What is a medical appraisal?

A medical appraisal is:

• an annual meeting between a doctor and a colleague who is trained as an appraiser
• a process of facilitated self-review supported by information gathered from the full scope of your work.

The supporting evidence you gather is key to demonstrating your GMC fitness to practise whatever your branch of practice.

If more detailed guidance is needed, individuals should contact their appraiser responsible officer. It may also be appropriate to discuss specialty issues with the appropriate college or faculty.

Objectives of your medical appraisal

Medical appraisal can be used for a number of purposes, including:

• to reflect on your individual practice and performance with your appraiser, which helps inform your responsible officer's revalidation recommendation to the GMC
• to help you plan your professional development
• to identify learning needs
• to ensure you are working in line with the organisational priorities
• to demonstrate that you are remaining up to date and fit to practise.

The appraisal process is important for agreeing and monitoring personal development objectives.

Whilst it interacts with the job planning process, the two should be kept separate in order to mitigate any conflicts of interest.

Stages of the appraisal process

1. Inputs into appraisal.
2. The confidential appraisal discussion.
3. Outputs from appraisal.

For more information on the stages in the appraisal process view the guidance from the NHS Revalidation Support Team.

The restart of appraisals during COVID-19

To allow doctors to focus on the demands of the COVID-19 pandemic, the appraisal process were paused in March 2020. In most of the UK, they were then resumed in October 2020. 

This section summarises the situation in each nation. See the resources section below for links to the guidance relevant to each nation, which give more detail and advice.

England

Since the restart, Medical appraisal 2022 has been introduced as the new approach to appraisals. It is a streamlined appraisal format that meets revalidation requirements and places more focus on wellbeing. It is also intended to reduce pre-appraisal paperwork requirements. It can be used across the UK. 

Northern Ireland

Individuals will receive notification from their responsible officer when they need an appraisal.

Scotland

BMA Scotland and the Scottish Academy of Medical Royal Colleges have been working together with the GMC, NES and the CMO on a consistent approach to medical appraisal. In particular, we have focused on the impact it has on the wellbeing and morale of the medical workforce during the COVID-19 pandemic:

• guidance from the CMO in March 2021 recommends that you should have an appraisal in the next 12 months but there is some flexibility for delay in the short term
• lack of evidence will not stop the appraisal submission. All that needs to be stated on SOAR is ‘Nothing to submit’ and you are able to move to the next section
• GMC core requirements pertaining to patient safety are still required for appraisal. Therefore, compliments, complaints or adverse events and reflections should be uploaded, and the health and probity statements should be completed
• the appraisal itself should focus on your wellbeing and can be used as an opportunity to reflect on the experience and learning from working during the pandemic. The appraiser should signpost you to the range of online wellbeing support materials, and those available at local and national levels, as well as making you aware of the new confidential Workforce Specialist Service implemented to support doctors with mental health problems
• it is important to remember that appraisal is a contractual requirement led by Health Boards and part of a wider regulatory process of revalidation overseen by the GMC. Therefore, all bodies involved must work together to make appraisal an effective and beneficial process that includes reflection, professional and personal development.

Wales

From 1 April 2021, appraisals have been reintroduced for all doctors, with a particular focus on wellbeing and support. 

Virtual appraisals, initially introduced to cope with social distancing rules during COVID-19, can still be an option until the end of 2021. Appraisals in person require an agreement between both parties. 

HEIW (Health Education and Improvement Wales) has published guidance for doctors undertaking their post-pandemic appraisals.

The guidance recognises the challenges faced by COVID-19 and suggests a process that is more useful for appraisees, while still meeting GMC revalidation requirements.

Annual Review of Competence Progression (ARCP)

The ARCP is an annual process where a panel of Deanery educationalists meet to:

• consider and approve the adequacy of the evidence and documentation provided by the trainee in accordance with the curricula for that specialty programme
• make a judgement about the trainee’s suitability to progress to the next stage of training
• communicate the outcome to the trainee.

The purpose of the ARCP is not to determine whether a trainee can do all the things required of them, only whether they have the evidence they can do them.

Who has an ARCP

All specialty trainees or stR’s including general practice trainees, those in core training and less than full-time training.

This also includes trainees in combined academic or clinical programmes, trainees who are out of programme, trainees in Fixed Term Specialty Training Appointments (FTSTAs), trainees in Locum Appointments for Training (LATs).

More information

• Gold Guide: a reference guide for postgraduate foundation and specialty training in the UK.
• Review your Deanery website for specific information on the process you will undertake locally.

Appraisals for sessional GPs

Many sessional GPs have several portfolios and you will need to consider how you might evidence your fitness to practice in these different roles.

If you undergo a performance review in these roles, you should include the outputs of such meetings as additional supporting information.

In roles that are less formalised you should be able to demonstrate that your CPD and review of your practice (through quality improvement, SEAs and feedback) is drawn from the whole of the scope of your practice over the five-year revalidation cycle, with annual reflection on your competence for each role.

More information

For more information about evidence of fitness to practice, collating feedback from colleagues and patients, quality improvement activity and significant events, read the appraisal and revalidation guidance from the Royal College of GPs.