In my last article, I talked about why your medical portfolio is much more than a folder full of certificates.

A portfolio should tell the story of your professional development.

So, naturally, the next question is:

What should you actually put in it?

There are plenty of answers to that question.

But there is one part of portfolio work that I think deserves much more attention, particularly for doctors who are new to the UK:

Workplace Based Assessments, or WPBAs.

And if the phrase “WPBA” already makes you want to close this article, stay with me.

They really don’t have to be as complicated as they sound.

What exactly is a WPBA?

A Workplace Based Assessment is essentially a structured way of getting feedback and demonstrating your clinical practice in the workplace.

Depending on your role and training programme, you may come across things such as:

• Case Based Discussions (CBDs)
• Mini-CEX
• Direct Observation of Procedural Skills (DOPS)
• Clinical Evaluation Exercise (CEPS)
• Multisource Feedback (MSF)
• Patient feedback
• Other specialty or programme-specific assessments

The names and exact requirements can vary depending on your training pathway.

But the underlying idea is quite simple:

Someone observes, discusses or reviews part of your work, gives you feedback, and you use that experience to demonstrate learning and development.

That is much less frightening than the acronym makes it sound.

You are probably doing more portfolio work than you realise

One of the things I have always tried to highlight through my #PortfolioWednesday posts is that portfolio evidence doesn’t necessarily require you to do something completely separate from your normal working day.

You are already seeing patients.

You are already making clinical decisions.

You are already discussing cases with colleagues.

You are already performing procedures.

You are already receiving feedback.

You are already learning.

The trick is learning how to capture some of that learning properly.

For example, you might have a consultation with a patient that raises an interesting clinical question.

Rather than simply moving on to the next patient, you could discuss the case with your supervisor and use it as the basis for a ‘Case Based Discussion’.

Or perhaps you perform a procedure that you need evidence for.

Instead of thinking, “I’ll get around to doing a DOPS sometime,” ask yourself:

“Could this procedure today be observed and documented?”

That small change in mindset can make portfolio work much easier.

Don’t wait for the perfect opportunity

This is probably one of my biggest pieces of advice.

Don’t wait for the perfect case.

I have seen doctors put portfolio activities off because they are waiting for something particularly interesting, complex or impressive.

But portfolio evidence isn’t a competition for the most dramatic clinical case.

A straightforward case can generate excellent learning.

A routine procedure can provide useful evidence.

A normal consultation can demonstrate communication skills.

A discussion with a colleague can become a valuable reflection.

Sometimes the most useful evidence comes from ordinary clinical work.

The important thing is being intentional about it.

Use the opportunity while you are at work

Imagine you are working a normal clinical session.

You see a patient who would make a useful case for discussion.

You finish the consultation and think:

“That would make a good CBD.”

Don’t just make a mental note and promise yourself you’ll remember it later.

Speak to your supervisor or colleague.

Ask whether you can discuss the case with them.

Similarly, if you are doing a procedure and someone appropriately experienced is available to observe you, ask whether they can observe and complete the relevant assessment.

You don’t necessarily need to create another huge task for yourself.

Sometimes you simply need to recognise the opportunity when it is already there.

And this is particularly important if you are an IMG

If you are currently working outside the UK and planning to move here, I would strongly encourage you to start thinking about this before you arrive.

You may not use exactly the same terminology or the same portfolio platform in your current healthcare system.

You may also find that the exact requirements are different once you start working in the UK.

But understanding the principles now can make your transition much smoother.

Start getting used to asking yourself:

• What evidence do I have?
• What feedback did I receive?
• What did I learn from this case?
• Can someone observe me doing this?
• Can I document this learning?

You can start developing those habits wherever you are working.

If you are performing procedures overseas, become familiar with the idea of having your skills observed and documented.

If you are teaching, collect feedback.

If you have a challenging case, reflect on it.

If you receive constructive feedback from a colleague, don’t just forget about it.

You are already developing professionally.

The UK portfolio system is simply going to give you a more structured way of demonstrating some of that development.

Don’t think of a WPBA as an exam

This is another important point.

