In 30 years of holding a shotgun license it was never suggested to me to provide a
voluntary doctors letter upon renewal of license every five years.
You only had to provide two photos of yourself one being endorsed by (such as) a school teacher, a doctor
or even another license holder etc. known to you but not a police officer bizarrely.
Now as I said before it is mandatory and will cause a problem to a lot of shooters as it did me last year.
a friend I know has shot all his adult life, holding the relevent license etc, last few years he has had severe depression which then made him panic about getting the green light when his last one expired
he had to have an open and honest conversation with the doctor and then the police officer re his condition and if he has ever had suicidal thoughts etc
end result was that he got the license so it seems there is still some common sense in the system in places and not just a blanket approach
