Archer Julian, de Bere Sam Regan
NIHR Career Development Fellow, Clinical Senior Lecturer and Director of the Collaboration for the Advancement of Medical Education Research & Assessment (CAMERA), Plymouth University Peninsula Schools of Medicine & Dentistry.
J Contin Educ Health Prof. 2013 Fall;33 Suppl 1:S48-53. doi: 10.1002/chp.21206.
Assuring fitness to practice for doctors internationally is increasingly complex. In the United Kingdom, the General Medical Council (GMC) has recently launched revalidation, which has been designed to bring all doctors into a governed environment. Since December 2012, all doctors who wish to practice are required to submit and reflect on supporting documentation against a framework of best practice, Good Medical Practice. These documents are brought together in an annual appraisal. Evidence of practice includes clinical governance activities such as significant events, complaints and audits, continuing professional development and feedback from colleagues and patients. Revalidation has been designed to support professionalism and identify early doctors in difficulty to support their remediation and so assure patient safety. The appraiser decides annually if the doctor has met the standard which is shared with the most senior doctor in the area, the responsible officer (RO). The RO's role is to make a recommendation for revalidation every 5 years for each doctor to the GMC. Revalidation is unique in that it is national, compulsory, involves all doctors regardless of position or training, and is linked to the potentially performance moderating process of appraisal. However, it has a long and troubled history that is shaped by high-profile medical scandals and delays from the profession, the GMC, and the government. Revalidation has been complicated further by rhetoric around patient care and driving up standards but at the same time identifying poor performance. The GMC have responded by commissioning a national evaluation which is currently under development.
确保国际医生具备行医资格正变得越来越复杂。在英国，英国医学总会（GMC）最近启动了重新认证程序，其目的是将所有医生纳入一个受监管的环境。自2012年12月起，所有希望行医的医生都必须根据最佳实践框架《良好医疗规范》提交并反思支持性文件。这些文件在年度评估中汇总。行医证据包括临床治理活动，如重大事件、投诉和审计、持续专业发展以及同事和患者的反馈。重新认证旨在支持专业精神，并尽早识别有困难的医生，以支持他们的补救措施，从而确保患者安全。评估人员每年决定医生是否达到标准，该标准会与该地区的最高级医生即责任官员（RO）共享。RO的职责是每5年向GMC为每位医生提出重新认证的建议。重新认证的独特之处在于它是全国性的、强制性的，涉及所有医生，无论其职位或培训情况如何，并且与可能的绩效评估过程相关联。然而，它有着漫长且麻烦的历史，受到备受瞩目的医疗丑闻以及来自行业、GMC和政府的拖延的影响。围绕患者护理和提高标准但同时识别不良表现的言辞进一步使重新认证变得复杂。GMC已通过委托进行一项目前正在开展的全国性评估来做出回应。
