Fellowship by Assessment (FBA) is an award for the Royal College of General Practitioners’ (RCGP) members who can demonstrate high standards of patient care in their practices. Since 1989 nearly 300 general practitioners (GPs) have been awarded Fellowship, the College’s highest award, by this route. Patient care improves through FBA, in part through a culture of continuing education. FBA is a considerable achievement for GPs but requires great energy. FBA has developed considerably over the past 15 years and is now aligned with Good Medical Practice for General Practice. It has influenced, and in turn has been influenced by: General Medical Council statements on good medical practice, other RCGP awards and programmes, and the new General Medical Services contract.