To practise as a GP in the UK you must be registered with the General Medical Council (GMC), hold a licence to practise, and have the necessary professional indemnity insurance. This in itself is a complex process, as both those undertaking training in the UK or coming to work from elsewhere will know! Retaining a licence to practise requires a 5-year cycle of annual appraisal and formal revalidation; this was put in place to attempt to ensure professional competence over a working lifetime, though also aims to be supportive, developmental, and to uplift quality. However, this cycle requires active clinical service, with opportunities to undertake patient and colleague feedback, quality improvement work, and a full scope of general practice.

For doctors who are completing less than 40 sessions in general practice over 12 months, special low volume of clinical work guidance is available,1 and any GP who takes a break from clinical work will need to retain enough activity to fulfil revalidation requirements, unless they are prepared to give up their licence.

In reality, there are many reasons why GPs would consider this; a few examples include working outside the UK for a prolonged period, taking a break due to ill health or the need to care for dependants, or when approaching the stage of retirement from practice. The advantage of giving up a licence is primarily financial — full GMC registration plus medical insurance is costly when income is not coming in. For those who intend to return to UK general practice at some point, consideration needs to be given to …