What Actually Happens in a Medical Appraisal Meeting?
Hi, I’m Amelia. I’m an F5 locum doctor and Clinical Lead at Messly. Since leaving training after my F2 Year, I have worked as a locum doctor in both community and District General hospitals, as a clinical fellow, and in private industry.
In this article I’ll explain my history of appraisals, how I set up my appraisal meeting, and what happened in the actual appraisal meeting. Hopefully, this can help you feel more prepared for yours. To protect anonymity, I will not be referring to my appraiser by name and will be using the pronouns (they/them) when referring to them.
📋 My appraisal history
Appraisals are a source of anxiety for many non-training doctors and I am no different. During my F3 Year I spent most of my time out of work. I’d travelled a bit, and over the course of the year, I only worked a few shifts through my locum agency. After getting some advice through various Facebook groups, I decided not to do an appraisal that year. I was confused about whether or not I needed one, but mainly I was embarrassed about the very limited amount of medical work I had done that year, and was uncertain of whether or not I would ‘pass.’
In my F4 Year, I had a 12 month clinical fellowship role which required me to have an appraisal, and I was told to contact the appraisal lead for the Trust I was employed with. They assigned me an appraiser and told me that not having an appraisal in my F3 year meant my appraisal date would be brought forward to January (7 months earlier than it would usually be). My first appraisal was scary because I had no idea what to expect and I felt like there was no information or support online that helped me understand what actually happens in appraisal meetings. We booked in two dates for the appraisal, and it turned out that I had used the wrong forms and totally got the wrong end of the stick. My appraiser kindly explained what I needed to do, and we used the back-up date for the actual appraisal. With their advice and guidance, I was able to populate the MAG document properly and I had a successful appraisal meeting on the 2nd try.
My next appraisal (F5 Year) took place 13 months later due to scheduling difficulties between me and my appraiser. Ideally, we would have had the meeting 10-12 months after my F4 appraisal, to try and being the dates more in line with typical appraisal timings, but unfortunately this wasn’t possible. My F5 appraisal experience forms the basis of the article I will be discussing in this article.
My revalidation date is set at 5 years from when I gained full GMC registration in my F1 Year.
🩺 My current work situation
Since my F4 appraisal, I finished my 12 month full-time clinical fellowship and started working part-time as a locum through two different Trust staff banks, and also working for Messly as a freelance medical writer. I do approximately 2 days per week of locum work, and 3 days per week of writing.
🗓️ Preparing for the meeting
My appraiser this year was the same person as it was last year which was helpful as they now know me reasonably well. We had never worked together directly in a clinical setting as this is not a requirement of your appraiser according to the GMC.
We booked in two potential appraisal dates together, in the event that the first one was cancelled for some reason. This was a good strategy as we did actually have to delay the meeting by a week and it was reassuring knowing that we had a back-up date already booked in. We met on Zoom, and gave ourselves two hours to get through the appraisal meeting. I had already populated and submitted my MAG form to them in advance, so they had already reviewed the evidence I’d provided.
⏰ The meeting
👉 Part 1: Getting comfortable
The two hour Zoom call started with a bit of general chit chat about the weather, our recently holidays, and what I had been up to in my free time recently. The appraisal meeting is meant to feel casual, open, flexible, and safe - a space to air concerns, worries, and disappointments as much as to celebrate successes, achievements, and to discuss personal and professional goals.
Before launching into the evidence I had supplied on my MAG form, my appraiser asked me what my goals for this meeting where and whether there were any particular items I wanted to highlight and discuss today. I informed them that I wanted:
✅ clarification as to what work I needed to do this year given my unusual work situation
✅ reassurance that I am on track to achieve a positive result at my revalidation meeting next year.
My appraiser took note of my goals and used these as a guide for discussing my evidence and setting a personal development plan for my next appraisal later in the meeting.
👉 Part 2: Clarifications
My appraiser asked some exploratory and clarification questions regarding my work as a medical writer. They wanted to understand whether or not I needed to include this work on my appraisal document. When populating my MAG form, I included medical writer as part of my job role as a doctor because I had been uncertain as to whether it needed to be discussed at my appraisal. I figured that being open and upfront about all of my work was the best policy. By counting my medical writing as part of my appraisal, it meant that I needed to supply evidence that I was meeting the guidance outlined in the GMC’s good medical practice document when doing that particular work.
However, my appraiser informed me that I only needed to include work that requires me to have an active medical license in order to do it. After some discussion, we decided that the writing work did not require this, so it did not need to be discussed in our appraisal meeting. This benefitted me as it meant I could consider my medical (clinical) work as part-time (approximately 40% of full-time) therefore reducing the amount of CPD points I needed to collect this year.
