About This Page
This is a clinician-written, evidence-based summary aligned to the 2026 MLA Content Map. It is intended for medical students and junior doctors preparing for the UKMLA. Always cross-reference with NICE guidance, local protocols, and clinical judgement.
The Bottom Line
- Good Medical Practice (GMP, updated 2024): the GMC's core professional standards document. Sets out what is expected of every doctor in the UK
- Four domains: (1) Knowledge, skills, and performance, (2) Safety and quality, (3) Communication, partnership, and teamwork, (4) Maintaining trust
- Key principles: make patient care your first concern, treat patients as individuals, work within your competence, be honest and trustworthy, act with integrity
- Fitness to practise: GMC can investigate doctors who fall below expected standards. Outcomes range from undertakings to erasure from the medical register
- Revalidation: all licensed doctors must revalidate every 5 years — demonstrating they remain up to date and fit to practise
Overview
Good Medical Practice is the GMC's overarching professional guidance. Updated in 2024, it sets the standards expected of all doctors registered with the GMC. It covers every aspect of professional life: clinical competence, patient safety, effective communication, maintaining trust, and personal behaviour. GMP is the benchmark against which fitness to practise is assessed. Breaching its principles can lead to GMC investigation and sanctions up to and including erasure from the medical register. Revalidation was introduced in 2012, requiring all licensed doctors to demonstrate their continuing fitness to practise through annual appraisal and 5-yearly revalidation by a Responsible Officer.
Epidemiology
There are approximately 370,000 doctors on the UK medical register. The GMC receives approximately 8,000 complaints per year. Of these, approximately 200-300 result in a Medical Practitioners Tribunal Service (MPTS) hearing. The most common reasons for fitness to practise action are: clinical performance concerns, dishonesty/fraud, criminal convictions, and health issues (including substance misuse). Erasure from the register occurs in approximately 50-80 cases per year.
The Four Domains
Symptoms
Domain 1 — Knowledge, skills, and performance: keep knowledge and skills up to date, recognise and work within your competence, prescribe safely, maintain good clinical records
Domain 2 — Safety and quality: contribute to patient safety systems, respond to risk, raise concerns, support a learning culture, take part in audit and quality improvement
Domain 3 — Communication, partnership, and teamwork: communicate effectively with patients and colleagues, share information, work collaboratively, delegate appropriately, manage complaints
Domain 4 — Maintaining trust: be honest and transparent, maintain probity, act with integrity, maintain professional boundaries, manage conflicts of interest
Signs
Probity: be honest in financial dealings, research, publications, CVs, and professional communications
Professional boundaries: do not pursue sexual or emotional relationships with current patients. Avoid relationships with former patients if you have been their doctor for a significant period
Social media: maintain professional standards online. Do not post patient-identifiable information, offensive content, or material that undermines public confidence in the profession
Health: if your health may affect your fitness to practise, seek appropriate support and inform your Responsible Officer
Regulatory Framework
First-line
GMC registration and licence to practiseAll practising doctors must hold registration AND a licence to practise. Registration alone (without licence) does not permit clinical practice
Annual appraisalStructured review of practice: reflective log, CPD, quality improvement activity, complaints, significant events, feedback (patient and colleague), health declaration
Second-line
Revalidation (every 5 years)The Responsible Officer (usually the Medical Director) makes a recommendation to the GMC based on 5 completed annual appraisals. GMC then revalidates the licence
Fitness to Practise (FtP) processComplaint → GMC investigation → case examiner decision (close/warn/undertakings/refer to MPTS) → MPTS hearing (conditions, suspension, or erasure from register)
Specialist
Medical Practitioners Tribunal Service (MPTS)Independent tribunal that hears serious FtP cases. Can impose: no action, undertakings, conditions, suspension, or erasure. Decisions can be appealed to the High Court
Management
GMC Good Medical Practice (2024)1
Maintaining professionalism
- Keep knowledge and skills current — regular CPD, courses, teaching, learning
- Practise within your competence — seek help when you are out of your depth
- Maintain accurate and contemporaneous clinical records
- Be honest in all professional dealings — dishonesty is the single most damaging finding in FtP cases
2
Professional boundaries
- Never pursue a sexual or emotional relationship with a current patient
- Be cautious about relationships with former patients — consider power imbalance, vulnerability, and time elapsed
- Do not accept gifts from patients beyond small tokens
- Maintain boundaries on social media — do not "friend" patients on personal accounts
3
When things go wrong
- Report yourself to the GMC if you are charged with or convicted of a criminal offence, receive a police caution, or have a condition that could affect your fitness to practise
- Cooperate fully with any GMC investigation
- Seek support: BMA, medical defence organisation, NHS Practitioner Health, occupational health
Complications
- Erasure from the register: Loss of right to practise medicine — the most severe sanction
- Suspension: Temporary removal from the register (up to 12 months)
- Conditions on practice: Must work under supervision, complete training, etc.
- Reputational damage: FtP decisions are published publicly
- Criminal prosecution: For serious offences (fraud, assault, gross negligence manslaughter)
UKMLA Exam Tips
- 1Patient care is your FIRST concern — this is the overriding principle of GMP
- 2The four domains: Knowledge & skills, Safety & quality, Communication & teamwork, Maintaining trust — know them
- 3Dishonesty is the most damaging finding in FtP — more likely to lead to erasure than clinical error
- 4Revalidation = every 5 years, based on 5 annual appraisals, recommended by Responsible Officer
- 5Professional boundaries: no sexual relationships with current patients. Be cautious with former patients
- 6Social media: do not post patient-identifiable information or anything that undermines public trust in the profession
- 7If your health affects your fitness to practise — you must seek help and inform your RO. The GMC health programme supports doctors with health conditions
practicetest your knowledge on good medical practiceApply what you've learnt with UKMLA-style questions from the iatroX Q-Bank — ethics & law and beyond.
open q-bank