Appraisal & Revalidation
Once a year, someone sits down with you and asks how you're really doing. It's not a test — it's actually quite useful. Honestly.
📥 Downloads
Handouts, worked examples, teaching slides, and everything you need — ready when you are.
path: APPRAISAL
- appraisal-reflection-forms
- appraisal-reflection-forms-filled-in
- gp-trainee-appraisal
- gp-trainer-appraisal
- appaisal handbook for newbies.doc
- appraisal - what things to collect for your folder.doc
- appraisal and cpd (TEACHING RESOURCE).ppt
- appraisal and development - whats it all about then.doc
- appraisal and revalidation.ppt
- appraisal for nurse practitioners.doc
- appraisal for programme directors.doc
- appraisal process flowchart.ppt
- appraisal write up example.pdf
- appraisal.ppt
- appraiser guidance - points for discussion.doc
- appraiser's checklist.doc
- appraisers guide.doc
- fitness to practice appraisal and revalidation.ppt
- health declaration guidance.pdf
- keeping clinically up to date - good and bad doctors.doc
- probity guidance.pdf
- revalidation relicensing recertification.ppt
🌐 Web Resources
A hand-picked mix of official guidance and real-world GP training resources. Because the best pearls are not always hiding in the official documents.
Additional Bradford VTS pages that link closely with appraisal:
🎓 Just Got Your CCT? Your Appraisal Starter Guide
Congratulations — you are a GP. Here is everything you need to know about appraisal before your first one arrives.
Your appraisal as a newly qualified GP is not a test of everything you know. It is a supported, developmental conversation — and because you are fresh from training, expectations are proportionate. Your appraiser knows you are new. They will help you settle into the process.
Your post-CCT appraisal journey — step by step
CCT
Apply to the Performers List — do not leave this late
In England, apply to the GP Performers List via PCSE Online between 6 and 3 months before your expected CCT date. Apply as a GP Registrar first — not as a GP Performer. Once your CCT is confirmed, log back in and change your status to GP Performer. In Scotland, apply to your local health board. In Wales, your deanery manages this. In Northern Ireland, contact NIMDTA. Once on the Performers List, your designated body is identified and the appraisal process starts automatically.
Your CCT counts as your first revalidation
At the point of your CCT, the GMC revalidates you as part of the training completion process — this is your first revalidation. Your next revalidation date is set approximately 5 years later (usually around 60 days after your CCT date). Check this on GMC Online — it should appear automatically. Your first post-CCT appraisal begins a brand new 5-year revalidation cycle.
weeks
You are allocated a Responsible Officer and an appraiser
Once you join the Performers List, your designated body (NHS England for most GPs in England) assigns you a Responsible Officer (RO) and an appraiser. You do not choose your appraiser — they are allocated to you. Your appraiser will typically be a local practising or recently retired GP. You can expect to keep the same appraiser for around two to three years. If you have not been contacted within six weeks of your CCT, contact your regional appraisal team proactively — it is your professional responsibility to ensure you have an appraisal in year 1.
months
Your first appraisal — when to expect it
Your RO sets the date of your first appraisal. You can expect this to fall within the appraisal year following your CCT — broadly between 9 and 15 months after qualifying. Many areas allocate a dedicated appraisal month. You will receive notification around 3 months in advance. Once notified, it is your responsibility to contact your appraiser and agree the actual meeting date and format (face-to-face or remote).
onwards
Annual appraisal every year from now on
From your first post-CCT appraisal, you have one appraisal every year. Five of these feed into your revalidation recommendation to the GMC. Your appraisal month generally stays the same year on year unless you change region or take approved leave.
Yes — in an important way. Your WPBA evidence and training portfolio from your final year as a registrar is recognised as equivalent to appraisal supporting information. Your final ESR and ARCP PDP are brought forward as the starting PDP for your first post-CCT appraisal. Ask your trainer to email you the Agreed Action Plan from your final ESR — keep it safe. If you lose it, your appraiser can agree to let you summarise it "as best remembered", but it is much easier to just save it before you leave training.
What to collect for your first appraisal
Your first post-CCT appraisal is intentionally lighter than later ones. You will not yet have every type of evidence — and that is fine. Focus on what you genuinely have.
| Evidence type | What to bring for your first appraisal | When mandatory |
|---|---|---|
| Final ESR / ARCP PDP | Bring it and reflect on progress — this is your "previous PDP" for year 1 | First appraisal ✓ |
| CPD reflections | Any learning since CCT — courses, reading, cases, guidelines looked up | Every appraisal ✓ |
| Significant events | Any you have been involved in since CCT, with reflection | Every appraisal ✓ |
| Scope of work | List all roles requiring your GMC licence — main GP job plus anything else | Every appraisal ✓ |
| Complaints and compliments | Reflect on any received since CCT (formal or informal) | Every appraisal ✓ |
| Wellbeing declaration | Brief reflection on how you are doing and any reasonable adjustments needed | Every appraisal ✓ |
| Quality improvement activity (QIA) | Not required in year 1 — plan one over the 5-year cycle. Start thinking about it. | Once per 5-year cycle |
| Colleague feedback (MSF) | Not required in year 1 — plan to complete once in the cycle (takes 6–12 weeks) | Once per 5-year cycle |
| Patient feedback (PSQ) | Not required in year 1 — plan to complete once in the cycle | Once per 5-year cycle |
📱 Choose an electronic appraisal toolkit — do this in week one
Using an electronic portfolio is required in most English regions. Here are all the current options:
🐟 FourteenFish FREE for First5 GPs
The most widely used GP appraisal toolkit in the UK. Known for its clean interface and email-to-diary feature — forward a course confirmation or learning note straight into your portfolio from your phone.
Free for 5 years if you CCT'd from 2021 onwards and remain an RCGP member — applied automatically at FourteenFish checkout. After 5 years: approx. £42–50/year (RCGP members get 30% discount).
Includes: CPD diary, reflection templates, MSF and PSQ surveys, significant event templates, Portfolio mobile app.
Visit FourteenFish →🔷 Agilio Clarity
The other major platform — widely used in England and popular with ICBs and larger practices. Deeply integrated with the Agilio ecosystem (TeamNet, iLearn). Strong organisational dashboards. ISO 27001 certified.
Includes: CPD logging, MSF and PSQ tools, QI templates, integrated clinical update modules. Annual subscription — pricing varies by region.
Visit Clarity →🛠️ GP Tools
A free-to-use appraisal and revalidation portfolio for NHS GPs. GMC and NHS compliant, with patient survey and MSF feedback included at no extra cost. A solid lightweight option if you want something free and uncomplicated.
Visit GP Tools →📍 Mandatory regional systems
- Scotland: Scottish Online Appraisal Resource (SOAR) — provided automatically
- Wales: Medical Appraisal Revalidation System (MARS)
- Northern Ireland: GP appraisal registration form via NIMDTA
- Armed Forces GPs: PReP (Portfolio and Revalidation Portal)
In England, check with your regional appraisal office if you are unsure which platforms they currently accept.
The old paper-based Medical Appraisal Guide (MAG) form has been discontinued by NHS England. Do not use it. Use an approved electronic toolkit instead.
💡 Top tips for newly qualified GPs
Start your toolkit immediately
Set up FourteenFish or Clarity the week you get your CCT. The sooner it is live, the sooner evidence accumulates. Waiting until month 10 means reconstructing a year of learning from memory.
Email reflections to yourself
FourteenFish has an email-to-diary address. After anything notable — a difficult case, a guideline you looked up — fire off a 3-line email. Takes 90 seconds. Builds your portfolio throughout the year.
Save your final ESR PDP
Before you leave training, ask your trainer to email you the Agreed Action Plan from your final ESR. This is your year-1 PDP. Your first appraiser will ask for it. Losing it is surprisingly common.
Note your revalidation date now
Log into GMC Online, find your revalidation date, and put it in your phone calendar. The fifth appraisal before that date is the one where everything must be in order.
Chase up if you hear nothing
If you have not been contacted about an appraiser within 6 weeks of CCT, reach out to your regional appraisal team. It is your professional responsibility to have an appraisal in year 1 — do not assume the system will chase you.
Claim your free FourteenFish
CCT'd from 2021 onwards and an RCGP member? Your FourteenFish subscription is funded for 5 years automatically. That is your entire first revalidation cycle — free.
Year 1 is lighter — use that
No MSF, no PSQ, no formal QI project needed in year 1. You need CPD reflections, your ESR PDP, and scope of work. Use the lighter first year to build the habit solidly.
Practice appraisal with your trainer
Before finishing ST3, ask your trainer for a practice appraisal. Use it to agree your post-CCT PDP and ask to see how they prepare their own portfolio. An hour with your trainer is worth more than any guide.
Keep GMC Online up to date
Make sure GMC Online shows your correct designated body, email, and employer. If you move regions after CCT, update your connection promptly — appraisal allocation flows from this information.
✅ Post-CCT appraisal checklist — at a glance
Before CCT
Apply to Performers List (6–3 months before CCT date) via PCSE Online
At CCT
Change Performers List status to GP Performer on PCSE Online
At CCT
Email your trainer for the final ESR Agreed Action Plan (your year-1 PDP)
At CCT
Check and note your revalidation date on GMC Online
Week 1
Set up FourteenFish, Clarity, or GP Tools — start logging immediately
Within 6 weeks
Confirm you have been allocated an appraiser — contact regional team if not
Throughout year
Log CPD, reflections, significant events, complaints as they happen
Before appraisal
Review ESR PDP progress, draft scope of work, submit portfolio 2 weeks early
⚡ Quick Summary — If You Only Read One Thing
What it is
- Annual, structured, supported self-review with a trained appraiser
- Covers the full scope of your work — all roles, not just your main GP job
- Based on GMC's Good Medical Practice (GMP) 2024
- Not a pass/fail exam — it's a developmental conversation
The numbers
- Annual appraisal → every 12 months
- Revalidation → every 5 years, recommended to the GMC by your Responsible Officer (RO)
- Revalidation date is usually 5 years from your CCT (check with your appraiser)
- Pre-revalidation appraisal must have all evidence in order
Key principles
- Quality over quantity — one insightful reflection beats 50 course certificates
- Verbal reflection in the meeting counts equally to written work
- The appraiser is your peer and ally — not your examiner
- Collect evidence throughout the year, not the week before
What Is Appraisal — and Why Does It Matter?
More than paperwork. Less than terrifying.
The official definition
NHS England defines medical appraisal as a process of facilitated self-review, supported by information gathered from the full scope of a doctor's work. It is central to the revalidation process, and ensures doctors are both fit to practise and actively considering their professional development needs.
Appraisals are conducted annually, usually between the doctor and a trained GP appraiser — though in some cases the appraiser may not be a doctor.
The real purpose
In the early years, appraisal had a habit of becoming a data-collection marathon — gathering piles of certificates and attendance records to prove you were doing your job. That's no longer the point.
From 2020, the approach became "input-light, impact-heavy." The goal is genuine reflection and personal growth — not paperwork. The emphasis is now firmly on development and support.
A national survey found that around 90% of GPs report their appraisal was useful — for quality improvement, for patient care, and for personal and professional development. These are better satisfaction ratings than most NHS meetings manage to achieve.
Appraisal vs Revalidation — what's the difference?
| Feature | Appraisal | Revalidation |
|---|---|---|
| Frequency | Every year | Every 5 years |
| Who decides? | Appraiser facilitates discussion | Responsible Officer (RO) recommends to GMC |
| Format | Meeting (~2–3 hours, often remote) | GMC makes formal revalidation decision |
| Pass/fail? | No — it is developmental, not judgmental | Yes — licence to practise continues or is reviewed |
| Focus | Reflection, growth, wellbeing, PDPs | Demonstration that you are fit to practise |
| What feeds into the other? | 5 annual appraisals feed into revalidation | Revalidation is the culmination of 5 years |
The 5-year revalidation cycle
★ The Year 5 appraisal is the critical one — all mandatory evidence must be in order before this date.
Know your revalidation date. Check it on your GMC Online account. It is usually 5 years from your CCT, but verify this with your appraiser. If your pre-revalidation appraisal is missing key evidence, your revalidation will be deferred. Unlike training, you are not given repeated second chances.
Brief history of appraisal in UK general practice
Peer appraisal introduced for GPs
A formative, supportive process — developmental and voluntary in spirit.
Appraisal becomes linked to revalidation
Following the Shipman inquiry and broader concerns about fitness to practise, appraisal gained a formal regulatory role.
CPD credit doubling scrapped
Simplification — focus moved to quality of reflection, not quantity of evidence.
"Slimmed-down" appraisal approach
Input-light, impact-heavy. Emphasis on wellbeing, genuine reflection, and personal growth rather than data gathering.
GMC Good Medical Practice updated
GMP 2024 published — reinforces duty to delegate safely and reflects modern GP practice. Appraisals now align with GMP 2024 standards.
