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Revalidung macht frei!

Posted by Dr No on 20 February 2010

arbeit.jpgOne of the more striking and duplicitous bits of Nazi propaganda was their use of the slogan “Arbeit Macht Frei” – ‘work makes you free’. It was widely used, but never with more cynical and chilling effect than over the entrance gates to the death camps. Dr No cannot help but notice that the Obersturmführers of medical revalidation have already started a creep towards similar twisted propaganda.

Last summer, we had Obersturmführer Marshall ‘reminding’ us that revalidation was our duty, a professional imperative. Never mind that in his propagandist zeal, he turned his references inside out.

Last September, we had Obersturmführer Godden telling us why we need revalidation; and how it will promote ‘an environment in which excellence can flourish’. Never mind that he relies on the words of ex-Obergruppenführer Patricia Hewitt, perhaps the most detested Health Secretary of recent years.

Last November, we had Obersturmführer Professor Steve Field, Chief Pongo at the RCGP, urging doctors to embrace revalidation: 'Revalidation is solely about professional development, not weeding out bad doctors…If it just ends up as a guillotine, then we will have lost the plot.' Never mind that, according to his own College, as many as one in seven GPs may face le chop once revalidation gets going.

And now we have Obersturmführers Cole and Swart echoing Field, telling us it is ‘time to embrace revalidation’. Never mind that Obersturmführer Swart is sure that there will be ‘a few glitches’ (that’s having our careers set on fire to you and me) along the way.

The fact is, regardless of what these propagandists, these medical Goebbels, might want us to believe, embracing revalidation makes about as much sense as embracing a hand grenade with the safety pin out.

Revalidation is not ‘solely about professional development’ - were that so, there would be no need for the cumbersome bureaucracy of State control attached to it. No Sir, make no mistake, it has everything to do with professional control by the State. Far from enhancing professional freedom, it will achieve the opposite: direct control of the right to practice by a State quango; and doctors found wanting will indeed face le chop.

And yet, remarkably, the great majority of the medical profession seem oblivious to the growing menace. Surely they can’t believe ‘Revalidung macht frei!’ – can they?


When Dr. No mentions 'the great majority of the medical profession seems oblivious to the growing menace' - would this be anything to do with the age of 'the majority'?

The current trend in education seems to suggest to tomsanguish that indoctrination of the masses is part and parcel of this Totalitarian State.

If 'the majority of the medical profession' are youngsters then 'the majority' are brainwashed and obedient and know not to question.

Tomsanguish knows of Lecturers in our Universities that are complaining about the fact that there is 'no room for debate anymore'.

Notes to the most part are preformulated and handed out propaganda style.

The majority of the population are being offered degrees but at what cost?

I fear that the great majority of the medical profession are obliovious to the growing menace. That said, there is an outcry from GP land.

I have just read parts of the White Paper and must admit that this is the first time I have looked at it. I have also reread NMC guidelines on revalidation.

When I qualified, it was understood that we would all meet the requirements of PREP (Post Registration Education and Practice).
I average ninety hours of self directed learning per year. I work outside the NHS, so it is up to me to do this independently or through my employer. I do E-learning. Unfortunately, there does not appear to be anything offered on British sites - if there is, I haven't found it. I utilise Medscape to enhance my learning and keep me up to date. I sometimes do CME's on Univadis, just because I can.

I was suprised as to learn when rereading Revalidation on the NMC site that there have been no PREP Audits since 2006 as "there was no evidence to suggest that there was any particular group on the register posed a higher risk and should therefore be targeted for a Prep Audit." I was always led to believe that audits were targeted at nurses randomly, therefore creating a need to comply, just in case the person targeted was you.

Reading the White Paper - who will appraise me now? I work outside the NHS, I am the sole nurse as I work nights and therefore have to make my own decisions when deciding whether medical imput is required. No-one, bar the carers and residents are there to evaluate my practice.

My manager appraises me now and states that he knows that when I am 'on' that "the residents will be safe and well cared for." I give him proof of my learning. But will this now be enough?

