Quick Answer
In simple terms: appraisal is the yearly review; revalidation is the 5 year GMC checkpoint.
Your annual appraisals build the evidence that you are keeping up to date and engaging with your professional development. At revalidation, the wider picture is reviewed — including your appraisal record, patient and colleague feedback, quality improvement activity and other supporting information.
If you cannot show that you have engaged appropriately with the revalidation process, your licence to practise may not simply continue as normal.
How It Fits Together
Who Does What
| Who | What they do |
|---|---|
| Doctor | Completes annual appraisal, keeps supporting information up to date and engages with the revalidation process. |
| Appraiser | Reviews the portfolio, leads the appraisal discussion, agrees the PDP and completes the appraisal summary and statements. |
| Responsible Officer / Suitable Person | Reviews the wider revalidation picture and makes a recommendation to the GMC about whether the doctor should be revalidated. |
| GMC | Makes the final revalidation decision and decides whether the doctor can continue to hold a licence to practise. |
How the Process Works
As you approach revalidation, your Responsible Officer (RO) or Suitable Person reviews the overall evidence from your revalidation cycle and decides whether they can recommend you to the GMC for revalidation.
The basic pathway is:
Annual appraisals → supporting information across the cycle → RO/Suitable Person review → recommendation to the GMC → GMC decision → confirmation of revalidation and your next revalidation date
The evidence considered will usually include your appraisal record, patient and colleague feedback, quality improvement activity and other relevant supporting information or governance information.
The process is not always simply a case of submitting the evidence and receiving an immediate decision. Your revalidation or appraisal team may come back with questions. For example, they may ask why an appraisal was late or missed, whether a particular piece of feedback has been completed, or ask for clarification about gaps in your work. Some Responsible Officers review the record in more detail than others, but broadly anything missing or unusual may need explaining.
There are three main possible outcomes:
| Outcome | What it means |
|---|---|
| Revalidate | There is enough evidence and you have appropriately engaged with the process. Your RO/Suitable Person recommends revalidation and the GMC makes the final decision. |
| Defer | You are engaging, but more time or information is needed. This might allow you to complete missing evidence, another appraisal or another ongoing process before a recommendation is made. |
| Non-engagement | If you repeatedly fail to engage despite appropriate support and opportunity, your RO can ultimately recommend non-engagement to the GMC. This can put your licence to practise at risk. |
A deferral is not the same as a fitness-to-practise referral. If there is a genuine fitness-to-practise concern, this is dealt with through a separate process.
Why It Works This Way
A deferral is generally a chance to put the missing pieces in place — for example, completing outstanding evidence or fitting in another appraisal before a final recommendation is made.
Continued non-engagement is more serious. If a doctor repeatedly does not engage despite support and opportunities to do so, this can eventually put their licence to practise at risk.
The system does allow some flexibility for late appraisals, missed appraisals and genuine life circumstances. But the simplest approach is still the best one:
keep your appraisal record up to date and deal with any gaps early.
What Happens Next
Once the GMC accepts the revalidation recommendation, you receive confirmation of the decision and a new revalidation date — usually around five years later.
The cycle then starts again. You continue with annual appraisal and build a new set of supporting information over the next revalidation period, including patient and colleague feedback, quality improvement activity and other relevant evidence.
Common Situations
There are also a few situations which commonly cause confusion:
| Situation | What to know |
|---|---|
| Fewer than five appraisals | Revalidation is not simply “five appraisals = pass”. It can be possible to revalidate with fewer where there is a reasonable explanation and enough evidence overall. This is not a reason to deliberately miss appraisals. |
| Late or missed appraisal | Expect to be asked why. An unexplained gap may contribute to a decision to defer revalidation while further evidence or another appraisal is completed. |
| Going into training | Your revalidation arrangements move into the training/ARCP system. This should not be viewed as a way of avoiding previous appraisal requirements. |
| Working overseas | Working overseas does not automatically remove the need to remain engaged with appraisal if you retain a GMC licence. Relevant overseas work and evidence can often be included in your UK appraisal. |
If you do not have a Designated Body, revalidation becomes more complicated.
You can still keep your appraisal record up to date by arranging an independent whole-practice appraisal. After the appraisal, your appraiser completes a REV12 form, which is submitted to the GMC as part of your Annual Return. In simple terms, the REV12 provides the GMC with evidence that you have continued to engage with annual appraisal despite not having a Responsible Officer.
The difficulty comes when you actually reach revalidation. Appraisal + REV12 keeps your record up to date, but it does not automatically replace a Responsible Officer recommendation.
If you still have no Designated Body at revalidation, there are broadly two routes:
| Route | What happens |
|---|---|
| Approved Suitable Person | A GMC-approved Suitable Person reviews your appraisal and revalidation evidence and can make a recommendation to the GMC on your behalf. This is often a paid service. |
| No RO or Suitable Person | The GMC manages your revalidation directly and will usually require the GMC revalidation assessment, in addition to its other requirements. |
This is why many doctors without a Designated Body continue completing annual appraisal + REV12 while expecting to obtain a prescribed connection before their eventual revalidation date.
For example, they may later move into a substantive post or establish a genuine connection through an organisation such as an eligible locum agency. However, simply joining an agency or staff bank does not automatically give you a Designated Body — your actual prescribed connection needs to be checked.
Bottom line: REV12 helps you demonstrate that you are keeping up with appraisal while you have no Designated Body. The bigger issue is who will make your revalidation recommendation when the time comes.
Myth Trap
“My appraisal is my revalidation.”
No — they are completely different processes.
Your appraisal is an annual professional review. It looks at your work, learning, supporting information, reflection and development, and results in an appraisal summary and PDP.
Revalidation is the GMC’s formal decision about whether you can continue to hold a licence to practise. It normally happens around every five years.
Your annual appraisals help build the evidence used at revalidation, but completing an appraisal does not mean you have been revalidated.
In simple terms:
Appraisal = annual review of your practice Revalidation = GMC decision on your licence to practise
Revalidation also considers the wider picture across the cycle, including your appraisal record, patient and colleague feedback, quality improvement activity and other relevant information.
It is also not simply “five appraisals = revalidation.” Your Responsible Officer or Suitable Person reviews the overall evidence and makes a recommendation; the GMC then makes the final decision.
Sources / Last Reviewed
GMC — What is revalidation? Explains how revalidation works, the role of the Responsible Officer or Suitable Person, and the GMC’s final decision.
GMC — Guidance on supporting information for revalidation Sets out the supporting information doctors are expected to collect, reflect on and discuss through appraisal.
GMC — Meeting our revalidation requirements: overarching principles Explains annual appraisal expectations, whole-scope appraisal and how missed appraisals are considered.
GMC — Revalidation recommendations Explains the possible recommendations of revalidate, defer or non-engagement and what these mean.
GMC — Revalidation for doctors without a connection Explains the additional requirements for doctors without a Responsible Officer or approved Suitable Person, including Annual Returns and the revalidation assessment.
Last reviewed: August 2026