🆕 This section covers important changes to Good Medical Practice 2024 — every UK GP should know these
🆕 Good Medical Practice 2024 — What Changed?
The first major update in over a decade came into effect on 30 January 2024. Here is what every GP needs to know before their next appraisal.
Your appraiser has been trained to facilitate your reflection on the new standards. You will not be tested on your knowledge of GMP 2024, but you should be familiar with the themes and be ready to reflect on them. The new domains have also been renamed — make sure your digital appraisal toolkit is updated to reflect GMP 2024 (software providers were asked to update by April 2025 at the latest).
The 4 renamed GMP 2024 domains
Knowledge, Skills & Development
Previously: "Knowledge, skills and performance"
New emphasis: Staying up to date across all roles. Safe and effective care in both face-to-face and remote consultations. Managing resources sustainably.
Patients, Partnership & Communication
Previously: "Safety and quality"
New emphasis: Kindness, courtesy and respect as explicit requirements. Not making assumptions about what patients consider significant. Supporting shared decision-making.
Colleagues, Culture & Safety
Previously: "Communication, partnership and teamwork"
New emphasis: Positive, fair, compassionate workplace culture. Safe delegation. Supporting colleagues' wellbeing. Doctors' own health and wellbeing explicitly included.
Trust & Professionalism
Previously: "Maintaining trust"
New emphasis: Social media conduct. Environmental sustainability. Adequate and regularly reviewed indemnity insurance. Stronger focus on inclusive leadership.
New themes your appraiser may explore
Environmental sustainability
GMP 2024 says doctors should choose sustainable solutions when they can, without compromising care. This is now a reflectable topic. Think: inhaler choices, travel to appointments, paper vs digital. A short reflection on one sustainable change you made is a quick PDP win.
Remote consultations
GMP 2024 explicitly requires safe and effective care in both face-to-face and remote consultations. Be ready to reflect on how you decide which format is appropriate and how you maintain safety and quality in video or telephone consultations.
Social media
For the first time, GMP 2024 includes guidance on social media. If you use social media professionally, your appraiser may ask you to reflect on how you maintain appropriate boundaries and uphold GMC standards online.
Safe delegation
With ARRS roles expanding in many practices, GMP 2024 places a new emphasis on ensuring that those you delegate to are competent, supported, and working within their limits. If you supervise others, be ready to reflect on how you delegate safely.
Polypharmacy & medication review
GMP 2024 includes a new reference to regularly reviewing medications and considering whether benefits outweigh risks. This is an excellent QI topic — consider a polypharmacy or anticholinergic burden audit as a PDP item.
Your own wellbeing
Domain 3 now explicitly includes doctors' own health and wellbeing as key to practising safely. Your appraiser may ask — or may prompt you to reflect on — how you manage stress, protect your own health, and access support when needed.
- Reflect on one change you made to reduce the environmental impact of your prescribing (e.g. inhaler switch, reduced unnecessary investigations)
- Audit your approach to polypharmacy or anticholinergic burden in elderly patients
- Review your remote consultation practice — how do you decide face-to-face is needed?
- Read the GMC social media guidance and write a brief reflection on how it applies to your online activity
- If you supervise others, reflect on a specific case where you delegated and how you ensured safety
The 4 Domains of Good Medical Practice (GMP 2024)
Appraisal is structured around the GMC's Good Medical Practice (GMP 2024) framework, in force from 30 January 2024. Your portfolio must provide evidence across all four domains.
You are not expected to memorise these bullet points. Your appraiser knows them well and will guide the conversation. What matters is that your portfolio demonstrates evidence across all four areas and that you can reflect meaningfully on what you've done and why it matters. Check that your appraisal toolkit has been updated to use the GMP 2024 domain names — software providers were asked to update by April 2025.
Knowledge, Skills & Development
- Keeping clinical knowledge up to date across all roles
- Participating in CPD and educational activities
- Recognising your limits of competence
- Quality improvement and audit
- Safe and effective care in both face-to-face and remote consultations
- Managing resources effectively and sustainably
- Clear, accurate clinical documentation
Patients, Partnership & Communication
- Treating patients with kindness, courtesy, and respect
- Listening to patients and not making assumptions about what they consider significant
- Obtaining valid consent and supporting shared decision-making
- Safeguarding vulnerable patients
- Significant event reporting and learning
- Being open when things go wrong (duty of candour)
Colleagues, Culture & Safety
- Creating a respectful, fair, and compassionate workplace
- Working constructively with colleagues; delegating safely
- Supporting colleagues' wellbeing and raising concerns appropriately
- Your own health and wellbeing — key to practising safely
- Infection control and managing clinical risk
- Championing fair and inclusive leadership
Trust & Professionalism
- Respecting patient dignity, confidentiality, and privacy
- Honesty, probity, and transparency
- Responding to complaints promptly and openly
- Ensuring adequate and regularly reviewed indemnity
- Professional use of social media
- Honest reporting and research ethics
For each domain, evidence comes from: CPD (courses, journals, online learning, PUNs & DENs), Quality Improvement Activity (audits, case reviews, protocol updates), Significant Events, and Feedback (colleagues, patients, complaints, compliments).
The 5 Appraisal Inputs
Your portfolio must address all five areas — and for each of your professional roles, not just your main GP post.
If you work as a GP, a GP trainer, a GPSI in dermatology, and for an out-of-hours provider — your appraisal needs to reflect all four roles. Evidence for inputs 2–5 is needed for each one. This surprises many GPs who are used to a single-job mindset.
Personal information
Your name, contact details, GMC number, and confirmation of your registration status.
Scope and nature of work
All the work you do as a doctor — NHS and non-NHS, clinical and non-clinical. List every role that requires your GMC licence to practise.
Supporting information
Evidence of CPD, quality improvement activities, reflection on teaching or management. Also includes complaints, compliments, and feedback from patients or colleagues.
Review of previous personal development plan (PDP)
What did you set out to achieve last year? What did you achieve? For any unmet goals — what got in the way? Do you want to carry them forward?
Achievements, challenges, and aspirations
Your highlights, your struggles, and your plans for the year ahead. This is also where wellbeing and work-life balance are discussed.
What types of evidence should you collect?
📚 Learning from Clinical Encounters
- PUNs and DENs — Patient Unmet Needs / Doctor's Educational Needs: note when you look something up and what you learned
- Log when using GPnotebook or NICE CKS — both have trackers you can export
- Case reviews and learning from clinical events
🏥 In-House Protected Learning
- Significant events (they do not have to be catastrophic)
- Prescribing meetings, referral meetings, mortality meetings
- Safeguarding meetings (adult and child)
- Practice away days and team learning
🎓 External Learning Activity
- Courses, workshops, diplomas, certificates
- Red Whale or NB Medical GP Update days
- Mandatory training: safeguarding, PREVENT, health & safety, information governance, resuscitation
💻 Self-Directed Learning
- Reading: journals, books, guidelines
- eModules: RCGP eLearning, FourteenFish, BMJ Learning
- Podcasts, YouTube learning, online communities
- Learning through social media (anonymised cases only)
📊 Quality Improvement Activity
- Audits and re-audits
- Protocol development or review
- QoF — areas you lead on and what you changed
- Reviewing prescribing patterns
👥 Feedback
- Multi-Source Feedback (MSF) from colleagues
- Patient Satisfaction Questionnaire (PSQ)
- Learning from complaints — what changed?
- Compliments — what did you do well?
Never include anything that might identify a patient or a colleague in your appraisal portfolio. This includes rare diagnoses, unusual case details, and identifiable demographic information. A patient can be identified without their name, address or date of birth — be thoughtful about what you write. Your appraisal portfolio may be viewed by your next appraiser, your Responsible Officer, or — in exceptional circumstances — the GMC.
RCGP Mythbusters — Verified & Simplified
💥 Appraisal Mythbusters
These are the most common misunderstandings — officially addressed by the RCGP, GMC, and experienced appraisers. Every one of these beliefs trips up real doctors.
💥 MYTH 1: "Appraisal is a pass/fail event"
Appraisal is not a pass or fail assessment. Your appraiser simply confirms — or in rare cases questions — whether five process statements are met. A "disagreed" statement does not mean you have failed. It means there is something to discuss or clarify. The vast majority of appraisals are completed without any statement being disagreed.
💥 MYTH 2: "My appraiser decides whether I can keep my licence"
Your appraiser has no authority to make a revalidation recommendation. That authority belongs to your Responsible Officer (RO). The GMC then makes the final decision about your licence. Your appraiser's role is to facilitate your reflection, support your development, and summarise the evidence for your RO.
💥 MYTH 3: "The more CPD credits I submit, the better my appraisal will be"
The GMC sets no specific number of CPD credits required for revalidation. Submitting hundreds of credits is not impressive — experienced appraisers say it often signals an inability to prioritise. Focus on two or three items where your learning genuinely changed your practice. That is far more valuable than a long catalogue of attendance.
💥 MYTH 4: "I need to complete specific mandatory training to revalidate"
The GMC does not specify any mandatory training requirements for revalidation. Things like BLS, safeguarding, and PREVENT are RCGP recommendations or employer requirements — not GMC revalidation conditions. Check what your own practice or trust requires, but do not confuse employment requirements with GMC revalidation requirements.
💥 MYTH 5: "Appraisal is mainly how concerns about doctors are identified"
Concerns about performance, conduct, or health are almost never first identified through appraisal. They are almost always discovered through clinical governance processes. Appraisal is a supportive, developmental process — not a surveillance mechanism. If a concern arises unexpectedly during an appraisal, the meeting is paused and appropriate channels are followed.
💥 MYTH 6: "My appraiser must report any concern I share about a colleague"
Your appraiser's role is to support and signpost — not to report on your behalf. If you share a concern about a colleague, your appraiser can help you think through what GMC guidance says about acting on concerns. The responsibility to act remains yours, under GMC duty of care. Raising a concern should be encouraged, but the appraiser is not there to do it for you.
💥 MYTH 7: "I need to work a minimum number of GP sessions to revalidate"
There are no session number requirements in the GMC guidance. What matters is that for every role you hold — however small — you can demonstrate that you practise safely, keep up to date, and seek feedback. If you work a very small number of sessions, your appraiser can help you use the AoMRC "factors for consideration" template to structure your reflection on that role.
💥 MYTH 8: "If my PDP goals were not achieved, my appraisal will be marked down"
Unmet PDP goals are not a failure. Life changes, priorities shift, and sometimes goals are no longer relevant. What your appraiser wants to see is that you reviewed your PDP, can explain what happened, and have thought about whether to carry goals forward or drop them. A thoughtful explanation is perfectly acceptable — especially if circumstances changed significantly.
💥 MYTH 9: "I need to scan and upload every certificate I receive"
The RCGP states clearly: there is no need to scan certificates as proof of attendance. Thoughtful, documented reflection is far stronger evidence that learning occurred. Do not waste time uploading certificates. Put that time into writing one good reflection instead.
💥 MYTH 10: "My appraisal should only cover my main GP role"
Your appraisal must cover your full scope of work — every role that requires your GMC licence to practise, including OOH work, training roles, GPSI positions, leadership, research, and clinical lecturing. This is one of the most commonly incomplete aspects of GP portfolios. If a role is not covered in your portfolio, your appraiser must flag this.
💥 MYTH 11: "Reflective writing can be used against me in court"
This fear increased after the Bawa-Garba case, but the MDOs (MDU, MPS, MDDUS) all confirm that in the Bawa-Garba case, the e-portfolio was not used as evidence. Disclosure of reflective notes outside educational settings would be very rare and would require exceptional legal circumstances. The best protection is to anonymise all patient and colleague details. Write honestly — that is your professional obligation — but anonymise everything.
💥 MYTH 12: "Appraisal and revalidation are the same thing"
They are related but distinct. Appraisal is the annual developmental conversation — local, process-based, and formative. Revalidation is the regulatory process — GMC-managed, occurring every 5 years, involving a formal recommendation from your RO. Five appraisals feed into one revalidation. Missing an appraisal delays revalidation. Failing to engage repeatedly can ultimately result in licence withdrawal.
Appraisers consistently report that the doctors who get the least from the process are those who arrive defensively, prepared to justify their year rather than reflect on it. The doctors who get the most are those who come with honest questions, a genuine curiosity about their own practice, and at least one area where they know they want to grow. That mindset alone transforms the conversation.
❓ Quick Questions & Answers
The things people actually want to know but sometimes feel silly asking.
Can I fail my appraisal?
No. Appraisal is not a pass/fail assessment. Your appraiser will confirm whether the appraisal has taken place and whether appropriate supporting information was presented. They do not grade you. Their role is to facilitate reflection, not to evaluate performance.
What happens if I miss an appraisal?
