Do I Need An Appraisal As An F3 Or Locum Doctor in 2023?
If you’re starting locum work for the first time, you might not be sure about what an appraisal is, whether you need one, or even how to go about arranging one.
Thankfully, Messly has put together a series of articles and resources to help you navigate this confusing and difficult process.
In this article, we’ll take a look at all the appraisal FAQ’s we get from doctors, including:
👉 What is an appraisal
👉 How it is different to revalidation
👉 Do you actually need one
👉 How working overseas affects your appraisal requirements
👉 How working less than full time affects your appraisal requirements
👉 How to book your appraisal
If you want to explore the other articles and resources in our appraisal and portfolio series, click any of the links below:
👉 Top tips for acing your appraisal
👉 Understanding the GMC’s good medical practice guidance for appraisal
👉 How to build an incredible medical portfolio in 3 easy steps
👉 How investing in your portfolio will help you prepare for appraisal
👉 Find our what you can expect to happen during an appraisal meeting, from setting one up to what will be covered in the meeting
👉 Meet our Portfolio Companion - your ultimate guide to medical portfolios
📖 What is an appraisal?
Appraisals are the non-training doctor's version of an ARCP (Annual Review of Competency Outcomes). Annual appraisals are mandatory for all non-training doctors of any grade and involve a meeting between a doctor and a GMC approved appraiser, or responsible officer (RO).
The goal of an appraisal is to be a constructive discussion about a doctor's development, learning, practice, and ambitions. They are not pass-fail exercises.
Based on the portfolio evidence collected by the doctor being appraised, personal development plans (PDPs) are set for the coming year to help ensure that the doctor is on track to achieve their revalidation requirements and is meeting the principles set out in the GMC Good Medical Practice document.
At the end of a revalidation cycle, the responsible officer will make a recommendation to the GMC as to whether or not your liscence to practice medicine in the UK should be maintained or not.
🤔 How is appraisal different to revalidation?
Your annual appraisal is an opportunity for you to show that you are meeting the requirements set by the GMC’s Good Medical Practice guidance. Learn more about what this is in this article here.
Revalidation is the process by which the GMC confirms your ongoing fitness to practice, and makes the decision to maintain your license to practice medicine within the UK. This occurs every 5 years and uses the evidence you supplied in your annual appraisals to inform their decision.
🏃️ Can I get away with not doing one? 💨
For all non-training doctors of any grade, an annual medical appraisal is a mandatory requirement as set out by the GMC. They state “Appraisal is a key part of revalidation. It should be developmental and assurance focused, and is not a pass or fail exercise. You must participate in appraisal every year unless there are clear and reasonable mitigating circumstances that prevent you from doing so.”
The mitiating circumstances that they refer to is when the doctor is on maternity leave or long term sick leave. For everyone else, you will be expected to book an appraisal. This includes doctors who are working overseas unfortunately!
But with the intention of being unbiased, we have heard of many doctors in their F3 years who get away without doing an appraisal without long-term consequences. These doctors typically either do an early appraisal in F4, or return to training after F3 and have an ARCP instead of an appraisal. Effectively this means that they do the work either way, so skipping an appraisal it not really worth the risk.
When revalidatation time comes, if your Responsible Officer (RO) makes a statement to the GMC that you have failed to engage in the appraisal process then you may be referred to a GMC fitness to practise panel to consider whether your licence to practise should be revoked. If you do not have a Responsible Officer and fail to engage in the process, the GMC will themselves consider whether your licence to practise should be revoked.
It is also worth noting that most agencies will require proof from F4 doctors that they’ve had an appraisal done in the previous year.
🌎 How does working overseas affect your appraisal requirements?
If you work entirely abroad (i.e. you moved to Australia for F3) then you have a number of options.
👉 If you plan to stay abroad permanently, then you can give up your license to practice in the UK while maintaining your GMC registration. This means you will not need to revalidate (therefore no need for appraisals either). You can apply to have your license restored in the future if you do decide to return to the UK. Read more about this option on the GMC website here.
