I disagree with Jonathan Sleath, and, it would appear, with most responding to this. After working more than full time as a GP for many years, I came close to burn-out and retired at 60. But I certainly didn’t want to stop work entirely – I just wanted my life back. Since then I have worked part-time for a local GP co-op providing out-of-hours and walk-in centre care. I take more time off for non-medical activities in the summer, but, year-round, I now work an average of three sessions a week.
I have had colleagues say that they were not going to continue to work after retirement because of the appraisal requirements, but I think this is short-sighted. Some requirements are more difficult to meet, but recent changes have allowed for the situation of sessional doctors. Some aspects are much easier – I have far more time available now to do professional reading. I am less likely to fall asleep during an evening lecture, or struggle to find the time for a lunch-time meeting. It has never been easier to study flexibly on-line, and, provided I read critically and with some comment, I can use the hours I spend reading relevant parts of the BMJ; in fact, having the appraisal somewhere ahead reminds me that I must get reading, and once I am doing it, I find much of it very interesting. Furthermore, it became very evident to me that, although I can probably take a history and perform an examination as well as I used to, I have rapidly become less familiar with new drugs and changes in disease management. I may no longer be deciding on how best to manage someone’s diabetes, but I certainly need to know what the Canagliflozin a patient takes is, and what its interactions and side-effects may be. Reduced hours tends to narrow one's experience, but our patients still need us to be fully skilled and up to date. I have made a point of looking up any drug I do not recognise – and believe me, it only takes a couple of years before this starts to happen. I can include such looking-up in my appraisal – and I can allow for the time taken to enter it too.
Some of the mandatory training to comply with CQC requirements is certainly rather boring, but this is only a small part of what I do. So – while I deplore hoop-jumping as much as anyone, and I also recognise that appraisals cannot make me a good doctor, nevertheless, I find that my appraisal is a useful stimulus to maintain a good knowledge base, without which I cannot be a good doctor.
Competing interests: No competing interests