Reflection: One Year as FPM's Responsible Officer

This blog article has been prepared by Dr David Montgomery FFPM.

The article presents the views of the author and not necessarily those of the Faculty of Pharmaceutical Medicine (FPM).

Last summer was a pivotal moment for me, walking away from full time employment and setting up my own business had become, well, maybe almost existential. But it still filled me with terror. Despite the terror (or maybe, because of it?), I still vividly remember the discussion I had about becoming FPM’s Responsible Officer for Revalidation.

It hadn’t initially occurred to me to apply. I had a lot going on! And then I found myself sitting on a bench in Tavistock Square, just about to go into BMA house for a meeting of the Medical Academic Staff committee, having a completely unrelated discussion, when it came up in conversation.

Later that day, I submitted my application, and by the time it came to interview I was determined the role would be mine.

Even my memory of the interview leaves me feeling nostalgic. Conducted in FPM’s old offices at Angel Gate; offices I’d spent a lot of time at over the years during various events. I’d held appraisal meetings there. It was one of the last times I visited before the recent move to Holborn; one of my final memories from a building where a lot of pivotal moments happened.

And so the process of taking on this role sits very prominent in my memories and emotions from the past year or so. But what about the role itself?

I suppose I didn’t really know what it would entail. My initial assumption was that there would be a fair amount of process, some careful reading and perhaps the occasional meeting in which the words “governance framework” appear before coffee. And I wasn’t wrong in those assumptions.

Revalidation is necessarily structured. There are systems to follow, evidence to review, deadlines to meet, and forms which seem, on occasion, to have developed a rich and independent existence. I know many of you see the process as pedestrian, bureaucratic, without much return on your investment.

I now find myself defending some of the process. While we’ve sought to streamline it where possible, to be less didactic, good governance matters nonetheless. Patients should be able to trust the doctors involved in developing medicines. Doctors should be able to trust that the profession takes standards seriously. Revalidation provides an important opportunity to reflect on practice, maintain professional development and demonstrate that we remain up to date.

But after a year in the role, I am pleased that we’ve started to make it much more human.

Behind each portfolio, appraisal return or request for advice is a colleague trying to do a difficult job well. Pharmaceutical medicine is varied, demanding and often conducted in organisations with competing priorities, imperfect information and timelines that don’t always feel aligned to our own priorities. Most of us are used to being the ones expected to have the answers. It can therefore be surprisingly difficult to say that we are struggling, whether that struggle relates to workload, health, confidence, a complaint, career uncertainty or something happening outside work.

Doctors should be able to trust that the profession takes standards seriously. Revalidation provides an important opportunity to reflect on practice, maintain professional development and demonstrate that we remain up to date.

That initial discussion focussed very much on this human element. Sitting on that bench in Tavistock Square, I was intrigued by the question that was put to me: could you not see appraisal and revalidation driving not just standards, but support? Could you not see yourself working with a team of people whose purpose isn’t to catch people out, but to guide them through.

The GMC recently admitted they consider themselves to have no duty of care to doctors going through fitness to practice investigations. I was dismayed by that; duty of care to our colleagues and our patients is what defines us as doctors. And that drives me every day in this role.

So what I’ve enjoyed most in the last year, by far the most valuable aspect of being RO, has been the chance to support colleagues at those moments. Sometimes that means helping someone understand what they need to do for revalidation. Sometimes it means offering perspective when the process feels intimidating or disproportionately burdensome. Occasionally, it means recognising that the most useful intervention is not another checklist but a proper conversation, some reassurance and a reminder that asking for help is not evidence of professional failure.

The training we did for appraisers alongside Doctors in Distress reinforced this point powerfully. It gave us space to consider how doctors can respond when a colleague is under pressure, how easily distress can be hidden and how important it is to approach people with curiosity rather than judgement. It is tempting to believe that resilience means getting on with it, preferably without troubling anyone else. In reality, resilience is often collective. It is the confidence that someone will notice, listen and help you find the next sensible step.

This was also the theme of the blog I wrote for Mental Health Week – Supporting Doctors Through Revalidation. Revalidation should not become another source of avoidable anxiety. Done well, it can provide a supportive professional framework, a moment for reflection and an opportunity to identify where someone may need help before difficulties become more serious.

That does not mean pretending the system is flawless, or that every administrative requirement is a joyous expression of professional fulfilment. Some parts are unavoidably bureaucratic. There will always be dates, declarations and a modest quantity of document chasing. Yes, it would be helpful if some of you could get paperwork back to us a bit more quickly than you do!

Yet, the purpose of the process matters more than its mechanics. It is about supporting good doctors to continue doing good work, while protecting patients and maintaining public confidence in our profession.

the purpose of the process matters more than its mechanics. It is about supporting good doctors to continue doing good work, while protecting patients and maintaining public confidence in our profession.

As I approach the end of my first year, I remain pleased to have taken on the role. I am now rather clearer about what it involves, including the paperwork.

I have gotten to know our amazing FPM staff team even better than I did, have spent more time with our appraisers and appraisal leads and developed some important friendships. I have said goodbye to colleagues who have retired; some of whom have had an outsized influence on my career. I’ve made revalidation recommendations to towering figures in our industry, including one person who signed off my PMST completion over a decade ago (you can imagine my relief when these portfolios support positive recommendations, and my dismay when they don’t).

Most importantly, I have seen how much value there is in making time for colleagues, particularly when things are not straightforward.

I hope, at the end of my first year, that the changes we’ve made as a team are filtering through to all of you and that they feel positive. I’ve said it before and I’ll say it again; if that isn’t the case, get in touch and let me know.

You can contact David by emailing ROrevalidation@fpm.org.uk.