Gadit’s comment that `local psychiatrists in Pakistan should get
united, refrain from petty politics, display tolerance, develop national
spirit and wage crusade against mental illness’ is interesting. There is
no doubt there is a serious crisis of integrity within medicine in
Pakistan in general and in Pakistani psychiatry in particular. The reasons
are many and varied but one of the most important is the lack of integrity
in the practitioners of the speciality. Take for example the question of
higher qualification. Some senior psychiatrists in Pakistan do not have
proper, exam- based qualifications. Instead many hold honorary degrees and
diplomas and have used them to establish themselves in academic positions-
both in Pakistan and abroad. For e.g. every year the Royal College of
Psychiatrists, UK grants a number of Memberships (the MRCPsych) without
examination to psychiatrists from all over the world who ‘have practiced
with distinction over many years and are of international repute’ (Khan,
2006). In practise however, all one needs are two referees from the
College. A number of Pakistani psychiatrists have been beneficiaries of
this largesse. The College does not require them to write ‘Honorary’ after
their names, so there is no way anyone can tell whether the qualification
is an honorary one or exam based.
Similarly, a number of Pakistani psychiatrists write FRCP after their
names, trying to give the impression this is Fellowship of Royal College
of Physicians, UK, (which one gets elected to after obtaining the exam-
earned MRCP). In fact the FRCP Pakistani psychiatrists write after their
names is awarded by the Royal College of Surgeons, Ireland and is not exam
-based.
Many psychiatrists in Pakistan have too close a relationship with the
pharmaceutical industry, which is only too happy to oblige. Taking
psychiatrists on drug launches in exotic locations, funding various
personal functions, giving expensive gifts and sponsoring psychiatrists
for conferences abroad are some examples of buying psychiatrists’ favors.
With no regulation to restrain drug companies from bribing physicians or
prohibiting physicians from accepting inducements, the issue has reached
epidemic proportions as companies vie with each other to get a share of
the US$1.5 billion Pakistani pharmaceutical market (Khan, 2006).
All this erodes public confidence in a speciality fighting for
acceptability both within the medical profession as well as general
population.
The local ‘spirit’ will only develop when senior psychiatrists stop
pretensions about themselves and become true role models for the coming
generations of psychiatrists. Until this is done we will remain part of
the problem rather than its solution.
References
Khan, M. M. (2006) Murky waters: pharmaceutical industry and
psychiatrists in developing countries. Psychiatric Bulletin, 30, 1-4.
Khan, M. M. (2006) Through the back door: the College and award to
Membership without examination (MWE). Psychiatric Bulletin, 30, 3-5.
Rapid Response:
Part of the problem, not the solution!
Gadit’s comment that `local psychiatrists in Pakistan should get
united, refrain from petty politics, display tolerance, develop national
spirit and wage crusade against mental illness’ is interesting. There is
no doubt there is a serious crisis of integrity within medicine in
Pakistan in general and in Pakistani psychiatry in particular. The reasons
are many and varied but one of the most important is the lack of integrity
in the practitioners of the speciality. Take for example the question of
higher qualification. Some senior psychiatrists in Pakistan do not have
proper, exam- based qualifications. Instead many hold honorary degrees and
diplomas and have used them to establish themselves in academic positions-
both in Pakistan and abroad. For e.g. every year the Royal College of
Psychiatrists, UK grants a number of Memberships (the MRCPsych) without
examination to psychiatrists from all over the world who ‘have practiced
with distinction over many years and are of international repute’ (Khan,
2006). In practise however, all one needs are two referees from the
College. A number of Pakistani psychiatrists have been beneficiaries of
this largesse. The College does not require them to write ‘Honorary’ after
their names, so there is no way anyone can tell whether the qualification
is an honorary one or exam based.
Similarly, a number of Pakistani psychiatrists write FRCP after their
names, trying to give the impression this is Fellowship of Royal College
of Physicians, UK, (which one gets elected to after obtaining the exam-
earned MRCP). In fact the FRCP Pakistani psychiatrists write after their
names is awarded by the Royal College of Surgeons, Ireland and is not exam
-based.
Many psychiatrists in Pakistan have too close a relationship with the
pharmaceutical industry, which is only too happy to oblige. Taking
psychiatrists on drug launches in exotic locations, funding various
personal functions, giving expensive gifts and sponsoring psychiatrists
for conferences abroad are some examples of buying psychiatrists’ favors.
With no regulation to restrain drug companies from bribing physicians or
prohibiting physicians from accepting inducements, the issue has reached
epidemic proportions as companies vie with each other to get a share of
the US$1.5 billion Pakistani pharmaceutical market (Khan, 2006).
All this erodes public confidence in a speciality fighting for
acceptability both within the medical profession as well as general
population.
The local ‘spirit’ will only develop when senior psychiatrists stop
pretensions about themselves and become true role models for the coming
generations of psychiatrists. Until this is done we will remain part of
the problem rather than its solution.
References
Khan, M. M. (2006) Murky waters: pharmaceutical industry and
psychiatrists in developing countries. Psychiatric Bulletin, 30, 1-4.
Khan, M. M. (2006) Through the back door: the College and award to
Membership without examination (MWE). Psychiatric Bulletin, 30, 3-5.
Competing interests:
None declared
Competing interests: No competing interests