A tale of two doctors: casualties of an inverse education law?

Frances Wedgwood

doi:10.3399/bjgp24X738333

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Response to The tale of two doctors
William A. Hollington

Published on: 20 June 2024

Published on: (20 June 2024)
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Response to The tale of two doctors
William A. Hollington, Retired GP, Ivel Medical Centre, Biggleswade
‘A tale of two doctors: casualties of an inverse education law?’ BJGP June 2024 reminded me of my own experiences of the ‘educational’ and appraisal system that I experienced as a GP. As a white, Caucasian male brought up and taught medicine in the UK system, I did not have the additional pressures that Mabel experienced. However, I found the whole system of continued assessment of my ability and suitability to practice extremely and unnecessarily onerous, so much so that it actually impeded my own personally led development. I made a point of ensuring that I was up to date with advances by regular reading of the academic journals, with particular attention to my areas of clinical responsibility including diabetes, palliative care and occupational health. I sat on the local Diabetes Advisory Group for many years and when confronted with a new clinical area that needed additional expertise, I undertook relevant Diplomas (palliative care and occupational health). I also enjoyed helping out with our local St John’s Ambulance section in my early years. However, as the GP workload increased and the need to demonstrate overtly one’s professional development, this squeezed out these less formal but more important self-led initiatives. Indeed, I would suggest that the appraisal system is an example of the Heisenberg Effect. Heisenberg was an eminent German scientist who discov...
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‘A tale of two doctors: casualties of an inverse education law?’ BJGP June 2024 reminded me of my own experiences of the ‘educational’ and appraisal system that I experienced as a GP. As a white, Caucasian male brought up and taught medicine in the UK system, I did not have the additional pressures that Mabel experienced. However, I found the whole system of continued assessment of my ability and suitability to practice extremely and unnecessarily onerous, so much so that it actually impeded my own personally led development. I made a point of ensuring that I was up to date with advances by regular reading of the academic journals, with particular attention to my areas of clinical responsibility including diabetes, palliative care and occupational health. I sat on the local Diabetes Advisory Group for many years and when confronted with a new clinical area that needed additional expertise, I undertook relevant Diplomas (palliative care and occupational health). I also enjoyed helping out with our local St John’s Ambulance section in my early years. However, as the GP workload increased and the need to demonstrate overtly one’s professional development, this squeezed out these less formal but more important self-led initiatives. Indeed, I would suggest that the appraisal system is an example of the Heisenberg Effect. Heisenberg was an eminent German scientist who discovered that, by measuring a process in physics, the outcome was inherently affected. This applies to many other aspects of life, and no less to the personal and professional development of GP’s. The appraisal system has managed to impede the process which it is trying to measure and has been a major factor in the timing of my own and many of my colleagues’ retirement.

It is easy to complain about a system rather than provide answers and alternatives. Accepting that there must be some standard criteria for allowing continued practice as GP, I do feel that there must be greater flexibility to accommodate those who have already demonstrated that they have taken control of their own personal development and to allow them to continue along the same lines.

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Competing Interests: None declared.