Missing an appraisal can be recorded as "approved missed" if there is a valid reason (parental leave, long-term sickness, etc.). This is noted in your portfolio. However, repeated missed appraisals without explanation will cause difficulty at revalidation. The GMC does not allow repeated deferrals of revalidation — avoid this situation by staying organised.
Who else can see my appraisal portfolio?
Your appraisal outputs (including summaries) may be seen by: your next appraiser, your Responsible Officer (RO), and their designated proxy for quality assurance purposes. The GMC has the right to request the full portfolio only in exceptional circumstances. This means you should write your portfolio as a professional document — and ensure all patient and colleague details are properly anonymised.
How much evidence is enough?
The GMC and RCGP both emphasise quality over quantity. Focus on activities where new learning stimulated a change in practice. Include evidence across all four GMP domains and for all your professional roles. More than this is likely to be counterproductive — large portfolios with minimal reflection are generally less impressive, not more.
What if my revalidation is deferred?
A single deferral is not a disaster. However, the GMC does not allow repeated deferrals. If your revalidation is deferred, work closely with your appraiser and RO to understand exactly what is needed and create a clear plan to address it before the next cycle.
What if I have a conflict of interest with my appraiser?
If you know your assigned appraiser — for example if they employ you or you have a personal relationship — contact your regional appraisal office to request a different appraiser. You are likely to have the same appraiser for 2–3 years, but you can request a change if needed.
I do several jobs. Do I need evidence for all of them?
Yes. Your appraisal must cover the full scope of your work — every role that requires your GMC licence to practise. So if you work as a GP salaried partner, a GP trainer, and for an out-of-hours provider, you need supporting information for each role. This is a common oversight and one of the areas appraisers most frequently have to ask about.
Reflection & Impact — the Heart of Appraisal
What you write matters less than what it shows about how you think.
The GMC and RCGP both emphasise that reflection is the key evidence of learning. You are not collecting receipts for courses attended. You are demonstrating that you have thought about what you have learned and what you are doing differently as a result.
In simple terms, a good reflection answers: "What have I learned that is going to change my practice?" Thoughtful reflection in your portfolio is far stronger evidence of learning than a scan of a certificate of attendance.
The 4 elements of a strong reflection
1. Learning
What did I learn that I didn't know before? What specifically will change my practice?
2. Reaction
How did I feel about what I learned? Was it helpful, reassuring, thought-provoking, uncomfortable?
3. Change
What do I need to do differently as a result of what I have learned?
4. Impact
What actually changed in my practice? (This part may be completed at a later date.)
The "What? → So what? → Now what?" framework
This is one of the simplest and most effective frameworks for structuring any reflection, whether for a single event or a whole period of learning. It works equally well for your appraisal portfolio, your FourteenFish ePortfolio entries, or a quiet moment after a difficult consultation.
❓ What?
"What was I thinking when I made this decision?"
Focus on the experience itself. Describe the context, the actions you took, and the thought processes at the time. Be honest — the good and the uncomfortable.
💭 So What?
"How did I feel, and why was it important?"
Consider the significance of what happened. What values, assumptions, or feelings influenced your response? What did this reveal about your practice?
🎯 Now What?
"What will I do differently next time?"
Identify what you can learn from the experience and what concrete action you will take. This feeds directly into your PDP.
The RCGP is very clear: submitting large numbers of CPD credits is unhelpful. It can actually signal an inability to organise and prioritise evidence. Select the activities where genuine learning occurred and where your practice changed. Three strong, insightful reflections are worth far more than thirty certificates in a folder.
For a comprehensive toolkit of reflective frameworks and approaches, see: GMC Reflective Practitioner Guidance and the AoMRC / CoPMED Reflective Practice Toolkit (PDF).
Deep Dive
✍️ How To Write a Good Reflection
This is the part most doctors get wrong — and the part that matters most.
Writing "I attended this course and found it useful" is not a reflection. It is a description. Appraisers — and ultimately Responsible Officers — are looking for evidence that you are an active, self-aware learner. One brief but insightful reflection that shows changed practice is worth more than twenty lines of course attendance records.
Description vs Reflection — what's the difference?
❌ Description — not enough
"I attended a safeguarding level 3 update course. The trainer covered recognition of abuse, the local referral pathway, and documentation requirements. I found it informative and relevant to my practice."
Why it fails: It tells us what happened. It says nothing about how this changed you or your practice.
✅ Reflection — what good looks like
"After this safeguarding update I realised I had been inconsistently documenting my rationale when I decided not to refer. A week later I had a case that made me pause. I now write a brief sentence in the record explaining my thinking whenever I decide to monitor rather than refer. This feels both safer for the patient and fairer to me if my decision is ever reviewed."
Why it works: It shows insight, changed behaviour, and the reason behind that change.
The ABCDE reflection framework — a simple structure that works
You don't need to use every reflective framework in existence. Pick one and use it consistently. Here is one that works well for GP appraisal:
The GMC says: "CPD should focus on outcomes or outputs rather than on inputs. You must reflect on what you have learned from the activity and how this could help maintain or improve the quality of your practice." Your appraiser is specifically looking for evidence that you are applying your learning — not just attending events.
Useful sentence starters for reflective writing
If you are not sure how to start, these phrases help shift your writing from description into reflection:
The most important thing I learned was…
At the time I felt… because…
This surprised me because I had assumed…
As a direct result, I now…
I still feel uncertain about… and my next step is…
What this revealed about my practice was…
This changed my thinking about… because…
If a similar situation arose again, I would…
How to reflect on different types of evidence
| Type of evidence | What to focus your reflection on | Common mistake to avoid |
|---|---|---|
| CPD / Course | What specifically changed in your practice? How has patient care improved? | Just listing what the course covered with no personal learning |
| Significant event | What you felt, what you learned, what the system changed, how you would approach it differently | Being vague or over-professional — the learning comes from honesty |
| Patient feedback / PSQ | Themes that surprised you, areas you acted on, things you are proud of | Just writing "the results were positive" with no further thought |
| MSF (colleague feedback) | Patterns across responses, one area you will actively work on, one strength to build on | Cherry-picking only positive comments and ignoring patterns of concern |
| Complaint | Your emotional response, what you did well, what you would change, and what you put in the PDP | Becoming defensive or turning the reflection into a justification |
| QI / Audit | What the data revealed, what changed as a result, whether re-audit showed improvement | Describing the method without discussing the outcome or learning |
Some doctors worry — especially following the Bawa-Garba case — that honest reflective writing could be used against them in legal or regulatory proceedings. The MDO guidance is clear: reflective notes are very rarely disclosed outside educational settings, and the most effective protection is simply to anonymise all patient and colleague details. Medical Protection has stated it would be "extremely rare" for a GP's portfolio to be used outside its educational purpose. Moreover, honest reflection, appropriately anonymised, demonstrates the very professional values regulators want to see. Write openly — but write carefully.
The Personal Development Plan (PDP)
The living document that connects one year's appraisal to the next.
The PDP is what turns your appraisal discussion into action. It records the learning goals you set with your appraiser and tracks whether you achieved them. Each goal should be SMART — specific, measurable, achievable, relevant, and time-bound — and should reflect the scope of all your professional roles.
Your final Educational Supervisor's Review (ESR) includes an agreed PDP. Ask for a copy of this at your final ARCP — it will be the starting PDP for your first post-CCT appraisal. Your new appraiser will expect to see it. If you can't find it, your appraiser may agree to summarise it "as best remembered," but it's far easier to simply save it before you leave training.
The 6 markers of a well-written PDP entry
Need
What learning need have you identified? How did you identify it — was it through patient feedback, a difficult case, an audit result, a significant event?
Activity
What educational or practical activities will you do to address this need? What resources will you use?
Timescale
How urgent is this learning need? When do you expect to complete it? Give a realistic but specific target date.
Evidence
How will you know you have achieved this goal? What evidence will you produce or collect?
Outcome
How will your practice change as a result? What — if any — new learning need has this process uncovered?
Completed
Your appraiser's agreement at the following appraisal that you have satisfactorily met this need.
Review your previous year's PDP before your appraisal, not during it. If a goal wasn't achieved, think honestly about why — and whether it's still worth pursuing. Carrying forward an unachieved goal year after year without explanation is a pattern your appraiser will notice. But a thoughtful explanation of why circumstances changed is entirely fine.
What Will My Appraiser Actually Ask?
No surprises. Here is a fairly complete map of the appraisal conversation.
The large majority of GPs report positive experiences with their appraiser. Your appraiser is a trained peer — a working GP who knows how this job feels. They are there to support you, not challenge you. The questions below are designed to help you reflect and grow, not to catch you out.
🩺 Clinical Questions
- What are you currently good at, and not so good at? How has this changed from last year?
- What is your practice currently good at — and where are there areas for improvement?
- Have there been any clinical situations that gave you pause this year?
📚 Learning & Quality Improvement
- How has a particular learning event changed the way you practise or the care you provide?
- Have you engaged in any audit or quality improvement activity? What was the need, and what was the outcome?
- How does your practice share learning with each other?
- Have you met your PDPs from last year? How has that changed patient care?
👥 Feedback Review
- Let's look at your Multi-Source Feedback. What themes emerge? Is there anything you would like to work on?
- Let's look at your Patient Satisfaction Questionnaire. What patterns do you notice? What would you like to develop?
- How have you responded to any complaints or compliments this year?
🎯 Planning Ahead
- What are your developmental needs for the coming year? What should go in this year's PDP?
- Do these PDPs cover the whole scope of your work and are they SMART?
- How are you? What is your work-life balance like?
- Have you plugged your revalidation date into your diary?
Digital Tools — Making Appraisal Easier
The right tool turns a year of scattered notes into an organised, meaningful portfolio. Use technology — don't fight it.
FourteenFish
The most widely used GP appraisal platform. Stores everything in one place, helps you see what's missing at a glance, and supports shared learning groups.
Visit →Clarity
A sleek, modern alternative to FourteenFish. Excellent visual organisation and helpful prompts. Highly rated by GPs who prefer a clean interface.
Visit →GMC MyCPD App
Free app for any doctor to log CPD. Not GP-specific, but useful for capturing learning moments on the go.
Visit →If several GPs in your practice use FourteenFish, you can create a shared e-group. When one colleague writes up the notes from a practice meeting, those notes can be shared to the whole group — saving everyone the effort of writing their own version. Add your own brief personal reflection and it's done. This is an underused time-saver that experienced GPs quietly swear by.
The national MAG (Medical Appraisal Guide) form is technically a valid option, but many GPs find it clunky and difficult to use. Modern electronic platforms like FourteenFish and Clarity are more user-friendly and integrate MAG22 directly. If you are in England or Northern Ireland, you are encouraged to use an updated electronic toolkit rather than the standalone MAG document.
🐟 Getting The Most From FourteenFish & Clarity
These tools are only as good as the habits you build around them. Here is how experienced GPs use them well.
🐟 FourteenFish — top tips
- Use the email-in feature. Send learning moments directly to your portfolio from your phone. The email address is unique to your account — save it as a contact on your phone as "FourteenFish Portfolio".
- Join your practice e-group. If colleagues are on FourteenFish, create or join a shared group. Shared meeting notes mean you write once and everyone benefits.
- Use the Learning Diary as a log — record everything there first. At appraisal preparation time, select the best items to formalise. You will have more than enough and can choose quality over quantity.
- The toolkit alerts you if it detects patient identifiable information in your entries — a helpful safety net.
- RCGP First5 free offer: If you gained your CCT from 2021 onwards, the RCGP fully funds your FourteenFish subscription for 5 years — as long as you remain an RCGP member.
🔷 Clarity — top tips
- Clarity uses a clean, visual dashboard that shows at a glance what you have covered and what gaps remain — useful if you are the kind of person who prefers a visual checklist over a long list.
- It is approved for use in England and supports MSF and patient survey tools directly within the platform.
- Start early in the appraisal year. Like FourteenFish, Clarity is designed to be used continuously — not as a last-minute submission tool.
- If you are changing from one platform to another mid-cycle, speak to your appraiser first to ensure your previous portfolio evidence transfers smoothly.
In Lancashire & Cumbria, the MAG form is no longer accepted — you must use an approved digital platform. Check with your regional appraisal office if you are unsure which platforms are currently accepted in your area.
📆 Your appraisal year — a practical timeline
New appraisal year begins
Open your portfolio on FourteenFish or Clarity. Check last year's PDP — which goals are you carrying forward? Add today's date as the start of your new appraisal year. Find out your appraisal month.
First quarterly tidy (2 hours)
Add reflections for anything significant in the past 3 months. Review PDP progress. Are you on track? Have priorities changed? Add any significant events or complaints that occurred.
Midyear check — is anything missing?
Check your portfolio against the 6 supporting information types. If you have not yet started a QI activity, now is the time. Is your patient or colleague feedback due this revalidation cycle? If so, plan now — feedback takes 6–12 weeks to complete.
