The one-time partly elected General Medical Council, now reincarnated as a State appointed Stasi, has started to rev up its revalidation machine.
Appraisal will change from an annual tea and biscuits affair into a game of Russian roulette. Multi-source 360 degree feedback will provide a Catherine Wheel display of our gaffs. Serious Untoward Incident reviews will expose out deepest faults. No amount of lists of dutifully conducted CPD will erase the stain of our failures. The Herr Obersturmführer Appraiser will click his heels and pronounce our conduct inadequate; and the Herr Oberscharführer Responsible Officer too will click his heels, and regret to inform us that he is unable to make zee rekommendation that we be revalidated. Our career will end, not with a bang, but with a click.
These are the harsh threats that hang over the heads of practising doctors. And yet – when we look behind the brazen front of the GMC – as we have various means of doing – we see many remarkable signs of psychological and physical disintegration. We see the shortages of intellect and capacity which already begin to hamper both the quality and the volume of their revalidation effort. We feel the hesitancy of divided counsel, and the pursuing doubts which assail and undermine those who rely on revalidation, and revalidation alone, to sustain the credibility of a noble profession.
When we look deeper still – as we are able to do – we see that revalidation has emerged from a dark pool of dogma that is tainted: tainted by the rant of propaganda, by unfounded assertions of professional imperatives, and by the cant of ‘Revalidung macht frei!
We are told that revalidation is necessary to protect public confidence in the profession. Weaker members of our profession may be fooled by such rhetoric. Others – both inside and outside the profession – will not be so easily deceived. They will spot that the annual round of appraisal may increase in quantity, but not in quality, for it will remain largely a matter of self-reporting by the doctor. They will observe that revalidation is controlled by Quislings who will on a whim favour friend, and eliminate foe.
Revalidation will benefit no one. Many sound doctors of independent mind will fall foul of a Quisling, and for them it will be non revalido, ergo non sum. Others of a more subservient mind will choose to feed the crocodile, hoping that it will eat them last. As they do so, they will subjugate their professional identity to a state imposed set of arbitrary rules; and the more they cooperate with the State, the more they will dilute their professional identity, until the sad day will dawn when they have ceased to be doctors, and are instead servants of the State. For these revalidatchiks, it will be revalido, ergo non sum.