BMJ Posted on 23 August 2013 by Adrienne Garner

Recently I cried at work. Why? Because the evening before I’d been notified that my appraisal, submitted after hours of work, had been unsubmitted by my appraiser as it was ‘not sufficient for revalidation’.
I was gutted. My mind churned with a mixture of thoughts ranging from anger to fear, through frustration and disappointment. Sleep had been impossible.
Contrary to all the reassuring emails and letters my revalidation experience is proving to be a nightmare and extremely damaging to my psyche. As a freelance locum GP I receive no remuneration for the hours of study and preparation. I would have to pay for any courses myself and am already struggling to justify the financial costs of continuing to work.
Ironically my appraisal is full of green ticks indicating appraiser comments. When opened all of them are negative and they might just as well be red crosses. What is particularly galling is that, as far as I can see, there is no facility within the toolkit for me to respond to these criticisms.
I would like to explain the limitations imposed on doctors working in practices that are not ‘their own’, how difficult it is to conduct a valid audit when one only works ten weeks of the year, how impossible it is to follow up on referrals when letters from consultants arrive long after one has left the practice.
According to my appraiser I have failed to reflect, have not ticked the boxes for the GMC domains, and have not provided evidence. Why do I have to produce evidence? If I say I have done something I have done it – I am a doctor and inherently honest. I constantly ‘reflect’ and often find myself thinking of particular problems, and solving them, away from work.
I could only record one significant event which, I admit, isn’t really significant although it offered learning point. What am I supposed to do? Make one up? I have since been informed that significant events can be positive so I should be able to add more to this section. I will, however, have to leave empty the complaints box – I haven’t had any complaints in 43 years of working.
According to my appraiser research and learning as a result of personal experience cannot be counted. Why not? Which is more likely to result in effective learning: research undertaken for a specific reason or sitting in a meeting for three hours?
At a time in my life when many doctors are fully retired, many because they can’t take the agro involved in revalidation, I had hoped to continue doing GP locums during the school holidays – as I have done in the same two practices for the past ten years.
My colleagues tell me that I just have to ‘jump through the hoops’. I am fitter than average and still enjoy racing rafts and playing tennis but at this stage in my life I don’t want to learn how to jump through hoops.
Adrienne Garner is a GP locum from Hertfordshire

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