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Rapid Responses: Rapid Responses published:
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What happened to English?
- |Bernard Leary (19 March 2004)
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Re: What happened to English?
- Sam Lewis (20 March 2004)
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Swallow hard
- Geoff Wong (23 March 2004)
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The best revalidation
- Francesco Carelli (28 March 2004)
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|Bernard Leary, Retired Chesterfield S43 1AX
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Being retired and facing the possibility of being struck off I read the articles on revalidation with interest. But it seems that we have started to use a language other than English. I quote: Box 1 page 688 ( 20 March 2004) "Examples of criterion statement". What on earth does this mean? What is a criterion statement? I move to Box 2 "Examples of givens". Who or what are givens?Is it singular or plural? For the sake of the senile like me can we please speak English? Competing interests: None declared |
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Sam Lewis, GP Surgery, Newport, Pembrokeshire, SA42 0TJ
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Somebody has 'progressed this matter' into the Mid-Atlantic.. where the known unknowns are givens, and 'weapons of mass destruction' will eventually be found and revalidated. Competing interests: Welsh |
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Geoff Wong, GP Principal The Surgery, 5 Daleham Gardens, London NW3 5BY
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Sometime in 2005 (but who knows exactly when, as the authors of this paper (1) and van Zwanenberg (2), cannot seem to agree on a start date and the General Medical Council (GMC) are just as vague(3)), all the 100,000 or so doctors in the United Kingdom (UK) will be subject to revalidated. It is gratifying to see that the BMJ has published two papers on this potentially historic change in the licensing of medical practitioner in the UK. My reasons are two fold: Firstly, despite gravity of these changes there has been and still is so little debate on this matter (read through, for example, van Zwanenberg’s references and you will have just about read all that has been published on this matter). This change in the licensing of medical practitioners will affect the lives of every doctor registered with the GMC, yet few seem to have any concerns about the process, its implications and the fallout from revalidation. People obviously read the BMJ and respond to articles within it. For example, there was a flood of responses to Wald and Law’s paper on the PolyPill (4) but there has been not even what could be described as a trickle to this pair of articles on revalidation. Have we all been distracted by contract worries, or are we all putting our heads in the sand? Our new contracts will determine how much money goes into our pocket, but failing revalidation might send you down to your local job centre. Secondly, Bruce et al (1) provide one of the few published trials on the process of revalidation. But their trial is based on the views of only 53 doctors (and volunteers at that). Soon all the doctors in Scotland will have the choice of following their model of revalidation or engage in a bit of do-it-yourself revalidation. The Scots are the lucky ones, in the rest of the UK, there is even less to go on! Only unsupported statements like, “We believe that full participation in annual appraisal, with completed supporting documentation, during the revalidation cycle, is a powerful indicator of a doctor’s current fitness to practise.” (3). Or you could take your chances on the independent route where, “Acceptable evidence will include appropriate quality indicators, where necessary supported by other data and information (which may involve using some of the tools outlined later in this booklet) covering your whole medical practice over the period.” (3). I, however could not find these tools on the GMC’s website, as the link just took me to an electronic copy of Good Medical Practice. Revalidation is a mess. It has no clear purpose (1), hardly any evidence base behind it but will be forced upon all doctors in the UK. Maybe what we need to do is to reframe the problems surrounding revalidation. Look at it this way, if I told you I had a drug called ‘Revalidation’, but it had no clear indication, little research had been done on its efficacy and nothing had been done on either its effectiveness, cost-effectiveness nor its safety profile, would you swallow it? Well you won’t have a choice come 2005. References: 1. Revalidation for general practitioners: randomised comparison of two revalidation models. Bruce D, Phillips K, Reid R, Snadden D, Harden R. BMJ 2004;328:687-691 2. Revalidation: the purpose needs to be clear. van Zwanenberg T. BMJ 2004;328:684-686 3. General Medical Council. United Kingdom. http://www.gmc- uk.org/revalidation/index.htm (accessed 23 March 04) 4. A strategy to reduce cardiovascular disease by more than 80%. Wald N, Law M. BMJ 2003;326:1419-1424 Competing interests: None declared |
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Francesco Carelli, EURACT Council National Representative - GMC - RCGP - EGPRN 20123 - Milan - Italy
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We see, here, two models: 1) a criterion model, with revalidation as the primary purpose; 2) an educational outcome model, combining revalidation with continuing professional development. The second one would be better, as considering an educational agenda and as considering quality of life coming from professional development. Of course, in these kind of processes we have to take in consideration doctors' beliefs, expectations and agreement, also. So, we had to consider a mixing to get the best way, in this case, for real revalidation. Competing interests: None declared |
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