Education And Debate Revalidation

Revalidation in the United Kingdom: general principles based on experience in general practice

BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7218.1180 (Published 30 October 1999) Cite this as: BMJ 1999;319:1180
  1. Lesley Southgate, professor of primary care and medical education (l.southgate@chime.ucl.ac.uk),
  2. Mike Pringle, chairman
  1. a Centre for Health Informatics and Medical Education, Royal Free and University College Medical School, Whittington Hospital Campus, London N19 5NF
  2. b Royal College of General Practitioners, London SW7 1PU
  1. Correspondence to: L Southgate

    Editorial by Buckley

    Professional self regulation is at the heart of the organisation and philosophy of medical care in the United Kingdom. However, demands are growing for increasing transparency and accountability to patients in systems for ensuring doctors' standards. In response to this, the General Medical Council (GMC) has made a commitment to introduce periodic revalidation for all doctors on the medical register after 2002. Every five years all doctors will have to submit evidence that they are practising in accordance with clearly defined guidelines. There is debate about what methods of professional assessment are most closely linked with professional performance. In this article we describe an approach to establishing revalidation in the United Kingdom, highlighting areas of uncertainty and using examples of work in progress in general practice.

    Methods

    This article is based on our work in developing the performance procedures for general practitioners. The proposals are based on international guidelines for good practice in devising assessment programmes which emphasise the importance of using methods relevant to the purpose and content of the assessment.1 2

    Content of revalidation

    Revalidation will be a proactive, inclusive programme, designed to demonstrate that the performance of doctors is acceptable. It will apply to all doctors on the register, be conducted locally by peers and lay people, be monitored nationally by the GMC, and must be implemented with a “light touch” if it is to succeed.

    It is essential that an assessment programme assesses what it purports to assess.1 Revalidation should therefore seek evidence of a safe standard of practice for all areas in which a doctor works, both clinical and managerial. This presents particular problems for specialist practice. There are professional debates about core competencies for specialists (for example, in diabetes or breast surgery) who are on call as generalists for patients being admitted to …

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