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This paper introduces the first stage of the NHS Revalidation Support Team's (RST) proposals to strengthen medical appraisal. It reports on four focus groups held at London Deanery in 2010, with the aim of gauging initial reactions from general practitioners (GPs). The four groups consisted of two groups of appraisers and two groups of appraisees. After presentation of the proposals to strengthen appraisal, participants were invited to make comparisons between existing appraisal, and the new proposals, Interestingly, the matter which attracted most discussion was a proposal to include an element of self-assessment by the appraisee prior to appraisal, and not, as might have been expected, the proposals for assessment of the appraisee's progress towards revalidation by the appraiser. Since these focus groups, the model of strengthened medical appraisal referred to in this paper has been the subject of testing in the pathfinder pilot, a large scale pilot involving 3000 doctors in various settings in England. The evaluation of the pathfinder pilot was published (July 2011). After further refinement of the appraisal process, including taking into account new GMC and Royal College publications and more testing and piloting, the final version of medical appraisal to support revalidation, known as the Medical Appraisal Guide (MAG) is due to be published in March 2012, in time to permit the expected commencement of revalidation in late 2012.

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