Pre-appraisal tidy — 6 weeks before
Your portfolio should be nearing completion. Submit feedback surveys now if not already done. Draft your reflective statements for each domain. Review your PDP and make notes for discussion. Contact your appraiser to confirm the meeting date.
Submit portfolio to appraiser
Most platforms require submission at least 2 weeks before the meeting. Late submission means your appraiser has insufficient time to prepare — which reduces the quality of the discussion.
Appraisal meeting (~2 hours, usually remote)
Allow 3 hours in your diary. Choose a time when you will be alert. Have water. Prepare 2–3 things you genuinely want to discuss — not just to show, but to think through together. Remember: verbal reflection counts. Be honest. Be curious. Use your appraiser.
Sign off and start the next cycle
Review and agree the appraisal summary. Sign off. Save a copy of the outputs. Add the next appraisal year start date to your diary — and schedule your four quarterly tidy sessions immediately, while you still mean to do it.
Hot Tips for Making Appraisal Easier
Practical wisdom — especially for those new to the system.
🆕 Tips specifically for final-year trainees transitioning to post-CCT
- At your final Educational Supervisor's Review, fill in the Agreed Action Plan carefully with your trainer. Identify specific, measurable needs — these will transfer directly into your first post-CCT PDP.
- Request a copy of your ESR form to keep. It is the bridge between GP training and your first appraisal. Your new appraiser will expect to see it.
- Remember: your GP trainer will no longer be there to remind you. Build a personal system for collecting evidence throughout the year.
- Your appraisal portfolio must be submitted at least 2 weeks before your appraisal date. Unlike training, you will not be offered extensions easily.
- On completing training and gaining your CCT, you will be revalidated by the GMC as part of the training completion process. Your first post-CCT appraisal will then begin a new 5-year revalidation cycle.
📅 The 4 quarterly "tidy dates" system — Dr Ram's top tip
Most GPs collect appraisal data throughout the year but then face a chaotic fortnight before the appraisal trying to sort it all out. There is a better way.
Plug four dedicated 2-hour sessions into your diary calendar, spaced roughly 3 months apart. Use these to organise, review, and add reflections to your portfolio while events are still fresh.
Example: if your appraisal is in September, schedule tidy sessions on: 12 February, 12 May, 12 August, 12 November.
The result? An appraisal portfolio that almost builds itself — and no end-of-year panic.
🤝 Form a collaborative group and share your learning
Get the GPs you work with regularly to work collaboratively on shared learning documentation. When someone writes up the notes from a practice meeting — a significant event, a BLS session, an adult safeguarding training day — they anonymise them and share with the group.
Each doctor then uploads the shared notes to their own portfolio and adds a brief personal reflection. This takes minutes, not hours. It turns one person's effort into everybody's evidence.
🌱 Widening your learning: knowledge, skills & pastoral support
Knowledge & skills
- Evening courses, seminars, and workshops — many are free via your local Integrated Care Board (ICB). Contact them for a programme of events.
- GP Clinical Update days with Red Whale or NB Medical — full days focused on a topic or group of topics; excellent value.
- Communication skills workshops — often available via deaneries; well worth the cost.
- eModules for mandatory training (safeguarding, PREVENT, fire safety, information governance) — see eLFH.
- A WhatsApp group with former fellow trainees or practice colleagues — discuss clinical questions (anonymised), share interesting cases, and keep each other going.
Pastoral support
- Stay in touch with your GP trainer and TPDs, especially in the first post-CCT year.
- Maintain your peer group from training — these relationships are a professional lifeline, not a social luxury.
- Your appraisal discussion is a legitimate space to raise concerns about burnout, workload, or personal wellbeing. Don't skip this because it feels awkward.
Never post anything that could identify a patient, even without using their name. A rare diagnosis, an unusual detail, or a description of location can all be identifying. Use only closed, private groups for professional discussions and ensure you can delete content if needed. You are legally responsible for what you post.
❓ 5 questions to ask yourself before your appraisal
What do I want to get from this appraisal?
Go in with intention. This is your time. What do you actually want to talk about?
What am I genuinely proud of this year?
What went well? What did you do that you're quietly pleased about — even if nobody noticed?
How is my personal wellbeing?
Are you in a good place? Burning out? Feeling unsupported? Your appraisal is a legitimate time to discuss this honestly.
What is contributing to my work stress?
Name it. Bring it. Your appraiser has likely experienced something similar and may have practical suggestions.
What is the smallest thing I could change?
Not a total reinvention — just one small, achievable shift. Progress doesn't have to be dramatic to be real.
The section below is distilled from the experiences of GPs across the UK — things that work in the real world, beyond the official guidance
🧠 Practical Wisdom — What Experienced GPs Actually Do
The habits, strategies, and mindset shifts that make appraisal feel less like a burden and more like something genuinely useful.
📧 The email-to-yourself method
When you look something up after a consultation, spend 90 seconds writing a short email to yourself: what the clinical question was, what you found, and what you will do differently. Many GPs do this using FourteenFish's email-to-portfolio feature — it lands straight in your learning diary. By the time appraisal comes around, you have a year's worth of PUNs/DENs ready without ever having set aside dedicated time.
📅 The Sunday evening 10-minute rule
Some GPs set a recurring 10-minute reminder once a fortnight to add one brief reflection to their FourteenFish or Clarity portfolio. It does not have to be polished. It does not have to be long. What it does is prevent the February panic — when you realise your appraisal is in March and your portfolio is empty except for last year's entries.
🤝 The practice team reflection share
After a significant event meeting, a mortality meeting, or a safeguarding update, one colleague writes a brief anonymised summary and emails it to the practice group. Everyone uploads it to their own portfolio and adds two sentences of personal reflection. This turns one person's effort into five people's appraisal evidence — and genuinely builds team learning culture at the same time.
📊 Use what the NHS gives you for free
Your prescribing data, your referral data, your QoF dashboard — all of these are available to you throughout the year. Many GPs do not realise that a brief reflection on a prescribing trend ("I noticed my antibiotic prescribing was above the ICB average in Q1 — I implemented STRATIFY, and by Q3 it had fallen") is an excellent quality improvement activity. It does not require a formal audit.
🧑🤝🧑 The peer group advantage
GPs who belong to a peer support group — a Balint group, a small informal peer group, or a learning set — consistently describe their appraisals as richer and less stressful. These groups generate QI ideas, provide informal MSF insight, offer cases for SEA discussion, and — most importantly — normalise honest reflection. If you are not in one, consider starting one.
🎙️ Verbal reflection is genuinely enough
The RCGP states clearly that verbal reflection in the appraisal meeting is just as valid as written evidence. Several experienced GPs describe deliberately leaving some items for discussion in the meeting rather than writing everything up in advance. This keeps the conversation genuine, and it means preparation time does not spiral. Write enough to frame the topic — then talk about it live.
⚠️ What not to do — patterns that waste time and reduce quality
Uploading everything you have done. Appraisers find over-stuffed portfolios tiring and hard to navigate. They do not signal thoroughness — they signal an inability to prioritise. Select and curate.
Starting your portfolio the week before. Reflections written retrospectively — months after the event — are shallow, stress-inducing, and obvious to any experienced appraiser. Collect throughout the year.
Using patient or colleague identifiable details. Your portfolio is a professional document that can, in rare circumstances, be disclosed. Anonymise everything. This protects you, your patients, and your colleagues.
Ignoring your additional roles. GP trainer, GPSI, OOH, clinical lead — all require evidence. Appraisers consistently flag incomplete portfolios that cover only the main GP surgery role.
Writing justifications, not reflections. If a patient complained, the portfolio is not the place to argue your case. It is the place to show what you learned. A reflective entry on a complaint demonstrates professional maturity; a defensive one does not.
Confusing domain names (old vs GMP 2024). If your appraisal toolkit has not updated to GMP 2024 domain names, check with your appraiser. The content requirements are broadly similar, but the labelling matters for your RO's review.
GMP 2024 now explicitly includes your health and wellbeing within Domain 3. Your appraiser is trained to open this topic, but many doctors steer away from it out of habit, or because they fear it will affect their revalidation. It will not. Your appraisal is one of the very few protected, confidential spaces in medicine where a trained colleague asks how you are actually doing. Many GPs describe this as the most valuable part of their appraisal — and the most neglected. Use it.
💎 Insider Pearls & Real-World Wisdom
The things experienced GPs wish they had known earlier.
The single most common appraisal mistake is leaving reflection until the week before the meeting. A learning event from eight months ago is genuinely hard to reconstruct meaningfully. Capture your reflections within a few days of the experience, while it is still real. Even a single paragraph immediately after a difficult consultation is worth more than a polished essay written months later from a faded memory.
The RCGP explicitly states that verbal reflection during the appraisal meeting is just as valid as written evidence. If you have a rich conversation with your appraiser about a learning experience, that counts. You do not have to write a formal account of everything. Use your appraiser — that is what they are trained for.
This is perhaps the most important mindset shift for newly qualified GPs. Your appraiser is trained to help you think, not to test you. Resist the urge to be defensive. The most productive appraisal conversations happen when GPs show up curious and open rather than prepared to defend their record.
GPs who take on additional roles — trainer, GPSI, clinical lead, OOH — frequently underrepresent these in their portfolio. Every role that requires your GMC licence needs supporting information. If you are a GP trainer, there should be evidence relating to your training activity. Overlooking this is very common and easily avoided.
Appraisers report that overstuffed portfolios with dozens of certificate scans and minimal reflection are more tiring to review — and less impressive — than lean portfolios with thoughtful, specific reflections that clearly demonstrate changed practice. Choose your entries carefully. Quality is the signal; volume is the noise.
Appraisal is not a pass/fail test. There is no "correct" portfolio. When GPs approach it as an assessment to be passed rather than a conversation to be had, they often produce defensive, formulaic portfolios that miss the point entirely. The appraisal exists to serve you — not the other way around.
🩺 GP Locums & Sessional GPs — Appraisal Applies to You Too
All doctors need to engage with appraisal and revalidation — including GP locums and sessional GPs. The rules are the same: annual appraisal, revalidation every 5 years.
The practical challenge for locums is that evidence for quality improvement and feedback must be gathered across multiple practices. This is absolutely achievable — just requires a little more forward planning.
- Join a locum group or locum chambers — ask your colleagues how they manage their portfolio. You are not reinventing the wheel alone.
- Use FourteenFish as your centralised portfolio. You can join practice e-groups and share learning notes even as a sessional doctor.
- You must list all practices you worked in over the previous year, with details — every year.
- Check your designated body status in PCSE Online (England) — this can drift if you have moved regions.
- Seek advice from NASGP (National Association of Sessional GPs) — their AppraisalAid resource is excellent.
🎓 For Trainers & TPDs — Teaching Appraisal Well
Common trainee blind spots about appraisal
- Believing appraisal is an administrative task rather than a developmental conversation — set expectations early
- Confusing the FourteenFish ePortfolio with the training ePortfolio (they serve different purposes; FourteenFish is for post-CCT appraisal)
- Not appreciating that verbal reflection at the meeting itself counts — trainees often overprepare written documentation unnecessarily
- Failing to request a copy of their final ESR/Agreed Action Plan before leaving training
- Not understanding the difference between appraisal (annual, developmental) and revalidation (5-yearly, regulatory)
Tutorial ideas and reflective prompts
- "Talk me through a recent case that made you look something up. What changed in your practice?" — models the PUNs/DENs approach directly
- "If your appraisal was tomorrow, what would your greatest developmental need be? How do you know?"
- "Show me a reflection you wrote last month. What does it tell you about how you learn?"
- Role-play an appraisal conversation — one trainee as GP, one as appraiser
- Ask trainees to complete a What/So what/Now what reflection on a recent significant event in the practice
The final ESR — making the handover effective
The final Educational Supervisor's Review is the bridge between training and independent practice. Help your trainee to:
- Write specific, measurable PDP goals — not vague aspirations
- Understand that these goals will form the starting point of their first post-CCT appraisal
- Save a copy of the completed ESR form for their own records
- Understand their revalidation date and why the pre-revalidation appraisal matters most
The most common post-CCT difficulty is the sudden absence of structure. Your job in the final ESR is to help them build the internal systems they will need to stay organised without a training scheme to support them.
🎯 Final Take-Home Points
The bits to carry with you after you close this page.
Know your dates. Your appraisal month and your revalidation date. Check both on GMC Online and plug them into your diary now.
Collect throughout the year. A reflection written the same week as the experience is worth ten times more than one written the week before your appraisal.
Quality beats quantity. Three insightful reflections that changed your practice are more valuable than thirty certificate scans in a folder.
Cover all your roles. Every job requiring your GMC licence needs supporting information. Don't let your extra roles go invisible.
Your appraiser is on your side. They are a trained peer, not an examiner. Turn up open and curious — not defensive.
