The government is pushing ahead with what is being dubbed the biggest shake-up in doctor regualation for 150 years.
Every medic will face a five-yearly MOT following concerns doctors could go a whole career without being properly checked.
What happens currently?
Doctors undergo an annual appraisal system, which deals with things such as their prescribing habits, career development and general performance, as well as any personal problems.
However, England's chief medical officer Sir LIam Donaldson has branded the system "patchy" and not fit for practice.
It is thought some trusts are not carrying out the appraisals every year, while there is a lack of consistency about how rigourous they are in places they are done.
In particular, Sir Liam wants to see feedback from patients to play more of a role.
But beyond that doctors effectively face no testing. Critics often cite the example of pilots who can face 100 assessments during their career.
Why is this changing?
The issue of doctor testing has been talked about for years. The General Medical Council first drew up proposals in the late 1990s.
But the debate gathered momentum following the Dr Harold Shipman case.
The inquiry into the murders criticised the regulation of doctors, saying it was not focused enough on patients.
This has led to plans to strip the GMC of many of its powers. But the spotlight on regulation also highlighted the anomaly about doctors not facing testing.
However, the 'MOT system' is not designed to catch another Shipman - he may well have passed tests judging his competency as a doctor.
What is the new system?
There are two strands to what is called the five-year revalidation.
Firstly, there is relicensing which all doctors will undergo and will be based on a strenthened annual appraisal process.
It will be designed to assess the basic competency of a doctor.
But those doctors practising in specialities, such as GPs and hospital consultants, will face another process on top.
This will be called recertification and could involve computer simulation tests.
If doctors fail, they will be forced to under go extra training, more testing and may even be struck off.
Both parts of revalidation will be overseen by what the government is calling a responsible officer. This is likely to be the medical director of the individual NHS trust, who will be supported by a local GMC official.
When will it happen?
It is still very much in the planning process.
Over the next 18 months, various parts of revalidation will be drawn up, consulted on and piloted with full roll out to follow in 2010.
However, Sir Liam warned some parts of it may be ready earlier or later than that and the devolved administrations are yet to decide on their exact timetable.