Doctors should never stop learning. At every stage of their career, they should continue their professional development and refine their clinical skills and the quality of their interactions with others. Doctors must understand their strengths and weaknesses, their personal style, assumptions and beliefs. This requires doctors to be open to feedback and, with reflection and guidance, to be able to modify their behaviour.
The developmental process involves recognition that, at the start of their professional career, doctors have to work through an explicit set of processes before being able to formulate a hypothesis, which leads to a differential diagnosis. They may then use protocols and guidelines to decide on relevant investigations and management (see table X Dreyfus model below). They will observe that an expert clinician may reach a similar diagnosis and appear to have made an intuitive leap with relatively limited information. However, this clinical judgement will have been made using a complex decision-making process involving intuition and analysis, self-knowledge and 'theoretical' knowledge, based on extensive experience. This judgement may take account of the knowledge that 'common things commonly occur', but also that rare events are possible and can be suspected when there is something unusual in a patient's presentation. As the foundation doctor progresses through the foundation programme, they will hone their skills and gradually start to move towards more independent practice.
The foundation programme curriculum is designed to imbue and foster the ethos of continual learning aided by reflection, which will serve doctors throughout their career.
Foundation doctors are developing professionals and need to deepen and broaden their understanding and expertise. This means:
These attributes are recognised throughout the curriculum, which seeks to provide opportunities for development though practice and engagement with learning in the workplace. Supervised learning events encourage the recognition of good practice and also allow targets for development to be identified and worked on.