A WPBA is generally about learning and development, not simply proving that you are good enough.

You are not supposed to walk into every assessment terrified that one imperfect answer will expose you as a terrible doctor.

In fact, identifying an area for development can make the assessment more useful.

Imagine a Mini-CEX where you receive feedback that your clinical assessment was thorough, but your explanation to the patient could have been clearer.

That isn’t a failure.

That is useful information.

You now have something specific to work on.

And later, you may be able to demonstrate how you improved.

That is what makes portfolio evidence valuable.

The paperwork is not the point

This is probably the part of portfolio work that I enjoy talking about most.

I have spent a lot of time around portfolios and educational documentation over the years, and one thing I have learned is that it is very easy to become obsessed with completing the form.

But the form is not the learning.

The assessment is not the learning.

The certificate is not the learning.

The reflection is the learning.

The documentation simply gives you a way of capturing it.

So when you complete a CBD, don’t think:

“I’ve got another form to fill in.”

Think:

“I’ve just had an opportunity to discuss my clinical reasoning with another doctor and get feedback.”

That shift in mindset makes a surprisingly big difference.

Build your portfolio as you go

One of the worst times to start thinking about your portfolio is the week before your appraisal, assessment or job application.

That is when you suddenly realise:

• Where is that certificate?
• Who gave me that feedback?
• When did I do that teaching?
• What happened with that audit?
• Which patients could I use for a CBD?

And then comes the inevitable panic search through your emails, WhatsApp messages and various folders on your computer.

I’ve been around portfolios long enough to know that this is not a particularly enjoyable way to do it!

Instead, build your evidence as you go.

It doesn’t need to take hours.

After a useful clinical encounter, spend a few minutes recording what happened.

After teaching, save the feedback.

After completing a WPBA, make sure the evidence is stored where you can actually find it.

After learning something important, reflect on it while it is still fresh.

Small habits make a big difference.

If you are overseas, start learning the language of portfolios now

This is one of the things I wish more doctors knew.

You don’t necessarily need to wait until you arrive in the UK to start understanding portfolio development.

• Learn what a CBD is.
• Understand what a Mini-CEX is.
• Read about DOPS.
• Understand the purpose of MSF.
• Start becoming familiar with reflection and feedback.

You may not be able to complete every UK-specific requirement while overseas, and you should always check the requirements of your particular programme or employer.

But becoming familiar with the language and mindset of portfolio work can remove a lot of uncertainty later.

When you eventually start working in the NHS, you will already understand what people mean when they ask:

“Have you done a CBD?”

That may sound like a small thing.

For someone starting in a completely new healthcare system, it really isn’t.

Your portfolio should tell a story

When I look at a good portfolio, I don’t want to see a random collection of documents.

I want to see a journey.

• A clinical case led to a reflection.
• That reflection identified a learning need.
• The doctor completed some learning.
• They applied it in practice.
• They received feedback.
• Their practice changed.

That is a story.

And that is much more interesting than a folder containing 50 certificates.

So, if you take one thing away from this article, let it be this:

Don’t wait for portfolio opportunities. Start recognising them.

The patient you saw today might become tomorrow’s CBD.

The procedure you are already doing might become your next DOPS.

The feedback you received might become your next reflection.

The teaching session you delivered might become evidence of your development as an educator.

Your everyday work is full of potential portfolio evidence.

You just need to learn how to see it.

And if you are an international medical graduate still working overseas, start learning that mindset now.

It could make your first few months in the UK feel a little less overwhelming.

Because ultimately, your portfolio isn’t about collecting paperwork.

It is about making your professional development visible.

ABOUT THE AUTHOR

Dr Abdel-Rahman Nafie (Dr Abs)

Dr Abdel-Rahman Nafie (Dr Abs) is a UK doctor and medical educator, and the Founder and Course Director of UK: Survive To Thrive, supporting International Medical Graduates as they navigate their careers and lives in the UK.

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This article reflects personal experience and is intended for general educational purposes. Portfolio requirements vary between specialties, roles and training programmes, so doctors should always check the requirements relevant to their own position.