UK Medical Appraisals

^{Fast, supportive, and fully accredited — with no hidden fees. Providing free support and REV12 completion, if you don't have a Designated Body.

Appraisal Fees from £350
In addition to their appraisal, I provide Junior Resident Doctors, from the UK and outside the UK,
with all of following FREE of charge, as a standard part of their appraisals:
Appraisal preparation guidance
Advice on how to secure a FREE Clinical Attachment
Job application advice, including what to write in a personal statement
NHS interview skills / common questions
MSRA / SJT tips and tricks
CV advice}

About My Fully GMC-Compliant Private Appraisal Services

June 2026

Mr. Mark Golder

My General Medical Council (UK) registration number is: 4260026

I'm a UK trained and accredited Consultant General, Emergency and Colorectal Surgeon [CCT London 2008] and a highly experienced, trusted and certified Senior Independent Medical Appraiser.

I am one of the most experienced Medical Appraisers in the UK.

I facilitate Medical Appraisals for all types of Doctors, including International Medical Graduates (IMGs), who work, or who plan to work, in the UK National Health Service (NHS) and independent sectors.

I help these Doctors navigate their annual Medical Appraisals and Revalidation with ease.

I ensure the appraisals I facilitate, are in accordance with the General Medical Council (UK) [GMC] 2024, Academy of Medical Royal Colleges 2022, and NHS England guidelines on Medical Appraisals and Revalidation.

I meet all the GMC requirements to facilitate Appraisals for Doctors who do not have a Designated Body.

I also have considerable experience in appraising, guiding and mentoring Doctors who are under investigation by the GMC.

This accounts for, on average, 10% of my appraisal work.

Here, my aim is to provide friendly and supportive guidance to fellow Doctors who are navigating the challenges of Medical Appraisals and Revalidation.

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 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

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.

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

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

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

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

►Hot Topic of the Week

Monday 15th June 2026

Managing Angry or Challenging Relatives: Evidence-Based Communication Techniques for Doctors

Most doctors will, at some point, encounter an angry, distressed or challenging relative.

These interactions can occur in any specialty. A relative may be upset about a diagnosis, frustrated by delays, concerned about treatment decisions or dissatisfied with communication from the healthcare team. Such conversations can be stressful for everyone involved and, if handled poorly, may escalate into conflict, complaints or a breakdown in trust.

Fortunately, communication research and clinical practice have identified several techniques that consistently help de-escalate emotionally charged situations. These techniques are widely taught in healthcare communication, palliative care, counselling, mediation and conflict resolution.

Understanding the Emotion Behind the Complaint

One of the most important principles is recognising that anger is often a secondary emotion.

Behind the anger may be:

Fear

Anxiety

Helplessness

Grief

Guilt

Uncertainty

Loss of control

When a relative says:

"My father should never have been given that medication."

The underlying concern may actually be:

"I'm frightened that something has gone wrong."

Understanding this distinction can fundamentally change how the doctor responds.

The Most Common Communication Mistake

Doctors are trained to solve problems.

As a result, many clinicians instinctively respond to complaints by immediately providing explanations.

For example:

Relative:

"Nobody listened to my concerns."

Doctor:

"We reviewed your mother's condition several times and followed the appropriate guidelines."

Although factually correct, this response often fails because the emotional concern has not been addressed.

The relative may feel that they are still not being heard.

Before people are willing to hear an explanation, they usually want to feel understood.

Reflective Listening

Reflective listening is one of the most effective de-escalation techniques available.

Rather than immediately defending a decision, the clinician briefly reflects the concern back to the relative.

For example:

Relative:

"I'm angry that my mother was prescribed that medication."

Doctor:

"I can see that you're angry about the decision to prescribe that medication and worried that it may have affected your mother's health."

This technique is sometimes referred to as reflection or reflective listening.

Importantly, the doctor is not agreeing with the allegation.

The doctor is demonstrating understanding of the concern.

Research and communication training consistently show that people become less defensive when they feel heard and understood.

Validation: Acknowledging the Emotion Without Agreeing

Validation is another powerful technique.

Validation acknowledges that the person's emotional response is understandable.

Examples include:

"I can understand why that would be upsetting."

"I can see why you're concerned."

