This year the General Medical Council will introduce its new performance procedures, the greatest extension to its powers since 1858. Their purpose is to protect patients from “dodgy doctors”—doctors whose performance is seriously deficient. Failure to comply with the performance procedures may result in restricted registration or suspension.

The process begins with a preliminary review of the doctor's professional attitudes and approach to practice. If this raises concerns a more detailed appraisal will ensue, involving a visit to the workplace by an assessment team. The visit is agreed beforehand, but advanced notice is insufficient to remedy bad practice. The assessors provide a profile of the doctor's performance and make recommendations to the GMC.

I recently volunteered to take part in a national experimental assessment in obstetrics and gynaecology—luckily my own specialty. The purpose was not to determine my competence, but to enable the GMC to evaluate the feasibility and effectiveness of its assessment programme.

Before the visit I completed a portfolio and competence lists for communication and clinical skills to help the team understand my background and current professional responsibilities. It included details of recent operations, obstetric interventions, and outpatient clinics. It took several hours to check theatre lists and labour ward records, and to complete the various …