Colleagues, culture and safety

Why this matters on day one

The most substantial change in the 2024 edition. It makes creating a respectful, inclusive culture an explicit professional duty — and states that bullying, harassment and undermining are matters of patient safety, not just workplace unpleasantness. As an FY1 you are usually the recipient, and you need to know that raising it is supported.

What the domain requires

1. 1Contribute to a positive culture. Be civil. Do not bully, harass, discriminate against or undermine colleagues, and challenge it when you see it happening to others.
2. 2Work effectively in teams. Hand over safely, communicate clearly, respect the expertise of nurses, pharmacists and therapists, and understand your own role in the team.
3. 3Act on safety. Report incidents and near-misses, contribute to reviews, and take part in improvement rather than only observing it.
4. 4Raise concerns. If patient safety is at risk you must act. Start locally; escalate to the freedom to speak up guardian, guardian of safe working, medical director, and ultimately the GMC. You do not need to be certain, and you are protected.

What evidencing it looks like

• An incident or near-miss you reported and what changed.
• An exception report for unsafe hours or workload.
• Multi-source feedback from the wider MDT, not only doctors.
• A concern you raised, and how it was handled.

What falls short

• Staying silent about an unsafe colleague or rota out of loyalty or fear of the consequences.
• Escalating a clinical concern but not a cultural one, as though the second is not your business.
• Being the person who is short with nurses at 3am — it degrades handover quality and therefore safety.

Demonstrated by