Features: How will it be for me?
Doctors in non-standard roles
29 March 2010
For doctors who are having a career break or who are not in standard roles revalidation should not be any more difficult.
Here we look at how doctors in various situations will find the revalidation experience.
Independent practice
A doctor works wholly in independent private practice and has no contact with the NHS. Will this make it harder to revalidate?
Regardless of the setting for their clinical practice, doctors will need to participate in annual appraisal and link to a Responsible Officer in order to revalidate.
Once the health departments in England, Northern Ireland, Scotland and Wales have finalised the legislation and guidance for Responsible Officers, we expect a number of non-NHS organisations to be able to appoint Responsible Officers. These are likely to include the Independent Doctors Federation, the Faculty of Occupational Medicine, the Faculty of Pharmaceutical Medicine and the Faculty of Public Health Medicine. Doctors working outside the NHS should be able to revalidate using the services of these organisations.
EU locum doctor
A doctor who qualified as a radiologist in a European Union member state works once a month in the UK as a locum consultant. How will she be revalidated?
As a locum consultant the doctor will be required to demonstrate that she is practising to the specialty standards agreed by the Royal College of Radiologists. Whether she is on the specialist register or not, the specialty standards that she needs to meet will be the same.
EU doctors will need to revalidate in the same way as doctors who are based in the UK, i.e. by participating in a quality assured annual appraisal (relying on supporting information from their practice in the UK) based on GMC and College standards and by linking to a Responsible Officer who will make a recommendation to the GMC on their revalidation.
Breaks in service
A doctor has been working as a full-time GP in England for approximately five years and is shortly about to take 12-18 months’ maternity leave. However, she is worried about the impact this will have on her revalidation, particularly because her name may lapse from the PCT’s performers list during this time.
There will be many doctors in this situation. Taking maternity leave will not impact on her revalidation when she returns to work, even though she may miss an appraisal and CPD activity while away.
If she has no medical practice or CPD to draw on over a 12-18 month period, then the evidence from her previous appraisals should provide sufficient information on which a Responsible Officer can make a positive recommendation to revalidate to the GMC. Alternatively, the doctor’s Responsible Officer may ask the GMC to defer revalidation for another year until the doctor has had an opportunity to accumulate more recent supporting information and have a further appraisal. In these circumstances, the doctor’s licence to practise would simply continue during this interim period.
Clinical academics
A professor in paediatrics works in both research and teaching but does not see any patients or prescribe. Will she be able to revalidate if she is not able to obtain any patient feedback?
Even though the professor is not involved in clinical work she will still be able to revalidate.
If she holds a licence to practise, her revalidation will be based on the work that she actually does. Although she does not see patients, she should still be able to obtain feedback on her work from colleagues and take part in annual appraisals.
We are working with the Academy of Medical Royal Colleges and others to develop the standards for doctors in a range of non-clinical roles, and the types of information they might bring to appraisal showing how they are meeting those standards.
Medical management
A doctor is an associate medical director/senior manager in an NHS trust but still undertakes a limited amount of clinical work. How will he prepare for revalidation?
The doctor’s revalidation will be based on the whole of his medical practice, both clinical and non-clinical. Although he is only undertaking a limited amount of clinical work, he will need to be able to show that he is meeting the standards appropriate for his specialty across the breadth of the clinical work he undertakes. The relevant College/Faculty will be able to provide him with guidance on the information he will need to collect. His annual appraisal will need to cover the non-clinical and clinical aspects of his work.
Practising overseas
A specialist on sabbatical from full-time work in the NHS is currently working for an aid agency overseas. What should he do if there are no appraisal facilities available overseas?
First, the doctor should check with the agency to see whether they will contractually require him to hold a licence to practise while he is working for them. If not, and he intends to be away from UK practice for a number of years, it may make sense for him to relinquish his licence for the duration of his time overseas.
He can apply for his licence to be restored when he returns to the UK, at no cost. Restoring his licence will usually be straightforward. In general, it will be easier for him to do this than to maintain his licence while working overseas. Once he returns to practise in the UK he will need to link to a Responsible Officer and participate in annual appraisal in the same way as all other UK-based doctors.
If he decides to maintain his licence to practise while working abroad he will need to participate in revalidation. Revalidation is being designed to ensure that doctors practising in the UK are doing so to the appropriate professional standards. Systems (such as enhanced appraisal and multi-source feedback) are being put in place to support this and because those systems, or equivalent systems, may not exist in other countries, revalidation will be less straightforward for those who are overseas.
The doctor will need to look at the standards that the College or Faculty has developed for his specialty and at the supporting information which it recommends as necessary to demonstrate that he is continuing to meet the standards.
The doctor should also link with a Responsible Officer in the UK if at all possible. The Responsible Officer will help to ensure that the doctor is meeting the requirements for revalidation and will make recommendations to the GMC about whether the doctor should be revalidated. If the doctor is unable to link to a Responsible Officer in the UK, the only option is likely to be for the GMC to evaluate the information he can provide in support of his revalidation.
The GMC will also require confirmation of his continued good standing with the medical regulator in the jurisdiction where he is working.