Intended for healthcare professionals


Continuing professional development during a career break

BMJ 2013; 346 doi: (Published 16 January 2013) Cite this as: BMJ 2013;346:f67
  1. Louise Freeman, emergency medicine consultant
  1. 1Morpeth, UK
  1. louisejfreeman{at}


Continuing professional development matters even if you’re on a career break. Louise Freeman explains how to continue learning without spending too much money

Evidence of continuing professional development (CPD) will form a considerable part of any doctor’s appraisal portfolio and contributes to revalidation.

Doctors who are not working for any of a wide variety of reasons—for example, caring responsibilities or ill health—may at first overlook CPD or assume that any deficit can be made up at a later date. If a doctor’s absence from practice continues for a long period, however, the five year average CPD required by most colleges is unlikely to cover a major shortfall in CPD hours. Absences of three months or more from medicine are acknowledged in the recent guidance on returning to practice from the Academy of Medical Royal Colleges to be likely to affect “skills and knowledge.”1

Medical organisations and individual experts recognise that CPD can help doctors return to practice after a prolonged break. The benefits of an up to date CPD record include increasing your wellbeing and improving your future employment potential.

Claire McLaughlan, associate director of case management and the lead for the National Clinical Assessment Service’s back on track service, advises: “We encourage practitioners to continue with CPD while away from practice if at all possible. The doctors who do so usually feel more confident when they begin to return to practice and are better placed to resume working safely and effectively.”1

Consultant psychiatrist Richard Duggins, who is service lead for House Concern,2 an organisation that provides information and advice for UK doctors, particularly encourages doctors to undertake CPD while they are off sick.

“Doctors needing to take sick leave can be very hard on themselves and their self confidence can collapse,” he says. “They can go very quickly from believing they are superhuman to believing they are a super-failure. Restarting CPD and scheduling your time can therefore be an important first step towards making a successful and sustained return to work.”

Responsible officers

As well as CPD, doctors who are taking a career break will need to consider who will act as their responsible officer. In the context of appraisal and revalidation, all doctors need to be answerable to a responsible officer. It is the responsible officer of a doctor’s designated body who will make the recommendation, usually every five years, that a doctor is up to date and fit to practise.

The General Medical Council has developed online tools to help doctors identify their designated body and to help doctors without designated bodies. Doctors who do not have a designated body and want to ask someone to be their responsible officer must consider whether there is anyone suitable who could support them with their revalidation and make a recommendation about them. The General Medical Council needs to approve anyone chosen to act as such a suitable person. The suitable person may not have to work with the doctor in every case, and the council expects a variety of arrangements to be in place.


Doctors on a career break often have limited income, but CPD does not have to be expensive to be relevant. It is probably more important to maintain your general medical knowledge than to attend specialist, expensive courses. The latest high powered course can usually wait until you are back at work with a study leave budget to draw upon.

Another potential reason for avoiding excessive expenditure on CPD is that a career break may result in a change of direction. It can therefore be difficult to know whether an expensive training investment will pay off in the long term.

Training does not have to be specifically aimed at doctors to be useful. Training in information technology, teaching, and other areas can be appropriate for recording in a CPD log.

During a career break, a lack of internet access can present a barrier to learning. Most local UK libraries offer free internet access, although this often has a daily time limit. The BMA has a full medical library service, which is free for BMA members.3 Books and journals are posted out by the library and returned at members’ expense.

Framework for CPD

The list of suggestions provided in the box is not supposed to be exhaustive, but to act as a framework in which to consider your own CPD. Every doctor is likely to find a unique combination of local or specialty specific options that may suit their situation.

I have independently managed my medical education during an enforced career break owing to ill health. A senior colleague kindly volunteered to be my mentor and provides annual appraisals. I have concentrated on maintaining my general medical knowledge and skills, achieving over 100 hours of CPD a year with a combination of clinical and non-clinical learning.

I have undertaken e-learning in some cases but have acquired most of my CPD through local events at low or no cost. Local information technology tuition and a course on preparing to teach in the lifelong learning sector (box) were easy to access, and I learnt much more than I expected from both experiences. The effort of learning while I have been unwell has always proved worthwhile, and the learning process had been extremely beneficial for my wellbeing.

Framework for continuing professional development during a career break

Journal reading

General and specialist medical journals help keep doctors up to date while they are not working. Medical college criteria vary as to whether relevant reading counts towards annual CPD totals, but even if it doesn’t boost your hours the benefits of the reading will be far greater than just reducing your guilt inducing stack of unread journals. The cost of a journal subscription may be lower if your income is reduced. The BMA, for instance, has a salary link scheme offering reduced fees for those on lower incomes.4

Internal teaching sessions

Employed doctors on long term leave may be permitted to attend teaching at their place of work. This also has the invaluable added benefit of social contact with colleagues.


Local deaneries provide excellent training courses that are frequently cheap or free. It is worth asking if it would be possible to attend such courses while you are not working.


The medical royal colleges often provide free e-learning modules for members via their websites. The Royal College of General Practitioners has some excellent modules on topics, for example, “Identification and brief advice for alcohol,” which are widely applicable to any doctor and are free to anyone.5

Conferences and courses

For conferences and courses, medical colleges may be willing to extend their retired doctor concessionary fee to doctors on a career break. This can dramatically reduce costs.

BMJ Learning

The BMJ website ( has over 1000 modules on clinical and relevant non-clinical career development topics. The BMJ portfolio function is also useful for recording CPD generally, not just for BMJ Learning modules. Access to all BMJ Learning modules is free for BMA members, and a large selection of modules is free for casual registered users.

Medical Protection Society

The society offers an excellent series of risk management workshops that are free to members, including those with deferred membership, which is free for people on a career break.6 The topics covered in these workshops are generic and are likely to be relevant to any specialty, such as “Mastering difficult interactions with patients.” The society also provides e-learning modules that are free for members.

Medical Defence Union

The union provides an e-learning “Medical ethics and law” CPD module, which is accredited by the Royal College of Physicians. It also has a series of workshops on a range of topics relevant to medical practice in general. Members can access the e-learning for free, but a fee is payable for the workshops.7

Information technology training

Proficiency in the use of information technology is a vital skill in any modern workplace. One example of relevant training is the European Computer Driving Licence, which is recognised by the NHS as a badge of proficiency in the use of Microsoft Office applications—Word, Excel, and PowerPoint.8 This qualification counts as 40 hours of CPD and, depending on the provider, may be conveniently completed online at home. Adult education organisations usually offer this type of training at a reasonable cost. In the United Kingdom, recipients of jobseekers’ allowance or employment and support allowance should be able to access free information technology training. Jobcentre Plus offices can also advise on relevant local options.

Preparing to teach in the lifelong learning sector (PTLLS)

This part time course is provided by local colleges of further education in the UK and is the first module of a postgraduate certificate in education in lifelong learning. Most doctors have had little or no training in teaching and the techniques taught in the course are extremely useful for anyone teaching adults in the course of their work.


  • Competing interests: I declare that that I have read and understood the BMJ Group policy on declaration of interests and I have no relevant interests to declare.


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