👉 If you want to continue to hold your UK licence to practise while practising abroad, you will need to revalidate every 5 years. To do this, you will need to connect to a UK organisation that can be your designated body. You will need to do annual appraisals and the schedule for your 5 yearly revalidation will remain the same.
If you work abroad for short periods either for volunteering or career breaks from the NHS, then you will still need to do annual appraisals and 5 yearly revalidations like all other UK doctors if you want to maintain your license to pracice in the UK. If you come to revalidaiton time and do not have all of the evidence you need to maintain your license then your Responsible Officer (RO) can decide to give you extra time to meet your revalidaiton requirements and defer the decision for several months.
⏳ How does working less than full time affect your appraisal requirements?
As a locum doctor, it is likely that you are not working as many hours as you may have as a trainee. Most doctors take time out of training in order to spend more time focussing on other interests and hobbies and it is becoming increasingly common for doctors to have a number of strings to their bow beyond clinical medicine only.
If you are not working at all, then think about whether you need to do an appraisal at all.
If you are working less than full time, you will still be expected to do an appraisal each year, and your revalidations will still be 5 years apart whether you work full time or 1 day per month.
Our advice would be, think about an average week or month for you. While it may be true that you only do 5 or 6 locum shifts per month, if you are also spending time volunteering, working for a private company, teaching or studying, this all can be considered work. Specifically, the GMC refers to this as your ‘scope of work’ or ‘scope of practice’ and it should all be discussed at yoru appraisal.
If you are only doing 2-3 days per week of locum shifts and using the rest of the time for personal hobbies and interests, caring responsibilities, or other unpaid activity that woudln’t be considered volunteering or studying, then you are truly less than full time.
The main way that being less than full time affects your appraisal is when you collect CPD evidence. CPD (continuing professional development) is a mandatory requirement of your appraisal, to demonstrate your commitment to ongoing improvement and learning. Your CPD activity should reflect your scope of practice that is proportionate to the amount of work that you do.
The GMC doesn’t give a value for how much you need to do but the generally accepted number for a full-time locum or employee is 20 hours per year (or 20 points). If you are less than full time, then you can use this table to estimate the amount of CPD you may be expected to do:
✍️ How to book your appraisal
If you are working as a locum doctor then you are responsible for arranging your own appraisal.
How to do this depends on your work circumstances.
To do an appraisal, you must be connected to a designated body (a.k.a. a GMC-approved organisation that follows GMC appraisal protocols and standards).
Your designated body will have a responsible officer (RO) who oversees all of the appraisers at that organsation. They will allocate you an appraiser, and can provide you support and guidance in the appraisal process.
Do you work… 👇
Mostly through a Staff Bank
If you are employed in a substantive role or work mainly with one particular Trust through their staff bank, then you may be able to get a free appraisal done through that Trust.
The Trust will be linked to a designated body and RO who will assign you an appraiser (usually one of the consultants in the Trust).
Some Trusts have introduced a minimum shift requirement for doctors to qualify to have an appraisal done through the Trust.The exact number is Trust-specific, but usually is around 3 shifts a week.
Mostly though a Locum Agency
If most or all of your work is done through a locum agency, then you may be able to get an appraisal done through them.
Some locum agencies have in-house appraisal teams and RO who will oversee your appraisal process. The teams are usually really knowledgeable and can explain the process, including what they expect you to achieve for your appraisal.
Other locum agencies outsource the appraisal to independent companies. This doesn’t affect the appraisal process but can make it more expensive for you.
You can join an agency simply for purpose of an appraisal. There are no minimum shift requirements when it comes to qualifying for an appraisal with an agency. If you only work sporadically then this could be a good option for you, but be aware that Trusts may not allow you to work with them through a locum agency for at least 6 weeks after leaving their staff bank.
Some agencies offer discounted or free appraisals if you work a specified number of shifts with them. Ask about it during the registration process as it could save you a few hundred pounds.
Other
👉 Private appraisal companies can offer 1:1 coaching in advance to help guarantee success, but may set you back £500. This might be the only option for doctors who work privately or outside the NHS. You can find the GMC Guidance about doing this here.