The next step was to explore in more detail the locum work I was doing. My appraiser wanted to understand what the ‘scope of practice’ of my locum work was - and in particular the departments and patient groups I worked with the most. The reason for this was that my CPD needed to reflect the work I was doing. I explained that my locum work varied week on week, but generally my work was in elderly care and general medicine wards.
👉 Part 3: Future goals
Next, we talked about my future aspirations. This was relevant as it would affect my next appraisal and the requirements for my PDP that we would agree at the end of this meeting.
If I go into training in August then I would not have an appraisal in 12 months but an ARCP meeting instead. This would have its own specific evidence requirements which are outlined by the royal college I’d be training with. However, if I stay out of training then my PDP is more flexible to reflect my own interests and my revalidation needs.
👉 Part 4: Review of evidence
My appraiser then reflected on the evidence I had provided. They linked my evidence to the GMC good medical practice domains of;
Domain 1: Knowledge, skills, and performance
This domain should demonstrate that you make patient care your first concern, and that you provide a good standard of practice and care by keeping your professional knowledge and skills up to date and recognising and working within the limits of your competence.
Domain 2: Safety and quality
This domain should show that I take prompt action when I think patient safety, dignity or comfort is being compromised, and that I protect and promote the health of patients and the public.
Domain 3: Communication, partnership and teamwork
This domain should show that I treat patients as individuals and respect their dignity by being polite, considerate, and respectful of a patient’s right to confidentiality. It should also so that I listen and respond to patient concerns and preferences, giving them the information they want or need in a way they can understand, respecting their right to reach decisions with you about their treatment and care, and supporting them in caring for themselves to improve and maintain their health. It is also about demonstrating that I work with colleagues in the ways that best serve patients’ interests.
Domain 4: Maintaining trust
This domain should demonstrate that I am honest and open, that I act with integrity, that I never discriminate unfairly against patients or colleagues, and I never abuse your patients’ trust in you or the public’s trust in the profession.
I provided a variety of evidence to demonstrate my commitment to these 4 domains, including;
✅ 3x case based discussions done over the course of the year with two different senior doctors.
✅ An excel spreadsheet listing the junior doctor teaching I had attended over the course of the year.
✅ Records of monthly supervision with my clinical supervisor.
✅ Evidence of compliance with my Trust’s mandatory and statutory training requirements.
✅ Feedback from medical students that I had provided teaching to during their placements.
✅ Plaudits submitted by colleagues that commended any particular work I had done.
✅ Thank you cards from patients (with patient-identifying information withheld)
✅ Certificates from courses and conferences I had attended over the year.
✅ Reflections, reports, and posters/presentation materials from the quality improvement and audit work I had done over the year.
They also reviewed the evidence that was a requirement of revalidation (patient feedback and peer feedback), and confirmed that I had not been named in any significant incidents or serious events over the last year.
👉 Part 5: Making a PDP
Finally, we started to formulate a Personal Development Plan (PDP) that would carry me through the next 12 months of my career. A PDP is meant to be both purposeful and achievable, and the goals should either help me towards revalidation, or help me pursue the specific career goals and interests I have. Agreeing the PDP is a collaborative process, and my appraiser was careful to check that the goals felt achievable before we signed off the meeting. In the end, we decided that my PDP should be:
✅ To collect 2 CBDs this year
✅ To think about how I might form a locum peer group
✅ To remain up to date with my mandatory training
✅ To attend 12.5 hours of CPD (based on 40% of the requirements for a full time Royal College of Physicians trainee).
✅ To attend a courses on improving my feedback skills (this was my personal goal)
✅ To collect more patient feedback
✅ To write a reflective report on the QI work I’d contributed to, to close off the project.
✅ To write and submit the audit report to close off the work I had done that year.
After two hours, we ended the call with the agreement that my appraiser would write his comments onto his sections of the MAG document I had shared with him a few weeks before, and that he would send it over to me by the end of the week. This would then allow me to review his comments before locking the document from further editing and saving it permanently in its final version as a completed appraisal.
Overall, the meeting made me feel listened to, valued as an individual, and excited to achieve the (quite easy) goals we had set for the year.
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.
Explore the other articles and resources in our appraisal and portfolio series:
👉 Top tips for acing your appraisal
👉 Do I need to do an appraisal as an F3 or locum doctor?
👉 How to build an incredible medical portfolio in 3 easy steps
👉 What evidence do I need to prepare for my medical appraisal?
👉 How investing in your portfolio will help you prepare for appraisal
👉 Meet our Portfolio Companion - your ultimate guide to medical portfolios
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