Table 1

Summary of national validation systems

ProgrammeEst.MandateProcess
American Board of Medical Specialties maintenance of certification2006Protect the public and patients by attesting to the quality, safety and effectiveness of US medical practitioners.4-part process that includes: (1) professional standing; (2) lifelong learning and self-assessment; (3) cognitive expertise; (4) practice performance assessment.
Federation of Medical Regulatory Authorities of Canada maintenance of licensure2010Designed to improve quality of healthcare delivery and engage in a ‘culture of continuous quality improvement and lifelong learning assisted by objective data and resulting in significant and demonstrable actions resulting in the improvement of patient care and physician practices’.(1) Ongoing process of reflective self-evaluation, self-assessment and practice assessment; (2) successful completion of appropriate educational and improvement activities. (3) commitment to lifelong learning to maintain skills and update knowledge. The expectation is that this would be an annual requirement.
Canadian revalidation2007To be a ‘quality assurance process in which members of a provincial/territorial medical regulatory authority are required to provide satisfactory evidence of their commitment to continued competence in their practice’. Revalidation requires all physicians to ‘participate in a recognised revalidation process in which they demonstrate their commitment to continued competent performance in a framework that is fair, relevant, inclusive, transferable and formative’.Since 2007, individual provinces have accepted the Maintenance of certification (MOC) Programme of the Royal College of Physicians and Surgeons of Canada and the Maintenance of Proficiency (MAINPRO) Program of the College of Family Physicians of Canada as sufficient demonstration of a physician's commitment to sustain their competence. Some provinces developed an alternative pathway for physicians who wanted an alternative to the MOC or MAINPRO programmes. Some provinces, such as Quebec and Ontario define a third or an alternative pathway for physicians to use in demonstrating their commitment to competent performance in practice
UK revalidation2012Doctors must ‘periodically demonstrate their continued fitness to practice, and for specialist doctors, to demonstrate that they meet the standards that apply to their particular medical specialty’.The model of revalidation is built on formative, periodic (eg, annual) peer appraisal/assessment processes and is applicable to all doctors, in any settings (private, public, and locums). Annual summative appraisal undertaken by a senior colleague (termed Responsible Officer) expected that includes doctors provide documentation based on the requirements of the General Medical Council's Good Medical Practice. All licensed physicians must provide the necessary supporting information that sufficiently demonstrates they are practicing in accordance with this programme in a cyclical manner (every 5 years).