Introduction
MMA HealthServe asked me to write this article because I sit on the UK General Medical Council, because I am therefore expected to know something about its proposals for revalidation, and because many doctors currently working overseas, or thinking of going overseas, are understandably worried that by doing so they will compromise their UK registration. This might thereby compromise their chances of successful re-entry to the UK, and/or compromise their registration status in their country of work.
The facts in the following article are correct at the time of writing (October 2002) but any opinions or views are my own and not necessarily those of the General Medical Council. This article refers only to the situation with UK-registered doctors, but I suspect other health disciplines will soon be following similar pathways if they are not doing so already.
Why revalidation?
I qualified in 1975, went onto the provisional register in 1976 and then onto the full register in 1977 after house jobs. At that time the assumption was that unless you were erased from the register for serious professional misconduct, you would automatically stay on it until retirement, and nobody would bother you in between.
But the times have changed. Throughout the 1990s there has been growing public concern about medical standards. Comparisons are drawn with the aviation industry where most of us would not want to fly with a pilot who had not received any checks on his or her safety standards for forty years!
Rightly or wrongly, and I personally strongly support it, the General Medical Council (GMC) decided that doctors must undergo regular checks of their standards. The process (inevitably christened an ‘MOT’ in the tabloids) is called revalidation. A binding decision has been taken to link revalidation to continuing registration. What does this mean? Simple. No revalidation, no registration. No registration, no work as a doctor.
(End of story? Well, not quite. To quote from the September 2002 Report from the GMC’s Revalidation Technical Group: ‘Doctors can choose not to participate in revalidation and stay on the register without the entitlement to exercise the privileges currently associated with registration’. But I suspect those reading this article will want to be fully revalidated in order to continue to practise medicine fully, in the UK or overseas. So read on!)
What is the likely timetable?
The work of the GMC is governed by Parliament, so implementing the now agreed proposals will require legislative change. Revalidation should take place two years after the legislation has been put in place. This means the GMC will start considering the first live cases (pilots are taking place now) at the end of 2004 or the beginning of 2005.
But because only one fifth of revalidating doctors will be checked each year, you have at least two years and maybe seven years before they come to you.
What will revalidation involve?
Quoting from the same report, ‘Doctors who take part in revalidation will be granted a licence to practise, and will be asked to submit evidence to the GMC on a five-yearly basis which will be assessed by a revalidation group. The group can recommend that the doctor is up-to-date and fit to practise medicine, and that the doctor’s licence to practise should be re-issued. Or, if the group feels the evidence raises some concerns or is insufficient, they can either request further information or refer the doctor to our fitness to practise procedures for further assessment.’
For doctors working in the UK National Health Service, annual appraisal procedures (launched for consultants in April 2001 and introduced for GPs in April 2002) would normally provide the evidence on which the revalidation group will make their decision. Pilot studies are currently going on into how this might work in practice, and are generally encouraging (though see below). This will therefore take care of about 90% of UK doctors, but the other 10% and those working overseas will need to produce evidence relevant to their own specific situations to satisfy the same criteria.
What should I be doing?
‘Doctors will be asked to collect evidence, which will be considered against the seven headings set out in the GMC guidance Good Medical Practice.’ This excellent publication lists a biblical seven categories (!) and they are:
But the principles are there. If you’re not doing it already, start recording data about what you do. Well-designed job plans, details of clinical activities, and supporting information such as simple lists of cases seen with their management and outcome, could assist the revalidation groups in making appropriate recommendations. Focus on your job description, keep your CV up-to-date, attend a CMF/MMA HealthServe Residential Refresher Course, record local educational activities. The annual report of your mission hospital might help regarding relationships with patients and colleagues and probity.
I won’t go on – nobody knows the details yet, but I do know that a good doctor collecting evidence faithfully should have nothing to fear. The actual assessment process will probably have to take place in the UK but if it’s only once every five years it could surely be co-ordinated comfortably with home leave.
Where can I get more information?
Regular updates should be coming from the GMC to your registered address (you are keeping it effective I hope!) There is a specific website:
www.revalidationuk.info
and you can always search the GMC’s general website:
www.gmc-uk.org
And finally
The quirky title for this article is based on that seminal movie Dr Strangelove. I chose the title because proving your strengths as an individual doctor should encourage you and your families, your mission boards, your hospitals, and your patients. If you’re worrying at this point, and many are, I believe you can stop doing so. Start collecting that evidence, and prove your strengths. You may yet love revalidation, and its reminder to you of the privilege and pleasure of your work.
Andrew Fergusson has a portfolio career at the interface of medicine and Christianity. It includes being an elected member of the General Medical Council
For more information on the Residential Refresher Course, click here.
