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Revalidation: swallow hard
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     EDITOR—Sometime in 2005 (but who knows exactly when), all the 100 000 or so doctors in the United Kingdom will be subject to revalidation.1-3

    Despite the gravity of this change in the licensing of medical practitioners, there has been and still is little debate on this matter. Read through, for example, van Zwanenberg's references and you will have read just about all that has been published about it.2 Revalidation will affect the lives of every doctor registered with the GMC, yet few seem concerned about its process, implications, or repercussions. Compare the flood of responses to Wald and Law's paper on the Polypill with what is barely a trickle to the two papers on revalidation.1-4 Are we all distracted by contract worries, or are we burying our heads in the sand? Our new contracts will determine how much money goes into our pocket, but failing revalidation might render us unemployed.

    Bruce et al provide one of the few published trials on the process of revalidation.1 But their trial is based on the views of only 53 doctors (who were volunteers). Soon all the doctors in Scotland will have the choice of following their model of revalidation or engaging in a bit of do-it-yourself revalidation. They are lucky: in the rest of the United Kingdom, there is even less to go on. Only unsupported statements from the GMC such as: "We believe that full participation in annual appraisal, with completed supporting documentation, during the revalidation cycle, is a powerful indicator of a doctor's current fitness to practise."3

    If I told you I had a drug called "Revalidation," but it had no clear indication, little research had been done on its efficacy, and nothing had been done on its effectiveness, cost effectiveness, or safety profile, would you swallow it?

    You won't have a choice come 2005.

    Geoff Wong, general practitioner principal

    The Surgery, 5 Daleham Gardens, London NW3 5BY g.wong@pcps.ucl.ac.uk

    Competing interests: None declared.

    References

    Bruce D, Phillips K, Reid R, Snadden D, Harden R. Revalidation for general practitioners: randomised comparison of two revalidation models. BMJ 2004;328: 687-91. (20 March.)

    van Zwanenberg T. Revalidation: the purpose needs to be clear. BMJ 2004;328: 684-6. (20 March.)

    General Medical Council. Revalidation. www.gmc-uk.org/revalidation/index.htm (accessed 23 Mar 2004).

    Wald N, Law M. A strategy to reduce cardiovascular disease by more than 80%. BMJ 2003;326: 1419-24.