Use the wellbeing space. Your appraisal is one of the few places in medicine where you are encouraged to talk honestly about how you are actually doing. Use it.
Use good tools. FourteenFish and Clarity exist to make this easier. Let technology do the organising so you can focus on the thinking.
Review your PDP regularly. Diarise four 2-hour tidy sessions per year. Your future self will thank your present self.
Bradford VTS — Free for all UK GP trainees, trainers & TPDs since 2002 | Created by Dr Ramesh Mehay | Disclaimer
Appraisal & Revalidation
Once a year, someone sits down with you and asks how you're really doing. It's not a test — it's actually quite useful. Honestly.
📥 Downloads
Handouts, worked examples, teaching slides, and everything you need — ready when you are.
🌐 Web Resources
A hand-picked mix of official guidance and real-world GP training resources. Because the best pearls are not always hiding in the official documents.
Additional Bradford VTS pages that link closely with appraisal:
🎓 Just Got Your CCT? Your Appraisal Starter Guide
Congratulations — you are a GP. Here is everything you need to know about appraisal before your first one arrives.
Your appraisal as a newly qualified GP is not a test of everything you know. It is a supported, developmental conversation — and because you are fresh from training, expectations are proportionate. Your appraiser knows you are new. They will help you settle into the process.
Your post-CCT appraisal journey — step by step
CCT
Apply to the Performers List — do not leave this late
In England, apply to the GP Performers List via PCSE Online between 6 and 3 months before your expected CCT date. Apply as a GP Registrar first — not as a GP Performer. Once your CCT is confirmed, log back in and change your status to GP Performer. In Scotland, apply to your local health board. In Wales, your deanery manages this. In Northern Ireland, contact NIMDTA. Once on the Performers List, your designated body is identified and the appraisal process starts automatically.
Your CCT counts as your first revalidation
At the point of your CCT, the GMC revalidates you as part of the training completion process — this is your first revalidation. Your next revalidation date is set approximately 5 years later (usually around 60 days after your CCT date). Check this on GMC Online — it should appear automatically. Your first post-CCT appraisal begins a brand new 5-year revalidation cycle.
weeks
You are allocated a Responsible Officer and an appraiser
Once you join the Performers List, your designated body (NHS England for most GPs in England) assigns you a Responsible Officer (RO) and an appraiser. You do not choose your appraiser — they are allocated to you. Your appraiser will typically be a local practising or recently retired GP. You can expect to keep the same appraiser for around two to three years. If you have not been contacted within six weeks of your CCT, contact your regional appraisal team proactively — it is your professional responsibility to ensure you have an appraisal in year 1.
months
Your first appraisal — when to expect it
Your RO sets the date of your first appraisal. You can expect this to fall within the appraisal year following your CCT — broadly between 9 and 15 months after qualifying. Many areas allocate a dedicated appraisal month. You will receive notification around 3 months in advance. Once notified, it is your responsibility to contact your appraiser and agree the actual meeting date and format (face-to-face or remote).
onwards
Annual appraisal every year from now on
From your first post-CCT appraisal, you have one appraisal every year. Five of these feed into your revalidation recommendation to the GMC. Your appraisal month generally stays the same year on year unless you change region or take approved leave.
Yes — in an important way. Your WPBA evidence and training portfolio from your final year as a registrar is recognised as equivalent to appraisal supporting information. Your final ESR and ARCP PDP are brought forward as the starting PDP for your first post-CCT appraisal. Ask your trainer to email you the Agreed Action Plan from your final ESR — keep it safe. If you lose it, your appraiser can agree to let you summarise it "as best remembered", but it is much easier to just save it before you leave training.
What to collect for your first appraisal
Your first post-CCT appraisal is intentionally lighter than later ones. You will not yet have every type of evidence — and that is fine. Focus on what you genuinely have.
| Evidence type | What to bring for your first appraisal | When mandatory |
|---|---|---|
| Final ESR / ARCP PDP | Bring it and reflect on progress — this is your "previous PDP" for year 1 | First appraisal ✓ |
| CPD reflections | Any learning since CCT — courses, reading, cases, guidelines looked up | Every appraisal ✓ |
| Significant events | Any you have been involved in since CCT, with reflection | Every appraisal ✓ |
| Scope of work | List all roles requiring your GMC licence — main GP job plus anything else | Every appraisal ✓ |
| Complaints and compliments | Reflect on any received since CCT (formal or informal) | Every appraisal ✓ |
| Wellbeing declaration | Brief reflection on how you are doing and any reasonable adjustments needed | Every appraisal ✓ |
| Quality improvement activity (QIA) | Not required in year 1 — plan one over the 5-year cycle. Start thinking about it. | Once per 5-year cycle |
| Colleague feedback (MSF) | Not required in year 1 — plan to complete once in the cycle (takes 6–12 weeks) | Once per 5-year cycle |
| Patient feedback (PSQ) | Not required in year 1 — plan to complete once in the cycle | Once per 5-year cycle |
📱 Choose an electronic appraisal toolkit — do this in week one
Using an electronic portfolio is required in most English regions. Here are all the current options:
🐟 FourteenFish FREE for First5 GPs
The most widely used GP appraisal toolkit in the UK. Known for its clean interface and email-to-diary feature — forward a course confirmation or learning note straight into your portfolio from your phone.
Free for 5 years if you CCT'd from 2021 onwards and remain an RCGP member — applied automatically at FourteenFish checkout. After 5 years: approx. £42–50/year (RCGP members get 30% discount).
Includes: CPD diary, reflection templates, MSF and PSQ surveys, significant event templates, Portfolio mobile app.
Visit FourteenFish →🔷 Agilio Clarity
The other major platform — widely used in England and popular with ICBs and larger practices. Deeply integrated with the Agilio ecosystem (TeamNet, iLearn). Strong organisational dashboards. ISO 27001 certified.
Includes: CPD logging, MSF and PSQ tools, QI templates, integrated clinical update modules. Annual subscription — pricing varies by region.
Visit Clarity →🛠️ GP Tools
A free-to-use appraisal and revalidation portfolio for NHS GPs. GMC and NHS compliant, with patient survey and MSF feedback included at no extra cost. A solid lightweight option if you want something free and uncomplicated.
Visit GP Tools →📍 Mandatory regional systems
- Scotland: Scottish Online Appraisal Resource (SOAR) — provided automatically
- Wales: Medical Appraisal Revalidation System (MARS)
- Northern Ireland: GP appraisal registration form via NIMDTA
- Armed Forces GPs: PReP (Portfolio and Revalidation Portal)
In England, check with your regional appraisal office if you are unsure which platforms they currently accept.
The old paper-based Medical Appraisal Guide (MAG) form has been discontinued by NHS England. Do not use it. Use an approved electronic toolkit instead.
💡 Top tips for newly qualified GPs
Start your toolkit immediately
Set up FourteenFish or Clarity the week you get your CCT. The sooner it is live, the sooner evidence accumulates. Waiting until month 10 means reconstructing a year of learning from memory.
Email reflections to yourself
FourteenFish has an email-to-diary address. After anything notable — a difficult case, a guideline you looked up — fire off a 3-line email. Takes 90 seconds. Builds your portfolio throughout the year.
Save your final ESR PDP
Before you leave training, ask your trainer to email you the Agreed Action Plan from your final ESR. This is your year-1 PDP. Your first appraiser will ask for it. Losing it is surprisingly common.
Note your revalidation date now
Log into GMC Online, find your revalidation date, and put it in your phone calendar. The fifth appraisal before that date is the one where everything must be in order.
Chase up if you hear nothing
If you have not been contacted about an appraiser within 6 weeks of CCT, reach out to your regional appraisal team. It is your professional responsibility to have an appraisal in year 1 — do not assume the system will chase you.
Claim your free FourteenFish
CCT'd from 2021 onwards and an RCGP member? Your FourteenFish subscription is funded for 5 years automatically. That is your entire first revalidation cycle — free.
Year 1 is lighter — use that
No MSF, no PSQ, no formal QI project needed in year 1. You need CPD reflections, your ESR PDP, and scope of work. Use the lighter first year to build the habit solidly.
Practice appraisal with your trainer
Before finishing ST3, ask your trainer for a practice appraisal. Use it to agree your post-CCT PDP and ask to see how they prepare their own portfolio. An hour with your trainer is worth more than any guide.
Keep GMC Online up to date
Make sure GMC Online shows your correct designated body, email, and employer. If you move regions after CCT, update your connection promptly — appraisal allocation flows from this information.
✅ Post-CCT appraisal checklist — at a glance
Before CCT
Apply to Performers List (6–3 months before CCT date) via PCSE Online
At CCT
Change Performers List status to GP Performer on PCSE Online
At CCT
Email your trainer for the final ESR Agreed Action Plan (your year-1 PDP)
At CCT
Check and note your revalidation date on GMC Online
Week 1
Set up FourteenFish, Clarity, or GP Tools — start logging immediately
Within 6 weeks
Confirm you have been allocated an appraiser — contact regional team if not
Throughout year
Log CPD, reflections, significant events, complaints as they happen
Before appraisal
Review ESR PDP progress, draft scope of work, submit portfolio 2 weeks early
⚡ Quick Summary — If You Only Read One Thing
What it is
- Annual, structured, supported self-review with a trained appraiser
- Covers the full scope of your work — all roles, not just your main GP job
- Based on GMC's Good Medical Practice (GMP) 2024
- Not a pass/fail exam — it's a developmental conversation
The numbers
- Annual appraisal → every 12 months
- Revalidation → every 5 years, recommended to the GMC by your Responsible Officer (RO)
- Revalidation date is usually 5 years from your CCT (check with your appraiser)
- Pre-revalidation appraisal must have all evidence in order
Key principles
- Quality over quantity — one insightful reflection beats 50 course certificates
- Verbal reflection in the meeting counts equally to written work
- The appraiser is your peer and ally — not your examiner
- Collect evidence throughout the year, not the week before
What Is Appraisal — and Why Does It Matter?
More than paperwork. Less than terrifying.
The official definition
NHS England defines medical appraisal as a process of facilitated self-review, supported by information gathered from the full scope of a doctor's work. It is central to the revalidation process, and ensures doctors are both fit to practise and actively considering their professional development needs.
Appraisals are conducted annually, usually between the doctor and a trained GP appraiser — though in some cases the appraiser may not be a doctor.
The real purpose
In the early years, appraisal had a habit of becoming a data-collection marathon — gathering piles of certificates and attendance records to prove you were doing your job. That's no longer the point.
From 2020, the approach became "input-light, impact-heavy." The goal is genuine reflection and personal growth — not paperwork. The emphasis is now firmly on development and support.
A national survey found that around 90% of GPs report their appraisal was useful — for quality improvement, for patient care, and for personal and professional development. These are better satisfaction ratings than most NHS meetings manage to achieve.
Appraisal vs Revalidation — what's the difference?
| Feature | Appraisal | Revalidation |
|---|---|---|
| Frequency | Every year | Every 5 years |
| Who decides? | Appraiser facilitates discussion | Responsible Officer (RO) recommends to GMC |
| Format | Meeting (~2–3 hours, often remote) | GMC makes formal revalidation decision |
| Pass/fail? | No — it is developmental, not judgmental | Yes — licence to practise continues or is reviewed |
| Focus | Reflection, growth, wellbeing, PDPs | Demonstration that you are fit to practise |
| What feeds into the other? | 5 annual appraisals feed into revalidation | Revalidation is the culmination of 5 years |
The 5-year revalidation cycle
★ The Year 5 appraisal is the critical one — all mandatory evidence must be in order before this date.
Know your revalidation date. Check it on your GMC Online account. It is usually 5 years from your CCT, but verify this with your appraiser. If your pre-revalidation appraisal is missing key evidence, your revalidation will be deferred. Unlike training, you are not given repeated second chances.
Brief history of appraisal in UK general practice
Peer appraisal introduced for GPs
A formative, supportive process — developmental and voluntary in spirit.
Appraisal becomes linked to revalidation
Following the Shipman inquiry and broader concerns about fitness to practise, appraisal gained a formal regulatory role.
CPD credit doubling scrapped
Simplification — focus moved to quality of reflection, not quantity of evidence.
"Slimmed-down" appraisal approach
Input-light, impact-heavy. Emphasis on wellbeing, genuine reflection, and personal growth rather than data gathering.
GMC Good Medical Practice updated
GMP 2024 published — reinforces duty to delegate safely and reflects modern GP practice. Appraisals now align with GMP 2024 standards.
🆕 This section covers important changes to Good Medical Practice 2024 — every UK GP should know these
🆕 Good Medical Practice 2024 — What Changed?
The first major update in over a decade came into effect on 30 January 2024. Here is what every GP needs to know before their next appraisal.