Perhaps naively. I do not fear for my future. But who knows? It might be, in the future, that some self-opinionated representative of some government department may decide my fate on how he/she feels on that particular day.

I do fear for you Dr. No as I do all other medics. If you face fits, you will be okay. If not, prepare to meet thy doom. "Resitance is futile. You will assimilate."

Well said Dr No.

I think the powers that be drive most doctors into a false sense of security. I know most doctors who will face problems on revalidation or appraisal will assume their defence union will be dealing with it :). This is the usual excuse given by doctors who fall into the GMC's hands.

Well written, bit too much Nazi Germany as I think the system is more a combination of Stalin's Russia and the Keystone Cops


Revalidation will be like the futile ARCP process that exists post MMC. Those who fill all the forms will pass no matter how useless. Bear in mind that in many training schemes noone, and I mean literally noone, has been thrown off for not being up to scratch. The costs of an unfair dismissal case are too high. So poor trainees cycle through endless retraining until the boxes are ticked, then are let out to practice. I can't see revalidation being any different. Fill the boxes and you will pass, no matter if you are another Dr Shipman, who would pass all these tests with flying colours.

My more senior colleagues will take retirement, some will emigrate, the rest of us will treat the forms as a cursory tickbox mentality. Treat the whole exercise with the contempt it deserves! If a jobs worth doing, it's worth doing well, if a jobs not worth doing...

Glad we are not the only ones seeing the increasing medical Totalitarianism. Appraisal is a pile of sh*te and will not stop any Harold Shipman. It is the equivalant of the "What I did in my summer holiday" essay from school and is a pointless Ground Hog day exercise resulting in the preparation of the annual Personal Retard Plan.

For those of us who engage in a lot of reading as a means of "self directed learning" this is now longer good enough we now have to keep reading lists. The next stage is obvious these lists will be read to check they meet with GMC/DoH approval.

Can't have the comrade doctors thinking any anti revolutionary or not NICE thoughts can we?

Still the appraisers don't mind as they get £500 for 2 hours work as Party enforcers. We get nothing at all out of it. An idea copied from the nursing profession that isn't working there as well. Keep on posting! Rant over.

Dr No appreciates that many struggle with the extreme nature of the Nazi analogy. But what Dr No is getting at is the similarity between the methodologies. It is all about central control of every aspect of an individual’s life – ‘misconduct’ can be anything - and police enforcement of that central control. Nobody can be trusted to be a good citizen/doctor/nurse/etc. All must be regulated, orders obeyed at all times, all forms filled and boxes ticked. Never mind that the country/profession is going to the dogs in the process. Ze State is all zhat matters! Jawohl! Zieg Niall! Zieg Niall!

Ritz - These Keystone Cops have been issued with live ammunition. They can shoot your career dead - just-like-that.

"Revalidation will set one half of the medical profession against the other". Sir David Carter, CMO Scotland.

Part of the game will be to "confess" your "learning needs" at each appraisal so as to provide the prosecutors with sufficient ammunition to convict you. Then, of course, your "case" will be heard at the civil standard and the test of insight will be applied at first instance i.e. if you fight these charges then you are clearly lacking insight - we say so. You will then be sentenced by the Nomenklatura of the Gulag (GMC or NCAS) - which you pay for incidentally.

For individual doctors exercising their professional judgment in the best interests of your patient - then you are at risk of the mendacity of colleagues, managers and patients. You are fodder for the GMC machine that has to incapacitate over 1000 doctors per year to achieve the political target of "proletarianisation of the profession". Rubin will be vilified as the least popular doctor t oset foot in the country but - it will be too late - the health care system will be destroyed.

(Dr No - we prefer Rita's metaphor - it has more scope with respect to the nomenclatura, apparatchiks, Stasi, etc)

Russia, E Germany, Nazi Germany - in fact I normally refere to the GMC as the Stasi, rather than the KGB or Gestapo. Russia and Nazi Germany had 'charismatic' leaders - Stalin and Hitler, E Germany and 'our' Stasi don't. But they are all totalitarian in their methods.

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