Letters Ensuring quality in primary care

Are UK revalidation proposals for GPs fit for purpose?

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d7906 (Published 13 December 2011) Cite this as: BMJ 2011;343:d7906
  1. Terry Kemple, general practitioner1
  1. 1Horfield Health Centre, Bristol BS7 9RR, UK
  1. tk{at}elpmek.demon.co.uk

The initial proposals for revalidation were exposed as unfit for purpose in 2004. Since then the plans for a more robust process have evolved, but it seems unlikely that the planned process that starts in 2012 can assure patients and the public, employers, and other healthcare professionals that revalidated doctors are up to date and fit to practise.1

How has this happened? The fatal flaw is that searching for evidence of competence cannot prove a doctor was always competent in the past, is competent now, or will be competent in the future. Karl Popper cautions against trying to prove a theory by finding confirming evidence. Instead, we should be searching for the contradictory evidence—evidence to show that a doctor is not competent. Although this reverse strategy may seem challenging, it is the better scientific approach.


Cite this as: BMJ 2011;343:d7906


  • Competing interests: TK is an appraiser for GPs who work for NHS Bristol.


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