UK Medical Appraisals
Independent, GMC-Compliant Medical Appraisals for UK and International Doctors
Fast, supportive, and fully accredited — with no hidden fees and free REV12 completion if you don't have a Designated Body.
Your Appraisal will also include my expert help with your approach to exam SJTs
and to your Personal Statement for UK Job Applications, if you would like that.
1. What can I expect from a Medical Appraisal with UKMA?
You will receive expert guidance and support with your Appraisal preparation.
Your appraisal will include my expert help with your approach to exam Situational Judgement Tests (SJTs), using my R.A.P.I.D. model, and your approach to writing Personal Statements for UK job applications, using my Five Pillars of Excellent Medical Practice model, if you would like that.
Your appraisal will be a formal, but relaxed, friendly and supportive meeting, with one of the most experienced Medical Appraisers in the UK. It will be via video link and will last about 1 hour.
Your appraiser will create an environment in which you will feel able to ask questions about the appraisal process and about any concerns you have.
During the meeting, your Appraiser will facilitate discussions and your reflections on the supporting evidence you have provided for your Appraisal. These discussions and reflections will be used to formulate your Personal Development Plan for the subsequent 12 months [your Appraiser will guide you on this].
Following your Appraisal, your Appraiser will complete [finalise] the Appraisal form and complete all sections of the REV12 form. They will then email these completed documents to you, during the 48 hours following your Appraisal.
You then upload these to your online GMC account. Within 14 days, the GMC will then email your Appraiser, to ask them to confirm that they met with you for your Appraisal and that they completed the Appraisal forms. Your Appraiser will confirm this within a few hours and your Appraisal process will then be complete.
Contact UKMA for more information
Your appraisal will include my expert help with your approach to exam Situational Judgement Tests (SJTs), using my R.A.P.I.D. model, and your approach to writing Personal Statements for UK job applications, using my Five Pillars of Excellent Medical Practice model, if you would like that.
Your appraisal will be a formal, but relaxed, friendly and supportive meeting, with one of the most experienced Medical Appraisers in the UK. It will be via video link and will last about 1 hour.
Your appraiser will create an environment in which you will feel able to ask questions about the appraisal process and about any concerns you have.
During the meeting, your Appraiser will facilitate discussions and your reflections on the supporting evidence you have provided for your Appraisal. These discussions and reflections will be used to formulate your Personal Development Plan for the subsequent 12 months [your Appraiser will guide you on this].
Following your Appraisal, your Appraiser will complete [finalise] the Appraisal form and complete all sections of the REV12 form. They will then email these completed documents to you, during the 48 hours following your Appraisal.
You then upload these to your online GMC account. Within 14 days, the GMC will then email your Appraiser, to ask them to confirm that they met with you for your Appraisal and that they completed the Appraisal forms. Your Appraiser will confirm this within a few hours and your Appraisal process will then be complete.
Contact UKMA for more information
2. What is Revalidation?
Revalidation is the date that your GMC licence to practise renews. It occurs once every 5 years and it is generally set 5 years after: a] you first registered with the GMC, or b] you completed FY1 training, or c] you completed specialist training.
Contact UKMA for more information
Contact UKMA for more information
3. What is a Medical Appraisal?
UKMA provides the annual process of facilitated self-review, supported by information gathered from the full scope of your work. Your scope of practice is defined by all the types of Medical work you do, inside and or outside of the UK. Looking back over a 5 year Revalidation Cycle, the supporting information should have been gathered predominantly from UK practice. However, for any given 1 year appraisal period, this is not necessary.
There are 6 types of supporting information that are provided for appraisals and that should cover your scope[s] of practice.
1. Continuing professional development (CPD / CME) [try to aim for 50 hours each year - this can include UK-based and non-UK based activities]. The number of hours maybe less than 50, particularly if this is your first appraisal.
There are 6 types of supporting information that are provided for appraisals and that should cover your scope[s] of practice.
1. Continuing professional development (CPD / CME) [try to aim for 50 hours each year - this can include UK-based and non-UK based activities]. The number of hours maybe less than 50, particularly if this is your first appraisal.
2. Any Quality improvement activity [such as audit, case-based discussions, service improvement activities]. UKMA will provide you with templates for these.
3. Any Significant Events that you and or your team were involved in [A Significant Event is an event that did lead, or could have led, to harm].
