skills, a courteous and compassionate approach, and respect for their privacy, dignity and cultural and religious beliefs / An MFOM holder will:
Establish and maintain a relationship of trust by:
- Being truthful and open.
- Treating patients politely and considerately.
- Listening to patients and having respect for their perceived needs.
- Respecting patients’ privacy and dignity.
- Ensuring that they do not enter into any improper personal relationships with patients.
- Respecting the rights of patients to decline treatment. / Experience (from recent practice)
-structured reports from supervisors and colleagues.
-formal assessments/appraisals.
-complaints regarding self or others.
-recognition of good performance.
-evidence from specific anonymised cases.
-multisource feedback, including that from patients.
-relevant training in communication skills.
2.2 Follow the principles and legal aspects of consent and confidentiality / Treat information about patients as confidential.
Ensure that managers understand the constraints on disclosure of personal health information imposed by the patient’s entitlement to confidentiality.
Ensure the confidentiality of the medical records they hold on patients, including security of storage and transmission.
2.3 Be able to manage difficult and complex situations with patients and their families, to advise them appropriately and to manage complaints effectively. / If a patient under their care has suffered serious harm through misadventure or through mistake or omission, or an occupational exposure, they should act to put matters right, if that is possible. They should explain fully and promptly to the patient what has happened and the likely short and long-term health effects, including if necessary, where they can obtain advice or counselling services about their condition. Where appropriate, they should offer an apology.

3. Maintaining Good Medical Practice

Keeping up to date

MFOM holders set high standards in their clinical care and ensure that they remain fully competent to practise through their commitment to continuing professional development and the process of revalidation. They foster the skills and abilities of colleagues and encourage their professional development by identifying and ensuring their participation in further training and research opportunities. MFOM holders are reflective practitioners and strive to improve standards in all aspects of their work. They demonstrate the ability to seek and respond constructively to feedback.

Generic Criteria / MFOM holder standards / Examples of evidence
MFOM holders will:
3.1 Take responsibility for and keep up to date in their own relevant professional and self-development, and facilitate that of others / An MFOM holder will:
Keep their knowledge and skills up to date and appropriate for all areas of their practice throughout their working life.
Observe and keep up-to-date with the laws and statutory codes which affect their practice / Experience
-professional development.
-evidence of CPD, either FOM certified or equivalent.
-evidence of reflective practice.
-awareness of current UK legislation, including one example of a workplace visit report or anonymised case report demonstrating this competence.
-research activity relevant to the specialty/use of research for evidence based practice/policy.
-participation in teaching and lecturing.
-departmental audit or continuous improvement activities.
-attendance at conferences.
-membership of relevant professional bodies/organisations.
-formal assessments/appraisals and structured reports from supervisors or colleagues.
3.2 Acknowledge that the balance of their skills and expertise will change as their careers progress and they specialise in certain areas of clinical practice

4 Teaching and Training, appraising and assessing

Making assessments and providing references

MFOM holders may be expected to teach and train students, trainees and colleagues and to appraise and assess their work. They will demonstrate effective communication skills in all of these activities, in the presentation and discussion of topics and in their personal interactions. MFOM holders will be able to demonstrate an understanding of and a commitment to the principles and practice of effective teaching and learning in clinicalcontexts. They must be able to take responsibility for the supervision of trainees and ensure that effective arrangements are in place. They must demonstrate the ability to be open, honest and objective in appraisals and in written references for colleagues.

Generic Criteria / MFOM holder standards / Examples of evidence
MFOM holders will:
4.1 Be able to demonstrate the potential to teach and train effectively at all levels of undergraduate and postgraduate education where required / An MFOM holder will:
Develop the skills, attitudes and practices of a competent teacher. / Experience
-participation in teaching, lecturing, and management over last five years
supported by confirmatory evidence.
-departmental audit or continuous improvement activities.
-feedback from students.
-structured reports from supervisors/colleagues.
-formal assessments or appraisals.
-attendance at relevant training courses.
4.2 Demonstrate skills and strategies in the process of feedback to colleagues and trainees, ensuring positive and constructive outcomes
4.3 Be capable of judging competence and professional attributes in others / Be honest and objective when appraising or assessing the performance of any colleague they have supervised or trained.

5. Working with colleagues

Working in teams and within organisations

MFOM holders work as members of a number of teams and within organisations. They must be able to demonstrate an understanding of the roles of others and a respect for the knowledge, skills and experience they bring to a team and to an organisation. They will demonstrate strong interpersonal skills and an open and non-discriminatory approach to professional working relationships with colleagues.

Generic Criteria / MFOM holder standards / Examples of evidence
MFOM holders will:
5.1 Strive for continuing improvement in all aspects of their work and that of colleagues while mindful of priorities and high standards / An MFOM holders will:
Take responsibility for ensuring that the team works effectively to achieve high standards of care, including clinical effectiveness and efficiency.
Participate in regular reviews and audit of the standards and performance of the team, taking steps to remedy any deficiencies. / Experience
-outline of experience/participation in management activities.
-examples of recent appraisals/evaluation of staff.
-outcomes from teamwork, for example meeting minutes and specific outcomes.
-feedback/360° appraisals.
-structured reports from supervisors/colleagues.
-formal assessments/appraisals.
-evidence of relevant training.
5.2 Have effective interpersonal skills which enable them to bring out the best in colleagues, to resolve conflicts when they arise and to develop and maintain productive working relationships within the team / Communicate effectively with colleagues within and outside the team.
Make sure that their patients and colleagues understand their professional status and specialty, their role and responsibilities in the team, who is responsible for each aspect of patient care, and what information will be shared between team members.
5.3 Support teams that bring together different professions and disciplines and other agencies, to provide high quality healthcare / Work constructively within teams and respect the skills and contributions of their colleagues.

6. Probity and health

Protecting patients and the profession

MFOM holders are honest and trustworthy, recognising the privileges and responsibilities of their position. They ensure the standards of Good Medical Practice as set out by the General Medical Council and other relevant Colleges/Faculties or professional bodies are met.

Generic Criteria / MFOM holder standards / Examples of evidence
MFOM holders will:
6.1 Always act in their personal and professional lives to maintain public trust in the profession / An MFOM holder will:
Demonstrate an understanding of regulatory bodies/probity in personal and professional life. / -current registration certificate with current regulatory body.
-health statement/declaration.
-current certificate of good standing with relevant regulatory body.
-structured reports from supervisors/colleagues.
-evidence from specific cases (anonymised).
-letters of appreciation from colleagues.
6.2 Act quickly and effectively if they have reason to believe that their own or a colleague’s conduct, performance or health may put patients at risk / If they have a serious condition which they could pass on to patients, or if their judgement or performance could be significantly affected by an illness or its treatment, they must obtain and follow advice from an independent specialist in occupational medicine on whether, and in what ways, they should modify their practice.
6.3 Undertake duties such as writing reports, giving evidence and completing and signing documents in a timely, honest and conscientious way. / Be honest and trustworthy when writing reports, completing or signing forms, or providing evidence in litigation or other formal inquiries.
6.4 Through their leadership encourage the development and practice of these qualities in their colleagues. / Ensure that team members meet the standards of conduct and care set out in FOM Good Medical Practice for Occupational Physicians.

Guidance for the award of Membership of the Faculty of Occupational Medicine under Regulation M1 (C). December 2009.


[1] From Good Medical Practice for Occupational Physicians (FOM, 2001), p.6: ‘Many occupational physicians use the term ‘client’, ‘employee’ or ‘worker’, rather than ‘patient’, to emphasise a relationship that is frequently non-therapeutic.’