Professor Terence Stephenson, Chair of the General Medical Council, sheds light on how doctors who have left clinical practice but continue to use their medical expertise should handle revalidation.
We’ve revalidated more than 133,000 doctors since revalidation was introduced in 2012, and that will have risen to almost 150,000 by April. It’s early days, and we know the model isn’t perfect, but it’s already had an impact. We have seen a significant increase in appraisal rates across all sectors and specialties and employers are telling us that it is helping them to identify emerging poor performance at an earlier stage.
Many doctors want to know whether they can give up their licence to practise if they no longer need it to do what it is they do.
I am frequently approached by doctors who are not in clinical practice but who work in roles requiring them to use their medical expertise and experience. As all licensed doctors need to revalidate, they often want to know how they can participate in revalidation if they don’t see patients.
Many also want to know whether they can give up their licence to practise if they no longer need it to do what it is they do. I know, for example, that many doctors who work overseas for long periods of time choose to give up their licence but maintain registration with the GMC while they are abroad. Doing so indicates they are in good standing with their regulator in the UK and, in addition, means they are automatically entitled to a licence to practise on their return.
Law versus practice
There are more than 900 activities and roles that are restricted by law to licensed doctors, including:
- Working as a doctor in any role in the NHS
- Having practising privileges in the independent sector
- Writing prescriptions and signing death certificates.
If your medical practice involves any of these activities you will not be able to practise medicine legally in the UK unless you have a licence. Even if it doesn’t, your employer or those who contract with you may require you to have a licence to practise as part of the terms of your contract.
Do I need a licence? Some examples
A doctor is employed by a University and works exclusively on research. This is focused on the effects of sedatives on memory recall and the doctor prescribes the sedatives to volunteers participating in the programme.
This doctor continues to prescribe so he must maintain a licence to practise and participate in revalidation.
A 66-year old doctor has retired from practice in the NHS but continues to work overseas as an examiner for a medical Royal College.
This doctor is not required by law to maintain a licence to do this work but all medical Royal Colleges require all examiners to have a licence to practise. She will need to maintain her licence and participate in revalidation if she wishes to continue in this role.
Gathering evidence for revalidation
All licensed doctors must gather supporting information and participate in an annual appraisal process to support their revalidation. But how do doctors who work in research or as College examiners meet our requirements on CPD or patient feedback?
We encourage doctors to think broadly about alternatives to patient feedback – so seeking feedback from volunteers participating in research might be one way of doing that.
There is no requirement for licensed doctors to seek feedback from patients if they don’t actually see any patients in the course of their work. I think we can all agree that that would be pretty absurd. However, we do encourage doctors to think broadly about alternatives – so seeking feedback from volunteers participating in research might be one way of doing that. We usually advise doctors to seek advice from their appraiser in these circumstances.
Similarly, CPD must be tailored to the specific needs and interests of you and your practice. As a licensed doctor, it is for you to decide which development opportunities will be most useful in the context of your practice. Revalidation is based on what a doctor actually does in practice and we rely on doctors’ innate professionalism to ensure that they only work within their competence.
So, in the examiner example above, the possession of a licence complies with the College’s requirements to be an examiner. However, the doctor would be foolish to prescribe medicines if she is no longer in active clinical practice and keeping up to date on clinical medicine.
As a licensed doctor it is for you to decide which development opportunities will be most useful in the context of your practice.
If you’re in any doubt about how to proceed with your revalidation, or whether you should remain licensed, always seek advice. And remember: this is a continuous five year process, not a fifth-year point in time exercise, so collect evidence and feedback as you go along.
We have launched a free GMC app to help you gather evidence in real time, whether at work, in training or at a lecture. Thousands of doctors are now using the app and we’re getting some good feedback that they are finding it helpful.
All licensed doctors, regardless of the nature of their practice, should be able to participate in revalidation through annual appraisals and a link with a Responsible Officer or Suitable Person. You can find some tools to help you identify how you might do this on our website.
Professor Terence Stephenson marks the 3rd anniversary of revalidation
Dr Toby Reynolds writes about the effect of revalidation on doctors’ practice
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Our Chair comments on revalidation 3 years after its introduction