Case study 2 – Dr Li

This case study will assist doctors who:

  • have had a break in practice shorter than 12 months
  • are able to present evidence of continuing professional development (CPD) or a clinical attachment or observership.


Dr Li was awarded a medical degree in 2001 and applied for full registration with a licence to practise in September 2017.

Since graduation Dr Li practised in Singapore in full time roles as a specialist in trauma and orthopaedics.

While practising in Singapore, Dr Li travelled to America and did a four-month observership in emergency medicine between June 2016 and October 2016. During the observership he was also engaged in structured and systematic CPD covering a broad range of core skills.

Dr Li then returned to Singapore in November 2016 and was employed as a general physician treating trauma patients in an acute setting, until April 2017.

Dr Li then moved to the UK in May 2017 to apply for registration and has been applying for medical posts in both trauma and orthopaedics and general internal medicine specialities. He has been working as a phlebotomist in a hospital in the UK and has continued to engage in structured CPD to prepare for his return to practice.

As part of his application Dr Li submitted:

  • copies of positive references for his posts in Singapore
  • a certificate of good standing from the Singapore Medical Council
  • evidence of the observership in America including a consultant supervisor’s report. This contains supportive statements that detail the length of the observership, the hours worked and the duties he performed. The report is positive about the doctor’s performance and provides a positive assessment of the core skills he developed during the observership
  • a statement from Dr Li describing what he has learned from the cases and clinical issues he encountered on the observership and from his completed CPD and how this will impact on his medical practice in the future.

What did the decision maker take into account?

The decision maker took into account the criteria and guidance on breaks in practice. In particular:

  • when Dr Li applied for registration, it had been 16 years two months since his graduation. He had practised for 15 years and three months since graduation, so met the criteria requiring that a doctor must have practised for 60% of the time since graduation
  • but he had a break in practice of eight months before he applied, so he did not meet the criteria of having practised for a minimum of 12 months prior to application.

As Dr Li did not meet both criteria, the decision maker considered the supporting evidence submitted, to assess if it mitigated the break in practice.

They considered:

  • Dr Li had provided evidence that he was actively engaged in CPD and ongoing structured and objective learning covering a broad range of medical skills, during the break in practice
  • he had submitted a personal development plan and a learning log relating to his observership and CPD
  • he had provided supportive references for previous posts
  • a certificate of good standing from the Singapore Medical Council.

What was our decision?

Although Dr Li has only met one aspect of our criteria, it is clear that he had practised for a significant amount of time since graduation. Dr Li provided evidence to demonstrate that he had mitigated his break in practice by taking steps to keep his knowledge and skills up to date during the break. The decision maker therefore decided to grant full registration with a licence to practise.