What Is a Medical Appraisal and Why Does It Matter?
A medical appraisal is an annual structured conversation between you and a trained appraiser. It is not a pass or fail exercise. It is a developmental process in which you review your work over the previous twelve months, reflect on your supporting information, discuss your learning and development needs, and agree a personal development plan for the year ahead. The appraisal process is designed to be supportive and constructive — it should help you identify strengths, address areas for improvement, and demonstrate that you are practising in line with Good Medical Practice 2024.
Appraisal matters because it is the foundation of revalidation. Over your five-year revalidation cycle, your responsible officer reviews your appraisal history before making a recommendation to the GMC about whether you are up to date and fit to practise. Doctors who engage well with annual appraisals and collect meaningful supporting information are well positioned for smooth revalidation. Those who treat appraisal as a tick-box exercise, or who fail to engage, risk delays, additional scrutiny, and in the worst case, withdrawal of their licence to practise.
Appraisal is the annual process. Revalidation is the five-year decision. Each yearly appraisal feeds into your revalidation recommendation. Miss appraisals or produce poor-quality portfolios, and your responsible officer may be unable to make a positive recommendation — which means your licence is at risk.
The Six Types of Supporting Information
The GMC requires you to collect, reflect on, and discuss six types of supporting information over your revalidation cycle. You do not need to cover all six every year, but you must cover all six over the five-year cycle. The GMC does not set a minimum or maximum quantity — what matters is the quality and the depth of your reflection.
CPD covers all learning activities that help you maintain and develop your skills and knowledge. The recommended target is approximately 50 hours per year, though this is guidance rather than a strict requirement. Your CPD should cover your whole scope of practice, including all the roles you hold. It can include courses, conferences, workshops, reading, teaching, online learning, and any other activity that contributes to your professional development. Our CPD-certified courses in ethics, professionalism, and probity count directly towards your CPD hours and provide certificates for your portfolio.
Quality improvement includes clinical audit, case reviews, evaluation of clinical outcomes, and any structured activity where you assess and improve the quality of care you deliver. If you have participated in audits, service evaluations, or improvement projects, include them in your portfolio. Reflect on what the activity revealed about your practice and what changes you made as a result. If you are a locum or work across multiple sites, quality improvement from any part of your practice is relevant.
Significant events are clinical or non-clinical incidents that provided learning opportunities. They include patient safety incidents, near misses, unexpected outcomes, complaints, and events where things went particularly well. Your appraiser wants to see that you can identify learning from these events, reflect honestly on your role, and show what changes you made. If you have been involved in a serious incident, a complaint, or a duty of candour disclosure, reflecting on these demonstrates maturity and insight.
Colleague feedback (multi-source or 360-degree feedback) must be collected at least once during your revalidation cycle. Choose colleagues from different professional groups — doctors, nurses, allied health professionals, administrative staff — who can comment on different aspects of your practice. Use a validated tool or questionnaire. Reflect on the feedback, including any areas where your self-assessment differs from how colleagues perceive you. This is one of the most valuable sources of insight for your development.
Patient feedback must also be collected at least once during your revalidation cycle. Use a validated tool and collect feedback from a representative sample of your patients. If your role does not involve direct patient contact, discuss alternative arrangements with your responsible officer. Reflect on what the feedback tells you about your communication, your manner, and the quality of care you provide. Patient feedback often reveals insights that clinical metrics alone cannot capture.
Record any complaints received and any compliments or positive feedback. For complaints, reflect on what happened, what you learned, and how you responded. For compliments, reflect on what aspects of your practice patients and colleagues value. Even if you have received no complaints, state this explicitly and reflect on what you do to maintain good relationships with patients and colleagues. If you are dealing with a complaint or a fitness to practise concern, honest reflection at appraisal demonstrates engagement and insight.
How to Reflect Properly for Your Appraisal
The GMC's guidance is clear: ongoing reflection is central to revalidation and must form part of your doctor appraisal preparation. You will not meet the requirements by simply collecting information. Your appraiser wants to see that you have thought about what your supporting information shows about your practice and what you have done as a result.
