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Revalidation FAQ

Question:

“I am retired and no longer treat patients. My practice is limited to writing medico-legal reports as an expert medical witness. Do I need to revalidate, and if so, how can I do that?”

Answer:

All doctors with a licence to practise medicine will have to revalidate.

There are a number of components to this question, and a number of different types of medico-legal reports which require different considerations.

If you retired from clinical practice some years ago, and if you only occasionally provide an expert opinion on the standard of care which would have been considered acceptable at the time when you were in active clinical practice, then it may be reasonable not to retain a licence to practise medicine just for that purpose. However, if you make yourself available for such opinions, then there are two very important considerations to keep in mind.

1. The first consideration is (a) to make it clear from the outset to the instructing solicitor or other person seeking your opinion, and (b) to prominently state in the substance of your report to the court or tribunal, that you no longer have a licence to practise medicine.

2. The other consideration is to make sure that your medical defence organisation subscription or insurance premium is appropriate for the work you undertake, and that not having a licence to practise is clearly known, whether that indemnity is arranged directly by you, or through an instructing solicitor for example.

Medico-legal reports in contemporary cases on the standard of care provided by another doctor will almost certainly have a requirement from the court or tribunal for a licence to practise. In the small number of cases which go to a court or tribunal hearing, the medical evidence may be challenged, and a medical expert witness without a licence to practise at the time the report was written could be placed at a disadvantage and criticised in public during cross-examination.

Many medico-legal reports are based on a clinical examination for current condition and prognosis, and there is an expectation that all doctors with direct clinical contact with patients will be licenced. It is probable that courts & tribunals would be unhappy to rely on clinical evidence given by a doctor without a licence to practise medicine. Furthermore, unless great care is taken, there is a risk that fully-informed patient consent to undergo the clinical examination could be challenged, even if you routinely mention to patients that you are “no longer licensed to prescribe”, and that in turn could raise a question of probity, and if such criticism is upheld, put your registration as a medical practitioner in jeopardy.

Turning to how you may revalidate, you need to establish a connection with a designated body, but that subject is dealt with elsewhere.

There is one aspect, unique to medico-legal report writing, that you need to be aware of. Your medico-legal reports may attract legal privilege in addition to medical confidentiality, so you would have to be careful to get proper consent before you disclosed evidence of your work to your Responsible Officer or appraiser, or as part of a governance procedure. Simple anonymisation may not be enough, and self-evidently that applies to high profile cases, but may also apply to less obvious cases. It is important to get written consent for any kind of disclosure through the instructing solicitor or other person who sought your opinion. You may also need to take expert advice on the need to get consent to disclosure from the other parties to the action as well.

Further case-specific advice for ROs, Appraisers and FFLM members may be available from the FFLM’s specialty advisers, at forensic.medicine@fflm.ac.uk, your medical defence organisation and/or your professional body.