4, Feedback from patients or those to whom you provide medical services. This needs to be collected at least once within each Revalidation Cycle, but it is not necessary to provide this for each appraisal].
5. Feedback from colleagues [Reference letters / letters of recommendation for each appraisal. These should cover each of your UK and any non-UK scope[s] of practice. Formal multi-source feedback from colleagues needs to be collected at least once within each Revalidation Cycle, but it is not necessary to provide this for each appraisal.
6. Any Compliments and complaints that you and or your team were involved in.
Contact UKMA for more information
Contact UKMA for more information
4. What is an Annual Return?
An Annual Return is the process by which doctors, who do not have a Designated Body, make a direct submission to the GMC. It comprises an Annual Appraisal [with an Appraisal form + a REV 12 form, completed by your Appraiser] + completion of certain documents on your GMC platform account, such as the REV11 form.
Please note, NHS England has discontinued the use of the MAG4 appraisal form, and it should no longer be used for appraisals. UKMA will provide you with an alternative, that is fully compliant with updated NHS England and GMC requirements.
Contact UKMA for more information
Please note, NHS England has discontinued the use of the MAG4 appraisal form, and it should no longer be used for appraisals. UKMA will provide you with an alternative, that is fully compliant with updated NHS England and GMC requirements.
Contact UKMA for more information
5. Does UKMA facilitate Appraisals for International Medical Graduates (IMGs) ?
The answer is yes, of course. We recognise the huge contribution that IMGs make to UK Medical Practice.
There are five common scenarios in which IMGs have an appraisal with the UK Medical Appraisals:
1. The IMG is working in paid clinical practice, both within the UK and outside of the UK
2. The IMG is working in paid clinical practice, outside of the UK, whilst they are actively applying for paid clinical work and or a Clinical Attachment / Observership, in the UK
3. The IMG is working in paid clinical practice, within the UK
4. The IMG is undertaking, or has recently undertaken, a Clinical Attachment / Observership in the UK, but is not in paid clinical work. However, they are actively applying for paid clinical work in the UK
5. The IMG has been on a career break / maternity leave and is actively applying for paid clinical work and or a Clinical Attachment / Observership, in the UK
Contact UKMA for more information
There are five common scenarios in which IMGs have an appraisal with the UK Medical Appraisals:
1. The IMG is working in paid clinical practice, both within the UK and outside of the UK
2. The IMG is working in paid clinical practice, outside of the UK, whilst they are actively applying for paid clinical work and or a Clinical Attachment / Observership, in the UK
3. The IMG is working in paid clinical practice, within the UK
4. The IMG is undertaking, or has recently undertaken, a Clinical Attachment / Observership in the UK, but is not in paid clinical work. However, they are actively applying for paid clinical work in the UK
5. The IMG has been on a career break / maternity leave and is actively applying for paid clinical work and or a Clinical Attachment / Observership, in the UK
Contact UKMA for more information
6. What Other Resources Does UKMA provide?
A certified course on Quality Improvement Activities for Doctors [3 CPD points] - free for all Doctors having an appraisal with UKMA
A comprehensive CPD Directory - free for all Doctors having an appraisal with UKMA
A Clinical Attachment Guide for IMGs, which includes a list of hospitals that provide Clinical Attachments - free for all Doctors having an appraisal with UKMA
A State of the Art Case Based Discussion Template - free for all Doctors having an appraisal with UKMA
A State of the Art Reference letter Template - free for all Doctors having an appraisal with UKMA
Contact UKMA for more information
A comprehensive CPD Directory - free for all Doctors having an appraisal with UKMA
A Clinical Attachment Guide for IMGs, which includes a list of hospitals that provide Clinical Attachments - free for all Doctors having an appraisal with UKMA
A State of the Art Case Based Discussion Template - free for all Doctors having an appraisal with UKMA
A State of the Art Reference letter Template - free for all Doctors having an appraisal with UKMA
Contact UKMA for more information
Hot Topic of the Week
Monday 9th June 2025
How Health Inequalities and Diversity Affect Disease Presentation
Monday 9th June 2025
How Health Inequalities and Diversity Affect Disease Presentation
Why doctors must recognise and respond to variation in clinical care
Good doctors treat every patient equally.
Excellent doctors recognise that not all patients are treated equally by society or by healthcare systems — and adjust their practice accordingly.
