This site is intended for health professionals only

Total internal reflection

All in all, it was going better than expected. We’d gone through a year’s worth of Continuous Professional Development, touched briefly on significant events (none significant enough to report ) and my appraiser had tried to convince me that the whole process was, in some indefinable way, ‘worthwhile’.

I’d reminded him, gently, that he had volunteered to spend Tuesday morning meeting up and that he was getting paid whereas I certainly had not and was not. We also managed to clear up the confusion about significant events and complaints. When he had said that the Revalidation Police would expect there to be at least one of each in my 2014-15 portfolio he had not intended that to be taken as carte blanche on my part to injure at least one patient and piss another off to the extent that they would put green ballpoint pen to paper.

Taking on board his advice that time spent preparing for my appraisal would actually count toward my appraisal I’d even managed to heave my CPD hours for the year past the recommended half century.

We had so nearly gotten to the vinegar strokes without a fight when he brought up the subject of this year’s personal development plan. ‘I see that you agreed to devote some time to reflection this year. I really can’t see much evidence of it in your submission.’

Putting that into my PDP list had not, I hasten to add, been my idea. It had been suggested by last year’s appraiser, in the way that Chicago mobsters suggested voluntary insurance premiums for local business owners. Agreeing to it got him out of the room as effectively as a completely unnecessary prescription detaches a heartsink’s arse from a chair.

Actually, what had been agreed was that I would actually put something, anything,  into the dozens of text boxes marked ‘reflection on your learning experience’ that would not need to be resubmitted to me for redaction. And I did. I wrote, ‘Please refer to my general comments about on-line learning, seminars and in house educational activities in the section marked ‘Pre Appraisal’’. And I cut and pasted that into every text box that would not close without some content being entered.

He went on, ‘What I think your appraiser had intended was that you should reflect upon the educational benefits of reflection per se, rather than simply make disparaging remarks about the quality of the questions your colleagues ask at medical meetings.’

‘So in essence, you’re asking me to reflect on reflection?’  ‘Exactly.’  ‘In the same way that you said that appraising my appraisal counted toward my appraisal. And next year you’ll be asking me to reflect upon my reflections on reflection as well as appraising my reflections on this appraisal?’ This one could run and run.

I offered him a ninety second up-sum of the articles and blog pieces I’ve written over the years on the subject. I wondered whether he was familiar with the oozlum bird, the mythical creature featured in ‘Carry On Up The Jungle’ that flew around in ever decreasing circles before vanishing up its own backside. He seemed unimpressed.

So picture me sitting at my keyboard with a plate glass mirror on either side. An infinite number of Copperfields stretching out to an infinite vanishing point. At least one of them will, in theory, eventually knock out Shakespeare’s ‘Complete Works’. However, rest assured, none will ever get around to reflecting upon reflection.

Apart from this, of course. A copy is already in my 2015 appraisal folder.


Dr Tony Copperfield is a GP in Essex. You can email him at and follow him on Twitter @DocCopperfield.