Effective reflection focuses on what you learned, not on retelling what happened. Your reflective notes should address what the experience taught you about your practice, whether it revealed any gaps in your knowledge or skills, what changes you made or plan to make, and how those changes will benefit your patients. Keep reflections focused and anonymised. The GMC advises against collecting multiple examples that demonstrate reflection on the same skills — choose clear, varied examples that generate meaningful discussion. Our guide on writing reflective statements provides a practical framework.
The doctors who get the most from appraisal are those who treat it as a genuine opportunity to think about their practice, not as paperwork to be completed. Your appraiser can tell the difference between genuine reflection and box-ticking — and so can your responsible officer when making your revalidation recommendation.
Probity and Health Declarations
As part of your revalidation, you must make declarations about probity and health. Your appraisal provides the opportunity to review and reflect on these before your revalidation date.
The probity declaration requires you to confirm that any information you have communicated is accurate and not false or misleading. This includes your legal obligation to hold appropriate indemnity or insurance, and your professional duty to declare and manage conflicts of interest. If there are any probity matters you need to discuss — including any involvement in regulatory proceedings, criminal matters, or complaints about dishonesty — your appraisal is the place to address these honestly.
The health declaration requires you to consider whether there are any matters relating to your health and wellbeing that you wish to discuss with your appraiser. This includes whether you have appropriate support in place to protect yourself and your patients. Good Medical Practice 2024 provides guidance on managing your health and wellbeing, and your appraiser can signpost further support if needed.
Building Your Appraisal Portfolio: Practical Steps
- Start early — do not leave portfolio preparation to the week before your appraisal. Collect supporting information throughout the year as it arises
- Cover your whole scope of practice — if you hold multiple roles (NHS, private, teaching, research, locum), your portfolio must reflect all of them. Appraisal covers your entire scope, not just your primary role
- Focus on quality — choose clear examples that demonstrate genuine learning and reflection. The GMC advises against collecting excessive amounts of evidence that all demonstrate the same thing
- Reflect as you go — write brief reflective notes when events happen, not months later when details have faded. Fresh reflection is more authentic and more useful
- Review your previous PDP — your appraiser will ask about progress against your personal development plan from last year. Review it before your appraisal and be ready to discuss what you achieved, what you did not, and why
- Complete relevant CPD courses — fill gaps in your portfolio with targeted CPD. If your scope of practice includes areas where you have limited recent evidence, our CPD courses can strengthen your portfolio
- Prepare your declarations — review the probity and health declarations in advance. If there are issues to discuss, prepare how you will address them honestly and constructively
- Use the appraisal constructively — treat the conversation with your appraiser as an opportunity to learn and develop, not an examination to survive
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Appraisal for Doctors Under GMC Investigation
If you are under GMC investigation, your annual appraisal becomes even more important. It is your opportunity to demonstrate that you are engaging with professional development, addressing the concerns raised, and showing genuine insight into the issues. Your appraiser is not there to judge your case — but the evidence you present at appraisal, including CPD certificates, reflective statements, and evidence of changed practice, forms part of the record that your responsible officer considers.
Complete CPD courses that are directly relevant to the concerns. If the investigation relates to clinical competence, complete courses on clinical standards and patient safety. If it relates to probity, complete our Probity for Healthcare Professionals course. If it involves professional conduct, complete our Ethics and Professionalism courses. Document your remediation activities and discuss them openly at appraisal. This demonstrates to your responsible officer and to the GMC that you are taking the process seriously.
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Bulk Buy 10 Courses →Frequently Asked Questions
What is a medical appraisal in the UK?
A medical appraisal is an annual requirement for all doctors with a UK licence to practise. It is a structured conversation with a trained appraiser where you review your work, reflect on supporting information, discuss development needs, and agree a personal development plan. It is not pass or fail — it is developmental and supports GMC revalidation.