Your appraiser has been trained to facilitate your reflection on the new standards. You will not be tested on your knowledge of GMP 2024, but you should be familiar with the themes and be ready to reflect on them. The new domains have also been renamed — make sure your digital appraisal toolkit is updated to reflect GMP 2024 (software providers were asked to update by April 2025 at the latest).
The 4 renamed GMP 2024 domains
Knowledge, Skills & Development
Previously: "Knowledge, skills and performance"
New emphasis: Staying up to date across all roles. Safe and effective care in both face-to-face and remote consultations. Managing resources sustainably.
Patients, Partnership & Communication
Previously: "Safety and quality"
New emphasis: Kindness, courtesy and respect as explicit requirements. Not making assumptions about what patients consider significant. Supporting shared decision-making.
Colleagues, Culture & Safety
Previously: "Communication, partnership and teamwork"
New emphasis: Positive, fair, compassionate workplace culture. Safe delegation. Supporting colleagues' wellbeing. Doctors' own health and wellbeing explicitly included.
Trust & Professionalism
Previously: "Maintaining trust"
New emphasis: Social media conduct. Environmental sustainability. Adequate and regularly reviewed indemnity insurance. Stronger focus on inclusive leadership.
New themes your appraiser may explore
Environmental sustainability
GMP 2024 says doctors should choose sustainable solutions when they can, without compromising care. This is now a reflectable topic. Think: inhaler choices, travel to appointments, paper vs digital. A short reflection on one sustainable change you made is a quick PDP win.
Remote consultations
GMP 2024 explicitly requires safe and effective care in both face-to-face and remote consultations. Be ready to reflect on how you decide which format is appropriate and how you maintain safety and quality in video or telephone consultations.
Social media
For the first time, GMP 2024 includes guidance on social media. If you use social media professionally, your appraiser may ask you to reflect on how you maintain appropriate boundaries and uphold GMC standards online.
Safe delegation
With ARRS roles expanding in many practices, GMP 2024 places a new emphasis on ensuring that those you delegate to are competent, supported, and working within their limits. If you supervise others, be ready to reflect on how you delegate safely.
Polypharmacy & medication review
GMP 2024 includes a new reference to regularly reviewing medications and considering whether benefits outweigh risks. This is an excellent QI topic — consider a polypharmacy or anticholinergic burden audit as a PDP item.
Your own wellbeing
Domain 3 now explicitly includes doctors' own health and wellbeing as key to practising safely. Your appraiser may ask — or may prompt you to reflect on — how you manage stress, protect your own health, and access support when needed.
- Reflect on one change you made to reduce the environmental impact of your prescribing (e.g. inhaler switch, reduced unnecessary investigations)
- Audit your approach to polypharmacy or anticholinergic burden in elderly patients
- Review your remote consultation practice — how do you decide face-to-face is needed?
- Read the GMC social media guidance and write a brief reflection on how it applies to your online activity
- If you supervise others, reflect on a specific case where you delegated and how you ensured safety
The 4 Domains of Good Medical Practice (GMP 2024)
Appraisal is structured around the GMC's Good Medical Practice (GMP 2024) framework, in force from 30 January 2024. Your portfolio must provide evidence across all four domains.
You are not expected to memorise these bullet points. Your appraiser knows them well and will guide the conversation. What matters is that your portfolio demonstrates evidence across all four areas and that you can reflect meaningfully on what you've done and why it matters. Check that your appraisal toolkit has been updated to use the GMP 2024 domain names — software providers were asked to update by April 2025.
Knowledge, Skills & Development
- Keeping clinical knowledge up to date across all roles
- Participating in CPD and educational activities
- Recognising your limits of competence
- Quality improvement and audit
- Safe and effective care in both face-to-face and remote consultations
- Managing resources effectively and sustainably
- Clear, accurate clinical documentation
Patients, Partnership & Communication
- Treating patients with kindness, courtesy, and respect
- Listening to patients and not making assumptions about what they consider significant
- Obtaining valid consent and supporting shared decision-making
- Safeguarding vulnerable patients
- Significant event reporting and learning
- Being open when things go wrong (duty of candour)
Colleagues, Culture & Safety
- Creating a respectful, fair, and compassionate workplace
- Working constructively with colleagues; delegating safely
- Supporting colleagues' wellbeing and raising concerns appropriately
- Your own health and wellbeing — key to practising safely
- Infection control and managing clinical risk
- Championing fair and inclusive leadership
Trust & Professionalism
- Respecting patient dignity, confidentiality, and privacy
- Honesty, probity, and transparency
- Responding to complaints promptly and openly
- Ensuring adequate and regularly reviewed indemnity
- Professional use of social media
- Honest reporting and research ethics
For each domain, evidence comes from: CPD (courses, journals, online learning, PUNs & DENs), Quality Improvement Activity (audits, case reviews, protocol updates), Significant Events, and Feedback (colleagues, patients, complaints, compliments).
The 5 Appraisal Inputs
Your portfolio must address all five areas — and for each of your professional roles, not just your main GP post.
If you work as a GP, a GP trainer, a GPSI in dermatology, and for an out-of-hours provider — your appraisal needs to reflect all four roles. Evidence for inputs 2–5 is needed for each one. This surprises many GPs who are used to a single-job mindset.
Personal information
Your name, contact details, GMC number, and confirmation of your registration status.
Scope and nature of work
All the work you do as a doctor — NHS and non-NHS, clinical and non-clinical. List every role that requires your GMC licence to practise.
Supporting information
Evidence of CPD, quality improvement activities, reflection on teaching or management. Also includes complaints, compliments, and feedback from patients or colleagues.
Review of previous personal development plan (PDP)
What did you set out to achieve last year? What did you achieve? For any unmet goals — what got in the way? Do you want to carry them forward?
Achievements, challenges, and aspirations
Your highlights, your struggles, and your plans for the year ahead. This is also where wellbeing and work-life balance are discussed.
What types of evidence should you collect?
📚 Learning from Clinical Encounters
- PUNs and DENs — Patient Unmet Needs / Doctor's Educational Needs: note when you look something up and what you learned
- Log when using GPnotebook or NICE CKS — both have trackers you can export
- Case reviews and learning from clinical events
🏥 In-House Protected Learning
- Significant events (they do not have to be catastrophic)
- Prescribing meetings, referral meetings, mortality meetings
- Safeguarding meetings (adult and child)
- Practice away days and team learning
🎓 External Learning Activity
- Courses, workshops, diplomas, certificates
- Red Whale or NB Medical GP Update days
- Mandatory training: safeguarding, PREVENT, health & safety, information governance, resuscitation
💻 Self-Directed Learning
- Reading: journals, books, guidelines
- eModules: RCGP eLearning, FourteenFish, BMJ Learning
- Podcasts, YouTube learning, online communities
- Learning through social media (anonymised cases only)
📊 Quality Improvement Activity
- Audits and re-audits
- Protocol development or review
- QoF — areas you lead on and what you changed
- Reviewing prescribing patterns
👥 Feedback
- Multi-Source Feedback (MSF) from colleagues
- Patient Satisfaction Questionnaire (PSQ)
- Learning from complaints — what changed?
- Compliments — what did you do well?
Never include anything that might identify a patient or a colleague in your appraisal portfolio. This includes rare diagnoses, unusual case details, and identifiable demographic information. A patient can be identified without their name, address or date of birth — be thoughtful about what you write. Your appraisal portfolio may be viewed by your next appraiser, your Responsible Officer, or — in exceptional circumstances — the GMC.
RCGP Mythbusters — Verified & Simplified
💥 Appraisal Mythbusters
These are the most common misunderstandings — officially addressed by the RCGP, GMC, and experienced appraisers. Every one of these beliefs trips up real doctors.
💥 MYTH 1: "Appraisal is a pass/fail event"
Appraisal is not a pass or fail assessment. Your appraiser simply confirms — or in rare cases questions — whether five process statements are met. A "disagreed" statement does not mean you have failed. It means there is something to discuss or clarify. The vast majority of appraisals are completed without any statement being disagreed.
💥 MYTH 2: "My appraiser decides whether I can keep my licence"
Your appraiser has no authority to make a revalidation recommendation. That authority belongs to your Responsible Officer (RO). The GMC then makes the final decision about your licence. Your appraiser's role is to facilitate your reflection, support your development, and summarise the evidence for your RO.
💥 MYTH 3: "The more CPD credits I submit, the better my appraisal will be"
The GMC sets no specific number of CPD credits required for revalidation. Submitting hundreds of credits is not impressive — experienced appraisers say it often signals an inability to prioritise. Focus on two or three items where your learning genuinely changed your practice. That is far more valuable than a long catalogue of attendance.
💥 MYTH 4: "I need to complete specific mandatory training to revalidate"
The GMC does not specify any mandatory training requirements for revalidation. Things like BLS, safeguarding, and PREVENT are RCGP recommendations or employer requirements — not GMC revalidation conditions. Check what your own practice or trust requires, but do not confuse employment requirements with GMC revalidation requirements.
💥 MYTH 5: "Appraisal is mainly how concerns about doctors are identified"
Concerns about performance, conduct, or health are almost never first identified through appraisal. They are almost always discovered through clinical governance processes. Appraisal is a supportive, developmental process — not a surveillance mechanism. If a concern arises unexpectedly during an appraisal, the meeting is paused and appropriate channels are followed.
💥 MYTH 6: "My appraiser must report any concern I share about a colleague"
Your appraiser's role is to support and signpost — not to report on your behalf. If you share a concern about a colleague, your appraiser can help you think through what GMC guidance says about acting on concerns. The responsibility to act remains yours, under GMC duty of care. Raising a concern should be encouraged, but the appraiser is not there to do it for you.
💥 MYTH 7: "I need to work a minimum number of GP sessions to revalidate"
There are no session number requirements in the GMC guidance. What matters is that for every role you hold — however small — you can demonstrate that you practise safely, keep up to date, and seek feedback. If you work a very small number of sessions, your appraiser can help you use the AoMRC "factors for consideration" template to structure your reflection on that role.
💥 MYTH 8: "If my PDP goals were not achieved, my appraisal will be marked down"
Unmet PDP goals are not a failure. Life changes, priorities shift, and sometimes goals are no longer relevant. What your appraiser wants to see is that you reviewed your PDP, can explain what happened, and have thought about whether to carry goals forward or drop them. A thoughtful explanation is perfectly acceptable — especially if circumstances changed significantly.
💥 MYTH 9: "I need to scan and upload every certificate I receive"
The RCGP states clearly: there is no need to scan certificates as proof of attendance. Thoughtful, documented reflection is far stronger evidence that learning occurred. Do not waste time uploading certificates. Put that time into writing one good reflection instead.
💥 MYTH 10: "My appraisal should only cover my main GP role"
Your appraisal must cover your full scope of work — every role that requires your GMC licence to practise, including OOH work, training roles, GPSI positions, leadership, research, and clinical lecturing. This is one of the most commonly incomplete aspects of GP portfolios. If a role is not covered in your portfolio, your appraiser must flag this.
💥 MYTH 11: "Reflective writing can be used against me in court"
This fear increased after the Bawa-Garba case, but the MDOs (MDU, MPS, MDDUS) all confirm that in the Bawa-Garba case, the e-portfolio was not used as evidence. Disclosure of reflective notes outside educational settings would be very rare and would require exceptional legal circumstances. The best protection is to anonymise all patient and colleague details. Write honestly — that is your professional obligation — but anonymise everything.
💥 MYTH 12: "Appraisal and revalidation are the same thing"
They are related but distinct. Appraisal is the annual developmental conversation — local, process-based, and formative. Revalidation is the regulatory process — GMC-managed, occurring every 5 years, involving a formal recommendation from your RO. Five appraisals feed into one revalidation. Missing an appraisal delays revalidation. Failing to engage repeatedly can ultimately result in licence withdrawal.
Appraisers consistently report that the doctors who get the least from the process are those who arrive defensively, prepared to justify their year rather than reflect on it. The doctors who get the most are those who come with honest questions, a genuine curiosity about their own practice, and at least one area where they know they want to grow. That mindset alone transforms the conversation.
❓ Quick Questions & Answers
The things people actually want to know but sometimes feel silly asking.
Can I fail my appraisal?
No. Appraisal is not a pass/fail assessment. Your appraiser will confirm whether the appraisal has taken place and whether appropriate supporting information was presented. They do not grade you. Their role is to facilitate reflection, not to evaluate performance.
What happens if I miss an appraisal?
Missing an appraisal can be recorded as "approved missed" if there is a valid reason (parental leave, long-term sickness, etc.). This is noted in your portfolio. However, repeated missed appraisals without explanation will cause difficulty at revalidation. The GMC does not allow repeated deferrals of revalidation — avoid this situation by staying organised.
Who else can see my appraisal portfolio?
Your appraisal outputs (including summaries) may be seen by: your next appraiser, your Responsible Officer (RO), and their designated proxy for quality assurance purposes. The GMC has the right to request the full portfolio only in exceptional circumstances. This means you should write your portfolio as a professional document — and ensure all patient and colleague details are properly anonymised.
