BMJ Careers: Guidance For Doctor Revalidation

UK practicing doctors must be registered with the GMC and have a GMC licence to practice. Medical revalidation is the process that ensures that practicing doctors are up to date and fit to practice. This process supports doctors’ professional and personal growth. The appraisal and revalidation process will be explained in this article. 

Breaking down jargon: 

• Designated Body: is an organisation where the doctor carries out the majority of their work. Designated bodies have a responsibility to appoint responsible officers to their doctors. 

• Responsible Officer: person from the designated body that oversees doctors’ revalidation, often a senior doctor, that communicates with the GMC about whether they should be revalidated or not. 

• Connection Details: all the information regarding the doctor, responsible officer and designated body. It is vital that these details are always up to date in your online GMC accounts. 

• Suitable Person: some may not have a designated body or a responsible officer. In these cases, a licenced doctor can be identified as a suitable person to support the revalidation process and make a GMC recommendation. 

• Annual Appraisal: is an annual part of the revalidation process. The annual appraisal consists of a meeting between a doctor and a colleague who’s trained as an appraiser. 

• Annual Review of Competence Progression (ARCP): is an annual meeting where a panel discusses a trainees’ suitability for training progression.  

Your individual GMC revalidation date will be sent to you three months before the set date. If your training programme is less than five years, the first revalidation will occur when you complete your Certification of Completion of Training (CCT).

If your training programme is longer than five years, your first revalidation will occur five years after full GMC registration and at completion of CCT. For those who have finished training programmes, the NHS revalidation process occurs every five years. 

The Revalidation Management System (RMS) is a system for all revalidating doctors in NHS England. RMS shows appraisal details and an overview of the revalidation status. It is not an appraisal tool. 

There are many revalidation toolkits available to choose from. It is best to check with your own trust whether there is a recommended one. 

Every hospital/designated body will have a revalidation support team often consisting of medical directors, responsible officers and coordinators but that can vary across sites. 

The outcome of revalidation ranges from: 

• Recommendation to revalidate: where you are deemed fit to practice and up to date. 

• Recommendation to defer: this does not reflect badly on the doctor but signifies that the responsible officer/suitable person requires more time before making the recommendation. 

• Recommendation of non-engagement: implies that the doctor is not participating fully in the processes required for revalidation or has not achieved the revalidation requirements.  

Revalidation Requirements: 

There are six domains of supporting information that should be collected and discussed in appraisals. This will also help your revalidation process as the five appraisals will form your revalidation cycle.  

1. Continuing Professional Development (CPD): these ensure that doctors remain up to date in the medical field. There is no set number of CPD points required for revalidation as it will vary depending on your needs. For the appraisal, pick the CPDs that allow for the most reflection.

2. Quality Improvement Activity: this allows for a review of the quality of work you provide and a chance to survey whether any changes made to policy/practice were beneficial.

3. Significant Events and Serious Incidents: serious events and incidents must be declared at every appraisal. This allows for a constant review and improvement of your work. The discussion and reflection allow for an opportunity to highlight any learning points and changes to your future practice. 

4. Feedback from Patients: this focuses on understanding the patient’s experience when it comes to your practice and helps increase self-awareness. Questions can be mapped out according to the domains of Good Medical Practice. 

5. Colleague Feedback: this feedback is from any professional who you interact with and not just other doctors. Here, strengths and potential improvements can be highlighted. It is important to reflect on any changes made since previous feedback and the impact that this has had. 

6. Compliments and Complaints: here, you can reflect on compliments and complaints that have resulted in learning and changes to your practice. Complements can amplify areas of strengths you already have. Formal complaints must be declared at your appraisal. If you do not have any personal complaints/compliments, you can reflect on local ones that have resulted in a change to your practice. 

Revalidation paperwork is often uploaded electronically and not in paper format. 

RCGP revalidation toolkit:

The key domains of supporting information are the same for GPs as the ones for other doctors and consist of the following: 

1. Continuing professional development (CPD)

2. Quality improvement activities (QIA)

3. Significant events (SE)

4. Feedback from patients or those to whom you provide medical services

5. Feedback from colleagues

6. Review of compliments and complaints

GP audits for revalidation can range from yearly flu vaccine uptake to the efficacy of health promotion posters in waiting rooms. 

There are many GP revalidation eportfolio options to choose from. These include Clarity, Fourteen Fish, GP Tools, CFEP and MAG/MAF Form. Appraisal documents are only accepted in electronic format. Click here for a comparison between the above-mentioned e-portfolios. 

There is no minimum number of GP sessions required for revalidation. However, it should be noted that if you work 40 sessions in a year, you are expected to reflect on practicing safely despite a low volume of work. 

References: 

1. Guidance for doctors: requirements for revalidation and maintaining your licence [Internet]. GMC; 2021 [cited 6 May 2021]. Available from: https://www.gmc-uk.org/-/media/documents/revalidation-guidance-for-doctors_pdf-54232703.pdf 

2. Your revalidation [Internet]. Gmc-uk.org. 2021 [cited 7 May 2021]. Available from: https://www.gmc-uk.org/registration-and-licensing/managing-your-registration/revalidation/your-revalidation 

3. Guidance on supporting information for appraisal and revalidation [Internet]. GMC; 2021 [cited 16 May 2021]. Available from: https://www.gmc-uk.org/-/media/documents/RT___Supporting_information_for_appraisal_and_revalidation___DC