International Induction Programme (IIP) and Return to Practice (RtP) GP Appraisal

The key requirements for all doctors to maintain a medical license to practise are defined by the General Medical Council (GMC) in

It is essential for all doctors wishing to maintain a GMC license to practise to engage in the annual appraisal process and use defined processes as laid out in the NHS Revalidation Support Team Medical Appraisal Guide (RST, London, Sept 2014) (MAG) and mirrored in the Medical Appraisal Guide Model Appraisal Form (MAGMAF)

All doctors licensed by the GMC are required to undertake an annual appraisal within the appraisal year, which runs from the 1st April to 31st March. Once GPs have registered for the programme and are included on the England Medical Performers List (MPL) their designated body will be the local NHS England and Improvement team.

  • For processes in Wales, Northern Ireland and Scotland please see their websites.

GPs who successfully apply to the International Induction Programme (IIP) or Return to Practice Programme (RtP) through the Portfolio Route or who have completed the MCQ, will usually be on the MPL with a probationary flag (PF) relating to satisfactory completion of the IIP/RtP programme. During their time on the programme, doctors returning to medical practice by this route will be expected to gather appropriate supporting information to form a portfolio for appraisal and revalidation. In the short one-month placements, this process and the amount of evidence that can be collected will of course be very limited, so doctors are advised to plan and start as soon as possible.

Successful completion of the IIP/RtP placement will allow the doctor to apply to be on the MPL without the PF and therefore work as an independent practitioner without the requirement of supervision. At this point, they become new entrants onto the MPL and eligible for an annual appraisal provided or commissioned by their local NHSE/I team, in exactly the same way as a GP moving from another area and transferring between teams.

IIP/RtP GPs should plan to have their first appraisal between 3 to 6 months after successfully completing the programme and gaining full inclusion on the MPL. Most IIP/RtP programmes are for short periods of 2-3 months but on occasion may be for 6 months.

If the programme is longer than 6 months (part time programme), the IIP/RtP GP should still seek advice from the local NHSE/I team on timing and arrangements for their NHS Appraisal. They may be required to undertake an Appraisal within 9-12 months of the start of a placement on the IIP/RtP programme, even if they have not completed the programme.

Only in exceptional circumstances, and with the prior agreement of the NHS England Medical Director (Responsible Officer) for the appropriate area, should the appraisal be delayed beyond six months after completion of the programme, or twelve months after the start of a part time programme. Most doctors find that an early appraisal is a useful opportunity to focus on the year ahead and produce a new Personal Development Plan (PDP).

The month in which the first appraisal falls will often become the future annual appraisal month though this may vary across the different NHSE/I areas.
In brief, the supporting information for appraisal and revalidation should include:

  • Any summary of discussion or PDP produced as a result of the IIP/RtP programme training, with reflection on progress with the PDP objectives
  • A Continuing Professional Development (CPD) log of evidence of learning (which can include CPD during the IIP/RtP programme) – needed annually with reflection on lessons learned and changes made. Supporting information about CPD should be proportionate to the time that the portfolio has been gathered, although it is appropriate to put in additional information relating to the whole 12 months before the first appraisal if available
  • Reflection on quality improvement activities that review how you put your knowledge and skills into practice is needed annually to demonstrate that you are a reflective practitioner - as evidence of ability to investigate and reflect on what you actually do, make changes according to best practice, and review what you do after the changes have been made
  • Reflection on any significant events involving you personally, that meet the GMC threshold for a significant event or critical incident, where serious harm could have, or did, come to a patient (or patients) - with evidence that the event(s) have been discussed with peers and about any changes introduced to try to prevent similar occurrences – this is needed whenever such an event occurs (or a statement that there has not been a Significant Event needs to be signed)
  • Reflection on any multisource feedback (MSF) and patient satisfaction survey (PSQ) undertaken as part of the IIP/RtP placement report – fully GMC compliant colleague and patient feedback surveys are essential once in every revalidation cycle, and it is best practice to ensure that those you undertake on your IIP/RtP placement are fully GMC compliant
  • Reflection on your lessons learned and any changes made in response to any formal complaints about you – required whenever a formal complaint occurs (or a statement that there has not been a complaint needs to be signed)
  • Reflection on the GMC Good Medical Practice requirements about health to enable you to sign a statement about health -– required annually
  • Reflection on the GMC Good Medical Practice requirements about probity to enable you to sign a statement about probity – required annually

Using this list as checklist will ensure that you don’t go far wrong, but reviewing the appropriate websites to check the latest RCGP and GMC guidelines is strongly recommended.

The information gathered during the IIP/RtP programme should be submitted as part of the evidence for the annual appraisal, as should any other supporting information that has been collected during the 12 months prior to the appraisal discussion.


Your educational supervisor on the IIP/RtP programme will be a good resource to help point you in the right direction, and your local appraisal team will also be able to help.

Some useful web sites

Page last reviewed: 14 July 2022
Next review due: 14 July 2023