How much evidence is enough?
The GMC and RCGP both emphasise quality over quantity. Focus on activities where new learning stimulated a change in practice. Include evidence across all four GMP domains and for all your professional roles. More than this is likely to be counterproductive — large portfolios with minimal reflection are generally less impressive, not more.
What if my revalidation is deferred?
A single deferral is not a disaster. However, the GMC does not allow repeated deferrals. If your revalidation is deferred, work closely with your appraiser and RO to understand exactly what is needed and create a clear plan to address it before the next cycle.
What if I have a conflict of interest with my appraiser?
If you know your assigned appraiser — for example if they employ you or you have a personal relationship — contact your regional appraisal office to request a different appraiser. You are likely to have the same appraiser for 2–3 years, but you can request a change if needed.
I do several jobs. Do I need evidence for all of them?
Yes. Your appraisal must cover the full scope of your work — every role that requires your GMC licence to practise. So if you work as a GP salaried partner, a GP trainer, and for an out-of-hours provider, you need supporting information for each role. This is a common oversight and one of the areas appraisers most frequently have to ask about.
Reflection & Impact — the Heart of Appraisal
What you write matters less than what it shows about how you think.
The GMC and RCGP both emphasise that reflection is the key evidence of learning. You are not collecting receipts for courses attended. You are demonstrating that you have thought about what you have learned and what you are doing differently as a result.
In simple terms, a good reflection answers: "What have I learned that is going to change my practice?" Thoughtful reflection in your portfolio is far stronger evidence of learning than a scan of a certificate of attendance.
The 4 elements of a strong reflection
1. Learning
What did I learn that I didn't know before? What specifically will change my practice?
2. Reaction
How did I feel about what I learned? Was it helpful, reassuring, thought-provoking, uncomfortable?
3. Change
What do I need to do differently as a result of what I have learned?
4. Impact
What actually changed in my practice? (This part may be completed at a later date.)
The "What? → So what? → Now what?" framework
This is one of the simplest and most effective frameworks for structuring any reflection, whether for a single event or a whole period of learning. It works equally well for your appraisal portfolio, your FourteenFish ePortfolio entries, or a quiet moment after a difficult consultation.
❓ What?
"What was I thinking when I made this decision?"
Focus on the experience itself. Describe the context, the actions you took, and the thought processes at the time. Be honest — the good and the uncomfortable.
💭 So What?
"How did I feel, and why was it important?"
Consider the significance of what happened. What values, assumptions, or feelings influenced your response? What did this reveal about your practice?
🎯 Now What?
"What will I do differently next time?"
Identify what you can learn from the experience and what concrete action you will take. This feeds directly into your PDP.
The RCGP is very clear: submitting large numbers of CPD credits is unhelpful. It can actually signal an inability to organise and prioritise evidence. Select the activities where genuine learning occurred and where your practice changed. Three strong, insightful reflections are worth far more than thirty certificates in a folder.
For a comprehensive toolkit of reflective frameworks and approaches, see: GMC Reflective Practitioner Guidance and the AoMRC / CoPMED Reflective Practice Toolkit (PDF).
Deep Dive
✍️ How To Write a Good Reflection
This is the part most doctors get wrong — and the part that matters most.
Writing "I attended this course and found it useful" is not a reflection. It is a description. Appraisers — and ultimately Responsible Officers — are looking for evidence that you are an active, self-aware learner. One brief but insightful reflection that shows changed practice is worth more than twenty lines of course attendance records.
Description vs Reflection — what's the difference?
❌ Description — not enough
"I attended a safeguarding level 3 update course. The trainer covered recognition of abuse, the local referral pathway, and documentation requirements. I found it informative and relevant to my practice."
Why it fails: It tells us what happened. It says nothing about how this changed you or your practice.
✅ Reflection — what good looks like
"After this safeguarding update I realised I had been inconsistently documenting my rationale when I decided not to refer. A week later I had a case that made me pause. I now write a brief sentence in the record explaining my thinking whenever I decide to monitor rather than refer. This feels both safer for the patient and fairer to me if my decision is ever reviewed."
Why it works: It shows insight, changed behaviour, and the reason behind that change.
The ABCDE reflection framework — a simple structure that works
You don't need to use every reflective framework in existence. Pick one and use it consistently. Here is one that works well for GP appraisal:
The GMC says: "CPD should focus on outcomes or outputs rather than on inputs. You must reflect on what you have learned from the activity and how this could help maintain or improve the quality of your practice." Your appraiser is specifically looking for evidence that you are applying your learning — not just attending events.
Useful sentence starters for reflective writing
If you are not sure how to start, these phrases help shift your writing from description into reflection:
The most important thing I learned was…
At the time I felt… because…
This surprised me because I had assumed…
As a direct result, I now…
I still feel uncertain about… and my next step is…
What this revealed about my practice was…
This changed my thinking about… because…
If a similar situation arose again, I would…
How to reflect on different types of evidence
| Type of evidence | What to focus your reflection on | Common mistake to avoid |
|---|---|---|
| CPD / Course | What specifically changed in your practice? How has patient care improved? | Just listing what the course covered with no personal learning |
| Significant event | What you felt, what you learned, what the system changed, how you would approach it differently | Being vague or over-professional — the learning comes from honesty |
| Patient feedback / PSQ | Themes that surprised you, areas you acted on, things you are proud of | Just writing "the results were positive" with no further thought |
| MSF (colleague feedback) | Patterns across responses, one area you will actively work on, one strength to build on | Cherry-picking only positive comments and ignoring patterns of concern |
| Complaint | Your emotional response, what you did well, what you would change, and what you put in the PDP | Becoming defensive or turning the reflection into a justification |
| QI / Audit | What the data revealed, what changed as a result, whether re-audit showed improvement | Describing the method without discussing the outcome or learning |
Some doctors worry — especially following the Bawa-Garba case — that honest reflective writing could be used against them in legal or regulatory proceedings. The MDO guidance is clear: reflective notes are very rarely disclosed outside educational settings, and the most effective protection is simply to anonymise all patient and colleague details. Medical Protection has stated it would be "extremely rare" for a GP's portfolio to be used outside its educational purpose. Moreover, honest reflection, appropriately anonymised, demonstrates the very professional values regulators want to see. Write openly — but write carefully.
The Personal Development Plan (PDP)
The living document that connects one year's appraisal to the next.
The PDP is what turns your appraisal discussion into action. It records the learning goals you set with your appraiser and tracks whether you achieved them. Each goal should be SMART — specific, measurable, achievable, relevant, and time-bound — and should reflect the scope of all your professional roles.
Your final Educational Supervisor's Review (ESR) includes an agreed PDP. Ask for a copy of this at your final ARCP — it will be the starting PDP for your first post-CCT appraisal. Your new appraiser will expect to see it. If you can't find it, your appraiser may agree to summarise it "as best remembered," but it's far easier to simply save it before you leave training.
The 6 markers of a well-written PDP entry
Need
What learning need have you identified? How did you identify it — was it through patient feedback, a difficult case, an audit result, a significant event?
Activity
What educational or practical activities will you do to address this need? What resources will you use?
Timescale
How urgent is this learning need? When do you expect to complete it? Give a realistic but specific target date.
Evidence
How will you know you have achieved this goal? What evidence will you produce or collect?
Outcome
How will your practice change as a result? What — if any — new learning need has this process uncovered?
Completed
Your appraiser's agreement at the following appraisal that you have satisfactorily met this need.
Review your previous year's PDP before your appraisal, not during it. If a goal wasn't achieved, think honestly about why — and whether it's still worth pursuing. Carrying forward an unachieved goal year after year without explanation is a pattern your appraiser will notice. But a thoughtful explanation of why circumstances changed is entirely fine.
What Will My Appraiser Actually Ask?
No surprises. Here is a fairly complete map of the appraisal conversation.
The large majority of GPs report positive experiences with their appraiser. Your appraiser is a trained peer — a working GP who knows how this job feels. They are there to support you, not challenge you. The questions below are designed to help you reflect and grow, not to catch you out.
🩺 Clinical Questions
- What are you currently good at, and not so good at? How has this changed from last year?
- What is your practice currently good at — and where are there areas for improvement?
- Have there been any clinical situations that gave you pause this year?
📚 Learning & Quality Improvement
- How has a particular learning event changed the way you practise or the care you provide?
- Have you engaged in any audit or quality improvement activity? What was the need, and what was the outcome?
- How does your practice share learning with each other?
- Have you met your PDPs from last year? How has that changed patient care?
👥 Feedback Review
- Let's look at your Multi-Source Feedback. What themes emerge? Is there anything you would like to work on?
- Let's look at your Patient Satisfaction Questionnaire. What patterns do you notice? What would you like to develop?
- How have you responded to any complaints or compliments this year?
🎯 Planning Ahead
- What are your developmental needs for the coming year? What should go in this year's PDP?
- Do these PDPs cover the whole scope of your work and are they SMART?
- How are you? What is your work-life balance like?
- Have you plugged your revalidation date into your diary?
Digital Tools — Making Appraisal Easier
The right tool turns a year of scattered notes into an organised, meaningful portfolio. Use technology — don't fight it.
FourteenFish
The most widely used GP appraisal platform. Stores everything in one place, helps you see what's missing at a glance, and supports shared learning groups.
Visit →Clarity
A sleek, modern alternative to FourteenFish. Excellent visual organisation and helpful prompts. Highly rated by GPs who prefer a clean interface.
Visit →GMC MyCPD App
Free app for any doctor to log CPD. Not GP-specific, but useful for capturing learning moments on the go.
Visit →If several GPs in your practice use FourteenFish, you can create a shared e-group. When one colleague writes up the notes from a practice meeting, those notes can be shared to the whole group — saving everyone the effort of writing their own version. Add your own brief personal reflection and it's done. This is an underused time-saver that experienced GPs quietly swear by.
The national MAG (Medical Appraisal Guide) form is technically a valid option, but many GPs find it clunky and difficult to use. Modern electronic platforms like FourteenFish and Clarity are more user-friendly and integrate MAG22 directly. If you are in England or Northern Ireland, you are encouraged to use an updated electronic toolkit rather than the standalone MAG document.
🐟 Getting The Most From FourteenFish & Clarity
These tools are only as good as the habits you build around them. Here is how experienced GPs use them well.
🐟 FourteenFish — top tips
- Use the email-in feature. Send learning moments directly to your portfolio from your phone. The email address is unique to your account — save it as a contact on your phone as "FourteenFish Portfolio".
- Join your practice e-group. If colleagues are on FourteenFish, create or join a shared group. Shared meeting notes mean you write once and everyone benefits.
- Use the Learning Diary as a log — record everything there first. At appraisal preparation time, select the best items to formalise. You will have more than enough and can choose quality over quantity.
- The toolkit alerts you if it detects patient identifiable information in your entries — a helpful safety net.
- RCGP First5 free offer: If you gained your CCT from 2021 onwards, the RCGP fully funds your FourteenFish subscription for 5 years — as long as you remain an RCGP member.
🔷 Clarity — top tips
- Clarity uses a clean, visual dashboard that shows at a glance what you have covered and what gaps remain — useful if you are the kind of person who prefers a visual checklist over a long list.
- It is approved for use in England and supports MSF and patient survey tools directly within the platform.
- Start early in the appraisal year. Like FourteenFish, Clarity is designed to be used continuously — not as a last-minute submission tool.
- If you are changing from one platform to another mid-cycle, speak to your appraiser first to ensure your previous portfolio evidence transfers smoothly.
In Lancashire & Cumbria, the MAG form is no longer accepted — you must use an approved digital platform. Check with your regional appraisal office if you are unsure which platforms are currently accepted in your area.
📆 Your appraisal year — a practical timeline
New appraisal year begins
Open your portfolio on FourteenFish or Clarity. Check last year's PDP — which goals are you carrying forward? Add today's date as the start of your new appraisal year. Find out your appraisal month.
First quarterly tidy (2 hours)
Add reflections for anything significant in the past 3 months. Review PDP progress. Are you on track? Have priorities changed? Add any significant events or complaints that occurred.
Midyear check — is anything missing?
Check your portfolio against the 6 supporting information types. If you have not yet started a QI activity, now is the time. Is your patient or colleague feedback due this revalidation cycle? If so, plan now — feedback takes 6–12 weeks to complete.
Pre-appraisal tidy — 6 weeks before
Your portfolio should be nearing completion. Submit feedback surveys now if not already done. Draft your reflective statements for each domain. Review your PDP and make notes for discussion. Contact your appraiser to confirm the meeting date.
Submit portfolio to appraiser
Most platforms require submission at least 2 weeks before the meeting. Late submission means your appraiser has insufficient time to prepare — which reduces the quality of the discussion.
