Clinical Practice
This achievement category is unique in that every candidate in
active clinical practice is required to submit evidence. The
intention is that patients of a doctor who is a Fellow of the
College should be confident that he or she, regardless of any other
accomplishments, practises to a clinical standard with which the
College is satisfied, delivering safe personal medical care.
That said, the Fellowship process needs to temper this
aspiration with respect for the diverse and sometimes disadvantaged
practice circumstances of candidates whose main claim to Fellowship
centres on other achievement categories. Examples include those
with interrupted or portfolio careers; locums or sessional doctors;
members of the Armed Services. Therefore – while the College has
much experience with clinical and organisational standards such as
FBA, MAP and QPA – it is not appropriate to apply these rigidly for
the present purpose. We are also keen to avoid routinely using
expensive or resource-intensive methods such as video or practice
visits in evaluating Fellowship applications.
The nature of a candidate’s clinical responsibilities should
be clear from the submitted personal statement. In addition:
- All candidates must submit documentary evidence of three
consecutive satisfactory appraisals
- Candidates working as partners should normally declare their
QOF point score together
with any explanatory comments.
- All other candidates in active practice must submit evidenced
and verifiable statements from clinical colleagues who are Members
or Fellows of the College that the candidate’s clinical performance
represents safe personal medical care.
Depending on the candidate’s declared working profile, the
Fellowship adjudicators may then wish to look for evidence of safe
personal care in relation to:
- Accessibility, e.g. normal time within which patients can
electively consult the candidate should not exceed 7 days
- Continuity of care, e.g. housebound and terminally ill
patients, or those with long-term physical or mental illness,
receive continued planned care from the candidate
- Effective consulting: while the practicalities of supplying
evidence of consulting skills preclude their inclusion as a routine
requirement for Fellowship, candidates who have undertaken video
assessment for teaching purposes or undertaken patient enablement
studies are welcome to include the results in this category
- Significant event auditing, e.g. evidence that instances of
adverse outcomes or diagnostic delay involving the candidate are
reviewed and lead to improved care.
Fellowship candidates whose application is based solely or
predominantly in this achievement category can be expected to
submit more extensive and rigorous evidence of their clinical
standards. As a guide, they may like to consult the final version
of the Fellowship by Assessment criteria (please email fellowship@rcgp.org.uk or
telephone 020 7344 3061 for a copy).
Applicants not working in general practice are encouraged to
demonstrate how activity in their own clinical field has furthered
the care of patients in general practice and how they have aimed to
uphold the ethos of the College.
It is anticipated that the criteria in this category are
likely to evolve more rapidly than in other categories, as the
revalidation process comes on stream and the Quality and Outcomes
Framework is periodically reviewed. The Fellowship Committee will
monitor and fine-tune criteria in this category particularly
closely and regularly.