What is good supervision?

Earlier this year, the General Medical Council (GMC) in the UK published a document setting out standards for training junior doctors. As such documents go, it is clear, comprehensive anddas the GMC might say itselfdfit for purpose. While no-one would be tempted to set it to music, it’s certainly useful to have a standard in writing like the following one: ‘Trainees must be supported to acquire the necessary skills and experience through induction, effective educational and clinical supervision, an appropriate workload, relevant learning opportunities, personal support and time to learn’. It’s also helpful to have such a standard broken down into unambiguous requirements including this: ‘Working patterns and intensity of work by day and by night must be appropriate for learning (neither too light nor too heavy), in accordance with the approved curriculum, add educational value, and be appropriately supervised’. Three cheers for that. Yet here the document falters, as such official documents so often do. What exactly does it mean to be ‘appropriately supervised’? How are trainees to know if the supervision they are receiving is appropriate or not? Indeed, how should a trainer or supervisor know if what they are offering is appropriate, good, excellent or inadequate? On this, the GMC is, perhaps understandably, silent.