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Restratification and Revalidation: United Kingdom and International Perspectives

  • John Martyn Chamberlain
Chapter

Abstract

This chapter explores the impact of the process of restratification on professional practice and medical regulation by looking at the implementation of revalidation. In doing so, this chapter acts as a necessary introduction to the exploration of the handling of fitness to practice cases in  Chap. 7.  Chapter 5 ended by noting that in addition to state intervention to reform medical regulation and re-establish the General Medical Council as an independent regulatory body, over the last decade, medical elites themselves have increasingly acted to strengthen peer review and appraisal mechanisms as they have sought to maintain professional self-regulatory privileges within the broader transformative context that is the emergence of the new neo-liberal governing conditions associated with the risk society. It was highlighted that the esoteric nature of medical expertise means that regardless of calls for greater consumer and inter-professional input into medical regulation, some semblance of medical control will be retained as peer appraisal remains the key mechanism by which the quality of medical work can be judged and its quality assurance assured. This chapter explores the consequences of this for the development of revalidation. This is the process by which the competence of medical practitioners will be quality assured in the United Kingdom. This chapter outlines how revalidation will operate when it is implemented sometime after late 2012. For comparative purposes, this chapter also outlines recent international trends in the quality assurance of medical practitioner’s continued competence. In doing so, this chapter highlights how a move towards increased professional accountability seems to characterise medical governance frameworks internationally. This provides some empirical support for the restratification thesis. Yet this chapter also points out that it is important to note that the situation internationally is more complex than the restratification thesis allows. The need to empirically explore this point further is taken up in  Chap. 8. End-of-chapter self-study tasks are provided so the reader can engage in further study in relation to chapter contents.

Keywords

Medical Regulation Royal College Medical Practitioner Continue Professional Development Performance Appraisal 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Boulay, C. (2000). Revalidation for doctors in the United Kingdom: The end or the beginning? BMJ, 320, 1490.CrossRefGoogle Scholar
  2. Burrage, M., & Torstendahl, R. (Eds.). (1990). Professions in theory and practice. London: Sage Publications.Google Scholar
  3. Cain, F. E., Benjamin, R. M., & Thompson, J. N. (2005). Obstacles to maintaining licensure in the United States. British Medical Journal, 350, 1443–1445.CrossRefGoogle Scholar
  4. Calman, K. (1993). Hospital doctors: Training for the future. London: Department of Health.Google Scholar
  5. Calman, K. (1994). Continuing medical education. London: Department of Health.Google Scholar
  6. Cato, G. (2008). Relicensing, recertification and regulation. Advances in Psychiatric Treatment, 14, 1–2.CrossRefGoogle Scholar
  7. Catto, G. (2006). GMC news 3. London: GMC.Google Scholar
  8. Chamberlain, J. M. (2009). Portfolio-based appraisal: Superficial or useful? British Journal of Hospital Medicine, 70(11), 176–177.Google Scholar
  9. Charlton, R., Coomber, J., & Thistlewaite, J. E. (2011). Re-licensing of general practitioners using the current UK revalidation proposals: A cross-sectional study. Postgraduate Medical Journal, 87, 807–813.CrossRefGoogle Scholar
  10. Davies, M. (2007). Medical self-regulation: Crisis and change. Aldershot: Asj Publishing Limited.Google Scholar
  11. Detsky, A., & Haylor, C. D. (2003). Canada’s health system- reform delayed. The New England Journal of Medicine, 349, 804–810.CrossRefGoogle Scholar
  12. Duffey, F. D., & Zipes, D. P. (2004). The future of certification and recertification. American Journal of Medicine, 117, 140–144.CrossRefGoogle Scholar
  13. Freidson, E. (2001). Professionalism: The third logic. Cambridge: Polity Press.Google Scholar
  14. General Medical Council. (1993). Tomorrows doctors. London: GMC.Google Scholar
  15. General Medical Council. (2010a). Revalidation update: Making revalidation work for doctors. London: GMC.Google Scholar
  16. General Medical Council. (2010b). Revalidation: The way ahead. London: GMC.Google Scholar
  17. Gerace, R. V. (2003). The shipman inquiry: International seminar statement by Dr Gerace. London: The Shipman Inquiry Report.Google Scholar
  18. House of Commons Health Committee. (2011a). Revalidation of doctors: Fourth report. London: The Stationary Office.Google Scholar
  19. House of Commons Health Committee. (2011b). Revalidation of doctors: General medical council’s response to the committee’s fourth report. London: The Stationary Office.Google Scholar
  20. Irvine, D. (2003). The doctors tale: Professionalism and the public trust. London: Radcliffe Medical Press.Google Scholar
  21. Kelly, B. D. (2010). Changing governance, governing change: Medical regulation in Ireland. International Journal of Medical Science, 179, 5–7.Google Scholar
  22. Lomdarts, M. J. M. H. (2003). External peer review by medical specialists in legal perspective. European Journal of Health Law, 33, 191–213.Google Scholar
  23. Lupton, D. (2011). Medicine as culture (3rd ed.). London: Sage Publications.Google Scholar
  24. Lynch, M. (2010). Commentary on Shepherd and Cameron and continuation of the revalidation debate. Journal of Evaluation in Clinical Practice, 16, 651–654.Google Scholar
  25. Mekur, S., Elias, M., Long, M., & Mkee, M. (2010). Physician revalidation in Europe. Clinical Medicine, 8, 371–375.Google Scholar
  26. Ministry of Social Affairs and Health. (2004). Health care in Finland: Brochure II. Helsinki: Ministry of Social Affairs and Health.Google Scholar
  27. NHS Revalidation Support Team. (2009). Strengthening NHS appraisal to support revalidation in England. London: Department of Health.Google Scholar
  28. Peck, C., McCall, M., McLaren, B., & Rotem, L. (2000). Continuing medical education and continuing professional development: International comparisons. British Medical Journal, 320, 432–435.CrossRefGoogle Scholar
  29. Pugh, M. (2003). Refining the paradigm: The transition from recertification to maintenance of certification. Annals of Family Medicine, 1, 56–58.Google Scholar
  30. Rose, N. (1999). Powers of freedom: Reframing political thought. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  31. Smith, R. (1992). The GMC on performance: Professional self-regulation is on the line. British Medical Journal, 304, 1257–1258.CrossRefGoogle Scholar
  32. Smith, R. (1993). The end of the GMC? The government not the GMC is looking at underperforming doctors. British Medical Journal, 307, 957–958.Google Scholar
  33. Smith, J. (2005). Shipman: Final report. London: Department of Health.Google Scholar
  34. Stacey, M. (1992). Regulating British medicine. London: Wiley.Google Scholar
  35. Stacey, M. (2000). The general medical council and professional self-regulation. In D. Gladstone (Ed.), Regulating doctors (pp. 45–65). London: Institute for the Study of Civil Society.Google Scholar
  36. Starke, I., & Brownbridge, H. (2010). Revalidation: A royal college of physicians perspective. Clinical Medicine, 10, 321–322.Google Scholar
  37. Swinkels, L. A. (1999). Reregistration of medical specialists in the Netherlands. British Medical Journal, 319, 1191–1192.CrossRefGoogle Scholar
  38. The Secretary of State for Health. (2007). Trust, assurance and safety: The regulation of health professionals in the 21st century. London: The Stationary Office.Google Scholar
  39. Tito, F. (1996). Compensation and professional indemnity in health care: Final report. Sydney: Australian Government.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • John Martyn Chamberlain
    • 1
  1. 1.Department of Social ScienceUniversity of LoughboroughLeicestershireUK

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