What are the six types of supporting information for appraisal?
The GMC requires six types: continuing professional development (CPD), quality improvement activity, significant events, feedback from colleagues, feedback from patients, and a review of complaints and compliments. You must cover all six over your five-year revalidation cycle, focusing on quality rather than quantity.
How many CPD hours do I need for my appraisal?
The GMC does not set a strict minimum, though the recommended target is approximately 50 hours per year. The emphasis is on quality and relevance rather than volume. Your CPD should cover your whole scope of practice and include activities that lead to genuine reflection and improvement. Our CPD-certified courses count towards your annual hours.
What happens if I miss my annual appraisal?
Missing an appraisal without good reason can delay or complicate your revalidation. Your responsible officer assesses whether the circumstances were reasonable. Repeated non-engagement can lead to an inability to make a positive revalidation recommendation, potentially resulting in licence withdrawal. You do not need to catch up approved missed appraisals.
How does appraisal link to GMC revalidation?
Appraisal is the foundation of revalidation. Over your five-year cycle, annual appraisals feed into your responsible officer's recommendation to the GMC about whether you are up to date and fit to practise. Doctors who engage well with annual appraisals are positioned for smooth revalidation.
What should I include in my reflective notes for appraisal?
Focus on what you learned and what changes you made or plan to make. Do not retell events in full detail. Cover both positive and negative experiences, the impact on your practice, and the actions taken. Keep reflections focused and anonymised. The GMC's Reflective Practitioner guidance provides a framework.
What is a personal development plan for doctors?
A PDP is an agreed plan between you and your appraiser setting out development goals for the coming twelve months. It is based on your reflections and discussions, your learning needs, and areas for improvement. At your next appraisal, you review PDP progress and set new goals. A well-constructed PDP demonstrates active professional development.
Do I need patient feedback for my appraisal?
Yes. Patient feedback is one of the six required types of supporting information. You must collect it at least once during your five-year revalidation cycle using a validated tool. If your role does not involve direct patient contact, discuss alternatives with your responsible officer. Reflecting on patient feedback is valuable for development.
What is colleague feedback and how do I collect it?
Colleague feedback (multi-source or 360-degree feedback) is collected using a structured questionnaire from colleagues across different professional groups. You must collect it at least once per revalidation cycle. Choose colleagues who can comment on different aspects of your practice. Reflect on the feedback, including any differences from your self-assessment.
What are significant events and how do I reflect on them?
Significant events are clinical or non-clinical incidents providing learning opportunities, including patient safety incidents, near misses, complaints, and events that went well. Describe the event briefly, reflect on what happened, what you learned, and what changes you made. Significant event analysis demonstrates commitment to learning from experience.
What is the role of the responsible officer in appraisal?
Your responsible officer is a senior doctor with statutory responsibility for making revalidation recommendations to the GMC. The RO oversees the appraisal process, ensures quality and consistency, monitors compliance, and uses your appraisal information to inform their revalidation recommendation. Contact your RO if you have concerns about the process.
How do I prepare for appraisal if I am under GMC investigation?
Your appraisal becomes even more important during investigation. Use it to demonstrate engagement with professional development and insight into the concerns. Complete relevant CPD courses covering the area of concern. Discuss the investigation with your appraiser honestly. Our courses provide CPD certificates that strengthen your portfolio during investigation.
Which CPD courses strengthen my appraisal portfolio?
Our Ethics and Ethical Standards for Doctors covers Good Medical Practice 2024. Professionalism addresses professional standards. Probity covers honesty, integrity, and the probity declaration. Our Bulk Buy of 10 courses for £500 builds a comprehensive CPD portfolio demonstrating breadth and depth of professional development for your appraiser.
This article is for general informational purposes only and does not constitute legal or professional regulatory advice. If you have concerns about your appraisal, revalidation, or a fitness to practise investigation, contact your responsible officer, your medical defence organisation, or seek independent legal advice.