👉 Find an independent appraiser by asking consultants you know if they would be willing act as your appraiser (they must meet the GMC appraiser criteria). They do not need to be from the same specialty as you.
🏥 What if I don’t have a designated body?
If you still aren’t sure who your designated body is, then there is a handy GMC quiz to help you identify all of your options, and guide you in the right directs if you truly have no connection to a designated body.
💰 Is there a fee for appraisals?
If you are working mostly through a staff bank then your appraisal through the Trust will be free.
If you are working mostly through an agency, there may not may not be a fee for your appraisal. You should discuss this with your agency at the registration call to see if you can get a free appraisal.
If you are going through a private appraisal company, there will be a fee.
If you are finding your own appraiser through a network of contacts, then the fee for the appraisal may be negotiable between you. These meetings are long and require quite a lot of work on behalf of the appraiser so it it expected that their time is paid.
🤝 What happens during the appraisal itself?
Although this might sound like a scary meeting, it’s actually pretty informal. But do bear in mind that the appraisal meeting itself does vary considerably depending on your appraiser.
In the meeting itself, with your appraiser facilitating, you will discuss the scope and nature of your day to day work, your previous ARCP or appraisal outcome (PDP), and the evidence that you have collected to show that you are meeting the GMC’s guidance.
One of the aims of this discussion is also to give you time to focus on the achievements and challenges that you met this year, and how they have affected your scope of practice in terms of your own career goals (i.e. how they relate to your PDP and long term goals) as well as how they have brought change to your clinical practice for the better.
At the end of your appraisal will work with your appraiser to create a PDP for the next year. Together you will identify goals, tasks, and opportunities for you should work on to reach your educational, clinical and career aspirations.
📚 How do I prepare for my appraisal?
When you first start working as a locum doctor, we recommend arranging a conversation with your responsible officer, or their team, to discuss the process, key dates and what evidence they’re expecting you to collect.
Your agency will normally contact you when the time you’re due for your appraisal is approaching. For most, this will be in June or July, a year from when your last appraisal was.
Here’s a summary of our top tips for preparing for your appraisal:
👉 Read our article “How to ace your annual appraisal as an F3 or locum doctor” for advice on what evidence you’ll need to collect for your medical appraisal and how to do this efficiently
👉 Ask your agency or Trust bank what the appraisal process is for them to make sure you’re going to meet their specific requirements during the year
👉 Budget for the cost of your appraisal, and book it early. Consultants prefer lots of notice because they get booked up quickly
👉 Allow plenty of time to fill in your appraisal form with your portfolio evidence. Most agencies use the Medical Appraisal Guide 4.2 (MAG 4.2) form, which can be found here.
💡 In Summary:
👉 An annual appraisal is a mandatory GMC requirement for all non-training doctors unless you meet the mitigating circumstances criteria.
👉 There is really no benefit to skipping an appraisal except for giving yourself slightly less admin in exchange for potentially serious consequences when it comes to revalidation.
👉 The purpose of appraisal is to prepare you for your 5 yearly revalidation with the GMC and support you in meeting the mandatory criteria in time.
👉 No matter how much you are working, or where you are working, you will still need to complete an annual appraisal and 5 yearly revalidation (unless you meet specific mitigating criteria).
👉 There are lots of ways to book and appraisal depending on your work circumstances. Some of these may involve a fee.
👉 Messly have created a large number of resources and articles to help guide you through the appraisal process.
If you want to explore the other articles and resources in our appraisal and portfolio series, click any of the links below:
🔹 Top tips for acing your appraisal
🔹 Understanding the GMC’s good medical practice guidance for appraisal
🔹 How to build an incredible medical portfolio in 3 easy steps
🔹 How investing in your portfolio will help you prepare for appraisal
This article is part of a wider series of resources designed to support doctors through the process of building great portfolios. The heart of this is Messly’s Portfolio Companion, which is a detailed set of guides, templates and tools to help you build and manage your portfolio with confidence. For other articles and discussion on the topic, click here.
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