"Many people would feel frustrated in that situation."

Validation does not mean accepting blame.

It simply communicates empathy.

This distinction is important.

Doctors sometimes avoid empathic statements because they fear they may be interpreted as admissions of fault. In reality, empathy and accountability are separate concepts.

The NURSE Framework

One of the best-known communication models used in healthcare is the NURSE framework.

NURSE stands for:

N – Name the Emotion

Identify the emotion being expressed.

Examples:

"You seem very worried."

"You sound frustrated."

"I can see that you're angry."

Naming the emotion demonstrates that you have recognised it.

U – Understand

Show that the emotional response is understandable.

Examples:

"I understand why you feel that way."

"Given everything that has happened, I can understand your concerns."

R – Respect

Recognise the relative's efforts or commitment.

Examples:

"You've clearly been advocating strongly for your mother."

"It's obvious how much you care about your father."

Respect often helps reduce adversarial dynamics.

S – Support

Demonstrate a willingness to help.

Examples:

"Let's work through this together."

"I want to make sure your concerns are addressed."

E – Explore

Encourage further discussion.

Examples:

"Tell me more about what worries you most."

"Can you help me understand your concerns in more detail?"

This final step frequently reveals the true issue behind the complaint.

Finding the Real Concern

The stated complaint is not always the real concern.

For example:

Relative:

"No one has explained anything."

The underlying concern may be:

"I'm worried my mother is dying."

"I don't understand what is happening."

"I feel excluded from decisions."

A useful question is:

"What is your biggest concern at the moment?"

This simple question often changes the entire direction of the conversation.

Avoiding Defensive Language

When under pressure, doctors may unintentionally use language that escalates conflict.

For example:

Avoid:

"That's not correct."

"You're mistaken."

"You don't understand."

"That's not what happened."

Instead try:

"I can understand why it may appear that way."

"Let me explain what information was available at the time."

"Can I talk you through our thinking?"

These responses maintain professionalism while reducing confrontation.

Managing Escalating Behaviour

Occasionally a conversation may become increasingly hostile.

Warning signs include:

Raised voices

Interruptions

Repeated accusations

Personal attacks

Threats of complaints or legal action

In such situations:

Remain calm.

Lower your voice rather than raising it.

Speak slowly.

Avoid arguing.

Focus on understanding rather than winning.

If behaviour becomes unacceptable, boundaries should be set respectfully.

For example:

"I want to understand your concerns and help if I can. However, I cannot continue the conversation if I am being shouted at. Let's try to discuss this calmly."

Empathy and professional boundaries can coexist.

A Practical Example

Relative:

"You doctors don't care. Nobody has told me what's going on."

Unhelpful response:

"That's not true. We have updated the family several times."

More effective response:

"It sounds as though you're frustrated and feel that you haven't received the information you were expecting. Can you tell me what concerns you most at the moment?"

The second response uses reflective listening, validation and exploration.

Only after understanding the concern should the doctor move on to providing information.

Reflection for Medical Appraisal

Managing challenging interactions with relatives can provide valuable material for reflection and appraisal.

Doctors may wish to consider:

Which communication techniques were effective?

What emotions were present during the conversation?

How did the relative's concerns influence the discussion?

What could have been done differently?

What learning can be applied in future encounters?

These reflections demonstrate development in communication skills, professionalism, patient-centred care and patient safety.

Conclusion

When relatives become angry or confrontational, the natural instinct is often to explain, justify or defend clinical decisions.

However, effective communication usually starts elsewhere.

Before people are willing to hear your explanation, they often need to feel that you have heard their concern.

Reflective listening, validation and the NURSE framework provide practical, evidence-based techniques that help doctors navigate emotionally charged conversations whilst maintaining professionalism and trust.

The goal is not necessarily to make the relative agree with you.

The goal is to ensure that they feel heard, respected and understood, even when difficult decisions must still be made.

^{Independent, GMC-Compliant Medical Appraisals for UK and International Doctors}

1. What can I expect from a Medical Appraisal with UKMA?

2. What is Revalidation?

3. What is a Medical Appraisal?

4. What is an Annual Return?

5. Does UKMA facilitate Appraisals for International Medical Graduates (IMGs) ?

6. What Other Resources Does UKMA provide?