Quiet man sets sights on leading a revolution

Interview - Newly installed GMC chairman Professor Peter Rubin speaks exclusively to Prisca Middlemiss.

It is hard to imagine more turbulent times for the GMC than the start of revalidation.

So it is interesting that council members have elected to chair them a man described by retired member and Bolton GP Dr Krishna Korlipara as 'nice enough but not visible and not a spontaneous communicator'.

Professor Peter Rubin, 60, took over from Professor Sir Graeme Catto last month. When his four-year term ends in December 2012 he will have presided over the 'biggest change to medical regulation since we were established in 1858'.

Put simply, there is no going back. So how will this quiet, nice and unassuming man sell revalidation to thousands of sceptical and unwilling doctors?

How will he alter the view that the GMC is an arm of government and boost its popularity from what Dr Korlipara describes as 'an all-time low'?

He may be an academic - professor of therapeutics at Nottingham University - but he is also a physician. He runs a weekly hypertension clinic at Nottingham's Queen's Medical Centre and before his GMC job was on call for its acute medicine rota.

So he will personally undergo revalidation, as will all 12 doctors now on the GMC, and all its fitness-to-practise panellists, Professional and Linguistics Assessment Board examiners and education assessors.

Professor Rubin has been undergoing appraisal for 20 years at the university. He has had a 360-degree appraisal. He wrote to The Times last week, in response to a threat to quit by Wiltshire GP Dr Henry Tegner, that the GMC is working with the NHS and royal colleges to limit bureaucracy.

'Where there are local systems in place, revalidation will be a small step from what is happening now,' he says.

As a working doctor, Professor Rubin knows about stress. In 1988 he was the subject of a complaint. It took five years for the patient to accept that there was no case to answer.

None of this is more than symbolically relevant to his new job.

He won because he has built a reputation in six years on the GMC's education committee and three years at the Postgraduate Medical Education and Training Board as a highly effective chairman who has fostered major policy changes, including the shift from process to competencies at medical school.

He has overseen radical change. As dean of the Nottingham medical school he led development of the UK's first graduate entry medical school.

Like RCGP chairman Professor Steve Field, he is the first person in his family to go to university (his father was an illegal off-course bookmaker).

Though he is entirely happy with lay parity on the council, he knows it matters that he is a doctor. 'We have to take the profession with us on a huge change.'

He counters the charge that the GMC is out of touch with ordinary doctors, pointing to similar fears in 1858 and again when the NHS began in 1948.

Winning doctors over
From September, Professor Rubin will be out and about monthly telling doctors about revalidation and hearing their concerns. 'For the vast majority of doctors who are keeping themselves up-to-date, revalidation will be a very straightforward process,' he says.

A recent survey found one GP in five could leave rather than revalidate (GP, 29 May). But Professor Rubin thinks this is unlikely. 'Once we have explained that we are not interested in introducing a cumbersome, bureaucratic process, I think we will begin to win over doctors who have concerns.'

Revalidation is led by the GMC but is a collaboration. 'This is the first time in the history of the GMC that to fulfil a statutory duty we are dependent on others - the NHS and royal colleges.'

Yet Professor Rubin is clear about whose head will roll if revalidation, like the Medical Training Application Service, goes horribly wrong.

'The GMC is responsible for revalidation. I chair the GMC.'


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