Registrar Appraisal at the End of Training

The last few weeks of training are an important time to take stock of one’s career and to make plans for the future. It is also important to ensure that there is a smooth transition from the educational supervision that trainees have experience during training to the NHS’s system of medical appraisal.

Severn School of Primary Care therefore recommends that GP Educational Supervisors consider some of these issues when performing their ST3’s final ESR. Although this will not cover all of the areas that might be covered in a NHS-style appraisal, it is possible to use the documentation from the final ESR as a handover to the appraisal system.


The aims of this mini-appraisal are

  • To assist the trainee to plan lifelong learning strategies
  • To offer career advice and development
  • To improve awareness of the requirements of appraisal and revalidation, and the evidence required
  • To ensure their PDP is appropriate for the post CCT environment


Newly Qualified GPs are a mobile and vulnerable group. 50% will move to a different area, where they may have few contacts and little support. Many will be working as locums or in out-of-hours services. Even as assistants or long term locums such as maternity cover, they may have little support from their practices. Their career structure is poorly defined, and time for learning may not be easy to protect. Helping trainees to navigate this transition to independent professional practice is a very valuable service that Educational Supervisors can provide.

Guidance to Educational Supervisors

Trainees completing their GP training are going to be asked to download and submit a copy of their final ESR (the one you carry out and complete about 2 months before they finish ST3) as supporting information for their first GP appraisal. It is therefore important that the final ESR includes information that may help the graduating trainee’s first appraiser when conducting the first appraisal. Likewise some thought should be given to the PDP that the newly qualified GP will be following during their first few months – the appraiser will want to know the degree to which this has been followed, and whether the doctor has completed any of the items on this PDP.

If the trainee has had any particular difficulties professionally during their training, mentioning this in their final ESR will alert the appraiser to these issues, and enable them to raise them in the appraisal meeting. Given that the trainee will have reached a level of minimum competence for their CCT in each of the RCGP Competencies, any areas where the trainee needs particular further development should be identified in the PDP, along with a SMART action plan for addressing these.

It would be appropriate to comment on the quality of the evidence and degree of reflection in the trainee’s e-portfolio (there are questions about this on the ESR), as this may give pointers to areas for the appraiser to focus on.

When deciding what to enter onto the ESR report, it may be helpful to consider things from the point of view of the appraiser, and ask yourself the question: “If I was conducting this trainee’s first appraisal, what would I want to know about them?”

It is of course important that any statements made are factual and not subjective, and should be discussed and agreed with the trainee at the ESR meeting.

Content – areas that might be appropriate to include:

Lifelong learning

  • You need to ensure that after they leave your protection, they have the skills and means to access information and services. Help them to plan this.
  • In the Severn region they should be advised to join an educational trust; the subscription is tax deductible.
  • The RCGP's Essential General Practice is one of a number of on-line education resources available
  • Encourage them to contact their local GP Education Office (usually based at Postgrad centres) as many areas now have newly qualified GP schemes, or self directed groups.
  • Severn Faculty of the RCGP has a mentorship scheme for newly qualified GPs
  • Do they have any special areas they wish to develop, such as coil fitting, or a specialist diploma like dermatology or geriatrics? How do they plan to achieve that?

Appraisal and Revalidation

  • Give a brief overview of the requirements; they may have had a session in their course about this
  • Direct them to the School appraisal pages for more resources e.g. RCGP guide
  • Help them to understand the need to continue to gather evidence in an electronic portfolio, perhaps help them choose one to use (Severn Appraisal Toolkit is now freely available to all GPs working in Severn) and encourage them to transfer their PDP to the one that they are going to be using.

If you have any queries, please contact your patch AD, or email Martyn Hewett

Leaving the training programme before completion of training

There have been some cases recently where a trainee has continued to be charged for their AiT membership, even though they have resigned from a GP training programme. If a trainee leaves a programme before completing, they need to contact the College's Membership Department to let them know, so that their membership can be terminated, and access to the Trainee ePortfolio suspended.