Understanding how health inequalities and diversity affect disease presentation is a core element of modern medical professionalism.
The GMC Good Medical Practice 2024 makes this clear:
“You must consider the factors that may affect patients’ access to care and how this might affect the care they need.”
Yet many clinicians were trained in systems where “normal” was defined by limited, non-diverse reference groups — and many clinical tools and guidelines still reflect this bias.
In this article, I’ll explore how inequalities and diversity affect clinical presentation, why this matters, and practical steps for doctors.
Why this matters: beyond fairness — this is about patient safety
Health inequalities refer to differences in health outcomes linked to social, economic, or demographic factors.
Diversity refers to variations in ethnicity, culture, sex, gender identity, disability, age, and other characteristics.
Both can affect:
How disease presents
How disease progresses
How patients experience healthcare
If doctors are unaware of this variation, risks include:
Misdiagnosis or delayed diagnosis
Undertreatment or overtreatment
Patient disengagement
Poorer outcomes
Patient safety is compromised.
Examples of how diversity affects disease presentation
Cardiovascular disease
Women with myocardial infarction often present with atypical symptoms. Yet many diagnostic tools were validated in male populations.
Black African and Caribbean patients in the UK have higher rates of hypertension, but may respond differently to standard drug treatments.
South Asian populations have higher rates of early coronary artery disease — often under-recognised in age-based risk tools.
Skin presentations
Classic teaching images of rash, jaundice, cyanosis and dermatological disease are often on white skin.
This leads to under-recognition of these signs in patients with darker skin tones — a known contributor to diagnostic delay.
Mental health
Cultural factors strongly influence how distress is expressed.
In some cultures, depression may present primarily with somatic symptoms such as pain or fatigue.
Certain minority groups are over-represented in specific diagnoses (for example, Black patients and schizophrenia diagnosis in the UK).
Autoimmune disease
Systemic lupus erythematosus (SLE) is more common and more severe in Black, Hispanic, and Asian populations.
Diagnostic delays are common because many clinical criteria were validated on less diverse populations.
Diabetes
South Asian and Black African-Caribbean populations have higher rates of type 2 diabetes, often at lower BMI thresholds.
If BMI thresholds are applied universally, prevention opportunities are lost, and diagnosis may be delayed.
The role of social factors
It’s not only biology and clinical markers that vary.
Social determinants of health affect:
Symptom reporting
Timing of presentation
Access to care
Response to care
Key factors include:
Language barriers → incomplete history, misunderstanding of symptoms
Health literacy → varying understanding of symptom significance
Mistrust of healthcare systems → delayed presentation
Poverty and housing insecurity → higher infection risk, poorer control of chronic disease
The GMC’s expectations
Doctors must now explicitly reflect on these issues.
Good Medical Practice 2024 states:
“You must take steps to understand the factors that contribute to health inequalities and how they affect patient care.”
The expectations include:
Recognising how inequalities and diversity affect disease presentation
Adjusting reasoning and care accordingly
Actively reflecting on bias in clinical tools and practice
Taking steps to reduce inequality where possible
This is not optional — it is a core professional responsibility.
Practical steps for doctors
Reflect on your training gaps
Have you seen diverse clinical images?
Have you been taught about variation in disease presentation across different populations?
If not, seek out this learning.
Use inclusive resources
Prefer guidelines and tools validated across diverse populations.
Where this is not possible, apply critical thinking when interpreting tools.
Ask about lived experience
Patients often reveal important factors in how they describe their symptoms and experience of illness.
Listen carefully — and validate their experience.
Challenge algorithm bias
Be aware that some clinical risk tools embed historical biases.
Raise concerns when algorithms may disadvantage certain groups.
Reflect on your own biases
No clinician is immune to unconscious bias.
Regular reflection, peer discussion and patient feedback can help identify and address blind spots.
Advocate for change
Support quality improvement work that seeks to embed health equity and diversity awareness in your workplace.
Conclusion: Awareness is the first step — action must follow
Recognising how health inequalities and diversity affect disease presentation is no longer just good practice — it is a professional requirement.
It affects:
Clinical safety
Diagnostic accuracy
Patient trust
Doctors must evolve their reasoning to match the real-world diversity of the populations we serve.
That means:
Updating knowledge
Challenging assumptions
Adjusting care
Helping others do the same
This is central to delivering excellent medical practice — and to building a safer, fairer NHS.
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