All doctors in the UK could face annual assessments under proposals from the chief medical officer.
Doctors face rigorous annual tests
The government says it wants to root out underperforming GPs, hospital consultants and private practitioners.
Doctors will also have to reapply for their licence every five years.
BBC News website readers have been sending in their views on this story.
Here are some comments from people in the medical profession:
I personally think it is a fantastic idea which should have come quite a few years ago. I am fine because for me the patients are a partner. I know surgeries in Grays where patients have to wait for days and hours to see a doctor if they are lucky, otherwise they have to contend with practice managers who have done a few days course.
Dr Anjan Bose, Essex
I'm a (semi) retired GP. We in general practice have been having annual appraisals for the last five years - and have known for at least that long that re-validation/re-licensing would come in time. Today's announcement is hardly news to us! Running the system out for hospital doctors and private practitioners has always been planned - so why the 'brouhaha' over this latest report? All of us are in favour of keeping standards as high as possible, after all.
Dr Catherine Marshall, Dronfield, UK
Now all practising doctors have to undergo annual appraisal. This should be enough to satisfy the Chief Medical Officer, and the public at large, as to how each doctor and their individual practice are performing and where they stand in the league table. Therefore, there is no need for further assessment. More bureaucracy for doctors translates into less time for patients.
Dr S Dasgupta, London
I'm a hospital consultant. Since qualifying in '94, I regularly take part in clinical audit. I have sat countless exams (I have 20 letters after my name), and have a formal yearly appraisal. I attend meeting after meeting looking at our service and how to better it. I attend more than two international meetings a year. I read at least four journals regularly (weekly). I work more than six or seven hours a week free for the NHS. I take part in countless clinical trials - and the list goes on. Most consultants do this. Do we need more? Who pays?
Medic in practice, London
I'm completely happy with the concept of annual assessment and revalidation - it's been happening for years! I've been a qualified doctor for 12 years. I've had to go through many rigorous, formal assessment of the type Sir Liam proposes. It is worth noting the current hospital trainee doctors today have even more assessments than I did. Furthermore, much of this (mandatory) training must be paid for by the doctor themselves, typically a cost of thousands of pounds. I object to the remarks made by Clare Rayner. The idea that doctors just collect a medical degree, put up a plate and carry on regardless is ridiculous and offensive.
Dr Simon Watson,