MMA HealthServe asked me to write this article because I sit on the UK General Medical Council, because I am therefore expected to know something about its proposals for revalidation, and because many doctors currently working overseas, or thinking of going overseas, are understandably worried that by doing so they will compromise their UK registration. This might thereby compromise their chances of successful re-entry to the UK, and/or compromise their registration status in their country of work.
The facts in the following article are correct at the time of writing (October 2002) but any opinions or views are my own and not necessarily those of the General Medical Council. This article refers only to the situation with UK-registered doctors, but I suspect other health disciplines will soon be following similar pathways if they are not doing so already.
Why revalidation?
I qualified in 1975, went onto the provisional register in 1976 and then onto the full register in 1977 after house jobs. At that time the assumption was that unless you were erased from the register for serious professional misconduct, you would automatically stay on it until retirement, and nobody would bother you in between.
But the times have changed. Throughout the 1990s there has been growing public concern about medical standards. Comparisons are drawn with the aviation industry where most of us would not want to fly with a pilot who had not received any checks on his or her safety standards for forty years!
Rightly or wrongly, and I personally strongly support it, the General Medical Council (GMC) decided that doctors must undergo regular checks of their standards. The process (inevitably christened an ‘MOT’ in the tabloids) is called revalidation. A binding decision has been taken to link revalidation to continuing registration. What does this mean? Simple. No revalidation, no registration. No registration, no work as a doctor.
(End of story? Well, not quite. To quote from the September 2002 Report from the GMC’s Revalidation Technical Group: ‘Doctors can choose not to participate in revalidation and stay on the register without the entitlement to exercise the privileges currently associated with registration’. But I suspect those reading this article will want to be fully revalidated in order to continue to practise medicine fully, in the UK or overseas. So read on!)
What is the likely timetable?
The work of the GMC is governed by Parliament, so implementing the now agreed proposals will require legislative change. Revalidation should take place two years after the legislation has been put in place. This means the GMC will start considering the first live cases (pilots are taking place now) at the end of 2004 or the beginning of 2005.
But because only one fifth of revalidating doctors will be checked each year, you have at least two years and maybe seven years before they come to you.
What will revalidation involve?
Quoting from the same report, ‘Doctors who take part in revalidation will be granted a licence to practise, and will be asked to submit evidence to the GMC on a five-yearly basis which will be assessed by a revalidation group. The group can recommend that the doctor is up-to-date and fit to practise medicine, and that the doctor’s licence to practise should be re-issued. Or, if the group feels the evidence raises some concerns or is insufficient, they can either request further information or refer the doctor to our fitness to practise procedures for further assessment.’
For doctors working in the UK National Health Service, annual appraisal procedures (launched for consultants in April 2001 and introduced for GPs in April 2002) would normally provide the evidence on which the revalidation group will make their decision. Pilot studies are currently going on into how this might work in practice, and are generally encouraging (though see below). This will therefore take care of about 90% of UK doctors, but the other 10% and those working overseas will need to produce evidence relevant to their own specific situations to satisfy the same criteria.
What should I be doing?
‘Doctors will be asked to collect evidence, which will be considered against the seven headings set out in the GMC guidance Good Medical Practice.’ This excellent publication lists a biblical seven categories (!) and they are:
- Good clinical care
- Maintaining good medical practice
- Teaching and training
- Relationships with patients
- Working with colleagues
- Probity
- Health
But the principles are there. If you’re not doing it already, start recording data about what you do. Well-designed job plans, details of clinical activities, and supporting information such as simple lists of cases seen with their management and outcome, could assist the revalidation groups in making appropriate recommendations. Focus on your job description, keep your CV up-to-date, attend a CMF/MMA HealthServe Residential Refresher Course, record local educational activities. The annual report of your mission hospital might help regarding relationships with patients and colleagues and probity.
I won’t go on – nobody knows the details yet, but I do know that a good doctor collecting evidence faithfully should have nothing to fear. The actual assessment process will probably have to take place in the UK but if it’s only once every five years it could surely be co-ordinated comfortably with home leave.
Where can I get more information?
Regular updates should be coming from the GMC to your registered address (you are keeping it effective I hope!) There is a specific website:
www.revalidationuk.info
and you can always search the GMC’s general website:
www.gmc-uk.org
And finally
The quirky title for this article is based on that seminal movie Dr Strangelove. I chose the title because proving your strengths as an individual doctor should encourage you and your families, your mission boards, your hospitals, and your patients. If you’re worrying at this point, and many are, I believe you can stop doing so. Start collecting that evidence, and prove your strengths. You may yet love revalidation, and its reminder to you of the privilege and pleasure of your work.
Andrew Fergusson has a portfolio career at the interface of medicine and Christianity. It includes being an elected member of the General Medical Council
For more information on the Residential Refresher Course, click here.