Appraisal meeting (~2 hours, usually remote)
Allow 3 hours in your diary. Choose a time when you will be alert. Have water. Prepare 2–3 things you genuinely want to discuss — not just to show, but to think through together. Remember: verbal reflection counts. Be honest. Be curious. Use your appraiser.
Sign off and start the next cycle
Review and agree the appraisal summary. Sign off. Save a copy of the outputs. Add the next appraisal year start date to your diary — and schedule your four quarterly tidy sessions immediately, while you still mean to do it.
Hot Tips for Making Appraisal Easier
Practical wisdom — especially for those new to the system.
🆕 Tips specifically for final-year trainees transitioning to post-CCT
- At your final Educational Supervisor's Review, fill in the Agreed Action Plan carefully with your trainer. Identify specific, measurable needs — these will transfer directly into your first post-CCT PDP.
- Request a copy of your ESR form to keep. It is the bridge between GP training and your first appraisal. Your new appraiser will expect to see it.
- Remember: your GP trainer will no longer be there to remind you. Build a personal system for collecting evidence throughout the year.
- Your appraisal portfolio must be submitted at least 2 weeks before your appraisal date. Unlike training, you will not be offered extensions easily.
- On completing training and gaining your CCT, you will be revalidated by the GMC as part of the training completion process. Your first post-CCT appraisal will then begin a new 5-year revalidation cycle.
📅 The 4 quarterly "tidy dates" system — Dr Ram's top tip
Most GPs collect appraisal data throughout the year but then face a chaotic fortnight before the appraisal trying to sort it all out. There is a better way.
Plug four dedicated 2-hour sessions into your diary calendar, spaced roughly 3 months apart. Use these to organise, review, and add reflections to your portfolio while events are still fresh.
Example: if your appraisal is in September, schedule tidy sessions on: 12 February, 12 May, 12 August, 12 November.
The result? An appraisal portfolio that almost builds itself — and no end-of-year panic.
🤝 Form a collaborative group and share your learning
Get the GPs you work with regularly to work collaboratively on shared learning documentation. When someone writes up the notes from a practice meeting — a significant event, a BLS session, an adult safeguarding training day — they anonymise them and share with the group.
Each doctor then uploads the shared notes to their own portfolio and adds a brief personal reflection. This takes minutes, not hours. It turns one person's effort into everybody's evidence.
🌱 Widening your learning: knowledge, skills & pastoral support
Knowledge & skills
- Evening courses, seminars, and workshops — many are free via your local Integrated Care Board (ICB). Contact them for a programme of events.
- GP Clinical Update days with Red Whale or NB Medical — full days focused on a topic or group of topics; excellent value.
- Communication skills workshops — often available via deaneries; well worth the cost.
- eModules for mandatory training (safeguarding, PREVENT, fire safety, information governance) — see eLFH.
- A WhatsApp group with former fellow trainees or practice colleagues — discuss clinical questions (anonymised), share interesting cases, and keep each other going.
Pastoral support
- Stay in touch with your GP trainer and TPDs, especially in the first post-CCT year.
- Maintain your peer group from training — these relationships are a professional lifeline, not a social luxury.
- Your appraisal discussion is a legitimate space to raise concerns about burnout, workload, or personal wellbeing. Don't skip this because it feels awkward.
Never post anything that could identify a patient, even without using their name. A rare diagnosis, an unusual detail, or a description of location can all be identifying. Use only closed, private groups for professional discussions and ensure you can delete content if needed. You are legally responsible for what you post.
❓ 5 questions to ask yourself before your appraisal
What do I want to get from this appraisal?
Go in with intention. This is your time. What do you actually want to talk about?
What am I genuinely proud of this year?
What went well? What did you do that you're quietly pleased about — even if nobody noticed?
How is my personal wellbeing?
Are you in a good place? Burning out? Feeling unsupported? Your appraisal is a legitimate time to discuss this honestly.
What is contributing to my work stress?
Name it. Bring it. Your appraiser has likely experienced something similar and may have practical suggestions.
What is the smallest thing I could change?
Not a total reinvention — just one small, achievable shift. Progress doesn't have to be dramatic to be real.
The section below is distilled from the experiences of GPs across the UK — things that work in the real world, beyond the official guidance
🧠 Practical Wisdom — What Experienced GPs Actually Do
The habits, strategies, and mindset shifts that make appraisal feel less like a burden and more like something genuinely useful.
📧 The email-to-yourself method
When you look something up after a consultation, spend 90 seconds writing a short email to yourself: what the clinical question was, what you found, and what you will do differently. Many GPs do this using FourteenFish's email-to-portfolio feature — it lands straight in your learning diary. By the time appraisal comes around, you have a year's worth of PUNs/DENs ready without ever having set aside dedicated time.
📅 The Sunday evening 10-minute rule
Some GPs set a recurring 10-minute reminder once a fortnight to add one brief reflection to their FourteenFish or Clarity portfolio. It does not have to be polished. It does not have to be long. What it does is prevent the February panic — when you realise your appraisal is in March and your portfolio is empty except for last year's entries.
🤝 The practice team reflection share
After a significant event meeting, a mortality meeting, or a safeguarding update, one colleague writes a brief anonymised summary and emails it to the practice group. Everyone uploads it to their own portfolio and adds two sentences of personal reflection. This turns one person's effort into five people's appraisal evidence — and genuinely builds team learning culture at the same time.
📊 Use what the NHS gives you for free
Your prescribing data, your referral data, your QoF dashboard — all of these are available to you throughout the year. Many GPs do not realise that a brief reflection on a prescribing trend ("I noticed my antibiotic prescribing was above the ICB average in Q1 — I implemented STRATIFY, and by Q3 it had fallen") is an excellent quality improvement activity. It does not require a formal audit.
🧑🤝🧑 The peer group advantage
GPs who belong to a peer support group — a Balint group, a small informal peer group, or a learning set — consistently describe their appraisals as richer and less stressful. These groups generate QI ideas, provide informal MSF insight, offer cases for SEA discussion, and — most importantly — normalise honest reflection. If you are not in one, consider starting one.
🎙️ Verbal reflection is genuinely enough
The RCGP states clearly that verbal reflection in the appraisal meeting is just as valid as written evidence. Several experienced GPs describe deliberately leaving some items for discussion in the meeting rather than writing everything up in advance. This keeps the conversation genuine, and it means preparation time does not spiral. Write enough to frame the topic — then talk about it live.
⚠️ What not to do — patterns that waste time and reduce quality
Uploading everything you have done. Appraisers find over-stuffed portfolios tiring and hard to navigate. They do not signal thoroughness — they signal an inability to prioritise. Select and curate.
Starting your portfolio the week before. Reflections written retrospectively — months after the event — are shallow, stress-inducing, and obvious to any experienced appraiser. Collect throughout the year.
Using patient or colleague identifiable details. Your portfolio is a professional document that can, in rare circumstances, be disclosed. Anonymise everything. This protects you, your patients, and your colleagues.
Ignoring your additional roles. GP trainer, GPSI, OOH, clinical lead — all require evidence. Appraisers consistently flag incomplete portfolios that cover only the main GP surgery role.
Writing justifications, not reflections. If a patient complained, the portfolio is not the place to argue your case. It is the place to show what you learned. A reflective entry on a complaint demonstrates professional maturity; a defensive one does not.
Confusing domain names (old vs GMP 2024). If your appraisal toolkit has not updated to GMP 2024 domain names, check with your appraiser. The content requirements are broadly similar, but the labelling matters for your RO's review.
GMP 2024 now explicitly includes your health and wellbeing within Domain 3. Your appraiser is trained to open this topic, but many doctors steer away from it out of habit, or because they fear it will affect their revalidation. It will not. Your appraisal is one of the very few protected, confidential spaces in medicine where a trained colleague asks how you are actually doing. Many GPs describe this as the most valuable part of their appraisal — and the most neglected. Use it.
💎 Insider Pearls & Real-World Wisdom
The things experienced GPs wish they had known earlier.
The single most common appraisal mistake is leaving reflection until the week before the meeting. A learning event from eight months ago is genuinely hard to reconstruct meaningfully. Capture your reflections within a few days of the experience, while it is still real. Even a single paragraph immediately after a difficult consultation is worth more than a polished essay written months later from a faded memory.
The RCGP explicitly states that verbal reflection during the appraisal meeting is just as valid as written evidence. If you have a rich conversation with your appraiser about a learning experience, that counts. You do not have to write a formal account of everything. Use your appraiser — that is what they are trained for.
This is perhaps the most important mindset shift for newly qualified GPs. Your appraiser is trained to help you think, not to test you. Resist the urge to be defensive. The most productive appraisal conversations happen when GPs show up curious and open rather than prepared to defend their record.
GPs who take on additional roles — trainer, GPSI, clinical lead, OOH — frequently underrepresent these in their portfolio. Every role that requires your GMC licence needs supporting information. If you are a GP trainer, there should be evidence relating to your training activity. Overlooking this is very common and easily avoided.
Appraisers report that overstuffed portfolios with dozens of certificate scans and minimal reflection are more tiring to review — and less impressive — than lean portfolios with thoughtful, specific reflections that clearly demonstrate changed practice. Choose your entries carefully. Quality is the signal; volume is the noise.
Appraisal is not a pass/fail test. There is no "correct" portfolio. When GPs approach it as an assessment to be passed rather than a conversation to be had, they often produce defensive, formulaic portfolios that miss the point entirely. The appraisal exists to serve you — not the other way around.
🩺 GP Locums & Sessional GPs — Appraisal Applies to You Too
All doctors need to engage with appraisal and revalidation — including GP locums and sessional GPs. The rules are the same: annual appraisal, revalidation every 5 years.
The practical challenge for locums is that evidence for quality improvement and feedback must be gathered across multiple practices. This is absolutely achievable — just requires a little more forward planning.
- Join a locum group or locum chambers — ask your colleagues how they manage their portfolio. You are not reinventing the wheel alone.
- Use FourteenFish as your centralised portfolio. You can join practice e-groups and share learning notes even as a sessional doctor.
- You must list all practices you worked in over the previous year, with details — every year.
- Check your designated body status in PCSE Online (England) — this can drift if you have moved regions.
- Seek advice from NASGP (National Association of Sessional GPs) — their AppraisalAid resource is excellent.
🎓 For Trainers & TPDs — Teaching Appraisal Well
Common trainee blind spots about appraisal
- Believing appraisal is an administrative task rather than a developmental conversation — set expectations early
- Confusing the FourteenFish ePortfolio with the training ePortfolio (they serve different purposes; FourteenFish is for post-CCT appraisal)
- Not appreciating that verbal reflection at the meeting itself counts — trainees often overprepare written documentation unnecessarily
- Failing to request a copy of their final ESR/Agreed Action Plan before leaving training
- Not understanding the difference between appraisal (annual, developmental) and revalidation (5-yearly, regulatory)
Tutorial ideas and reflective prompts
- "Talk me through a recent case that made you look something up. What changed in your practice?" — models the PUNs/DENs approach directly
- "If your appraisal was tomorrow, what would your greatest developmental need be? How do you know?"
- "Show me a reflection you wrote last month. What does it tell you about how you learn?"
- Role-play an appraisal conversation — one trainee as GP, one as appraiser
- Ask trainees to complete a What/So what/Now what reflection on a recent significant event in the practice
The final ESR — making the handover effective
The final Educational Supervisor's Review is the bridge between training and independent practice. Help your trainee to:
- Write specific, measurable PDP goals — not vague aspirations
- Understand that these goals will form the starting point of their first post-CCT appraisal
- Save a copy of the completed ESR form for their own records
- Understand their revalidation date and why the pre-revalidation appraisal matters most
The most common post-CCT difficulty is the sudden absence of structure. Your job in the final ESR is to help them build the internal systems they will need to stay organised without a training scheme to support them.
🎯 Final Take-Home Points
The bits to carry with you after you close this page.
Know your dates. Your appraisal month and your revalidation date. Check both on GMC Online and plug them into your diary now.
Collect throughout the year. A reflection written the same week as the experience is worth ten times more than one written the week before your appraisal.
Quality beats quantity. Three insightful reflections that changed your practice are more valuable than thirty certificate scans in a folder.
Cover all your roles. Every job requiring your GMC licence needs supporting information. Don't let your extra roles go invisible.
Your appraiser is on your side. They are a trained peer, not an examiner. Turn up open and curious — not defensive.
Use the wellbeing space. Your appraisal is one of the few places in medicine where you are encouraged to talk honestly about how you are actually doing. Use it.
Use good tools. FourteenFish and Clarity exist to make this easier. Let technology do the organising so you can focus on the thinking.
Review your PDP regularly. Diarise four 2-hour tidy sessions per year. Your future self will thank your present self.
Bradford VTS — Free for all UK GP trainees, trainers & TPDs since 2002 | Created by Dr Ramesh Mehay | Disclaimer