What Happens During and After the Appraisal Meeting?

I normally start quite informally. We introduce ourselves, build some rapport and talk about your current work. Although the appraisal is a formal professional process, the conversation does not need to be stiff or hierarchical. A newly qualified locum or IMG should feel able to speak openly to a consultant appraiser.

The first questions tend to be simple: Where have you been working? What does your day-to-day role involve? Which clinical settings, non-clinical responsibilities or other professional activities fall within your scope of work? How has the year gone?

We will often move naturally into your longer-term career plans — for example, whether you want to consolidate NHS experience, apply for specialty training, complete a qualification or develop a particular area of practice.

For many doctors, continuing professional development (CPD) and quality improvement make up the largest part of the discussion. The point is not to recite a list of certificates: it is to make sense of what you have learned and whether it has influenced your practice.

CPD / courses / conferences

“What was the most useful thing you learned? Was anything new or surprising? Has it changed how you practise?”

Postgraduate exam study

“What did you study, how much time did you devote to it, and how has it strengthened your clinical knowledge?”

Audit or QI

“What problem did you identify? What did your results show? What changed, or what would you change next?”

Case-based discussion / teaching

“What did the case or feedback reveal? What did you do differently afterwards?”

For instance, if you attended a substantial conference, I might ask about developments in that specialty, where current practice appears to be heading and which ideas you plan to bring back to your own work. A substantive activity gives us something meaningful to discuss; the certificate alone is only the starting point.

An experienced appraiser should ask questions that uncover relevant learning you may not have recorded clearly. A doctor might say they have “hardly any CPD”, then explain that they have spent hundreds of hours preparing for a postgraduate examination. That learning may be highly relevant to the appraisal, even if it was not originally presented in a formal CPD log.

This does not mean an appraiser should invent evidence or automatically award CPD hours. The activity, dates, relevance, learning and reasonable supporting material should be documented accurately, with any local recording requirements considered. The discussion is an opportunity to identify genuine work, not to disguise missing work.

We then discuss the other important elements of the appraisal: patient and colleague feedback where available, compliments, achievements and challenges, complaints, significant events, declarations, and any relevant wellbeing or professional issues. We also check that the whole scope of work has been represented.

If a complaint or difficult clinical event arose, be ready to explain what happened, what you learned and what changed. You do not need to rehearse a perfect answer. Honest reflection is more useful than defensive explanations, and patient-identifiable information should not be included in appraisal documentation.

The meeting is usually a supportive space, but it is not an absolute guarantee of confidentiality. Serious patient-safety or professional concerns may need to be addressed through the responsible officer or appropriate governance routes; they should not be contained solely within appraisal.

If you have had a previous appraisal, we will revisit its objectives. Not every goal needs to have been achieved: careers change, opportunities fall through and some objectives stop being relevant. What matters is an honest account of your progress, why things changed and what you learned.

The previous PDP is a development tool, not a pass/fail checklist. However, unresolved objectives tied to an identified safety concern, a professionalism issue or an essential training requirement warrant closer attention than an ordinary career goal that changed.

I tend to reserve time at the end for the next PDP. Good appraisal meetings are forward-looking. We look at the learning needs and ambitions that have emerged and turn them into goals that are specific enough to be meaningful, but flexible enough to accommodate changes during the year.

Your objectives should primarily reflect your own professional direction, developed through discussion with the appraiser. An IMG might want more NHS experience and a stronger set of job applications; an FY3 doctor may need to review the specialty person specification, build portfolio evidence and prepare for interviews. These are legitimate professional development goals when they are relevant to that doctor.

The strongest meetings combine real supporting activity with openness and a two-way conversation. You do not need to be extroverted. You do need to be willing to explain your work, reflect on it and consider ideas from the appraiser. A good appraiser can use their clinical and career experience to help you identify a clearer direction.

The written report commonly addresses practice through the four domains of the GMC’s Good medical practice:

1. Knowledge, skills and development

Maintaining knowledge, keeping up to date and learning from practice.

2. Patients, partnership and communication

Patient-centred care, communication and shared decisions.

3. Colleagues, culture and safety

Teamwork, raising concerns, safety and quality.

4. Trust and professionalism

Professional conduct, honesty and public trust.

The report also normally contains an overall appraisal summary, the agreed PDP and appraiser statements. These are appraisal outputs, not a guarantee of a later GMC revalidation recommendation.