All doctors working in England are to face annual appraisal of their skills and performance and will have to reapply for a medical licence every five years, according to plans announced by the UK chief medical officer, Liam Donaldson.

For most doctors not in substantive training posts revalidation will involve two components—relicensing, subject to their adherence to generic standards, such as the General Medical Council’s Good Medical Practice guidelines, and specialist recertification, which will depend on meeting criteria to be set by the relevant medical royal colleges.

Both the GMC and the Academy of Royal Medical Colleges worked with Sir Liam to develop the proposals, which the GMC’s president, Graeme Catto, called “the biggest change to medical regulation in 150 years.”

Although GPs and some specialties already have appraisal systems written into their contracts, Sir Liam’s working group argued that implementation was …