It is a regulatory requirement for all doctors working in the UK to have annual formative appraisals in which they discuss their practice and performance. Since December 2012, there has also been a requirement for UK doctors to revalidate every 5 years. Revalidation is a summative process by which doctors demonstrate that they remain up to date and fit to practice. The UK General Medical Council (GMC) document Good Medical Practice (GMP) outlines core ethical guidance for doctors [1]. Appraisal is structured to demonstrate compliance with the key principles and values set out in GMP. Doctors are required to provide supporting information about their practice, continuing education and professionalism as part of the appraisal process. Revalidation is largely determined by the outcome of annual appraisal. There is therefore a tension between the formative input from appraisal and the summative output of revalidation.
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