GMC needs to get its head out of the sand over revalidation
May 13, 2005 - 6:05:38 PM

The General Medical Council needs to get its head out of the sand over revalidation, argues a senior doctor in this week's BMJ.

In June 2000, the GMC set out its initial plans for revalidation to "protect patients from poorly performing doctors who would be identified as early as possible." This was enshrined in law in December 2002.

But by April 2003, the GMC revised its plans, basing revalidation on doctors' annual appraisals, even though appraisals were not set up to judge a doctor's competence. In 2004, the Shipman inquiry forced the GMC to shelve its plans, and a high level review is now being conducted by the chief medical office for England.

The GMC's revised plans for revalidation will not detect poorly performing doctors, writes Professor Aneez Esmail, medical adviser to the Shipman inquiry. Revalidation is supposed to weed out doctors that are not fit to practise, yet appraisal has probably not identified a single doctor whose performance is seriously deficient, despite being in operation for nearly three years.

The public has also been told that revalidation is rather like an MOT test for doctors, yet there are no clear standards by which a doctor's fitness to practise can be determined, no objective test, and no independent scrutiny of that test.

He believes that revalidation has immense value for individual doctors. "As a practising doctor I would like to be able to show my patients that I am practising at a standard which is safe and up to date," he says. "I do not fear revalidation and, like the majority of doctors, would welcome it."

Revalidation is not about catching another Shipman or about judges dictating to doctors how they should regulate themselves. It is about safeguarding patients ? nothing more and nothing less, he concludes.

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