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Consultant recruitment from India: the best-fit model?

  • Vinesh Gupta (a1) and Nitin Gupta (a2)
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Brockington, I. & Mumford, D. B. (2002) Recruitment into psychiatry. British Journal of Psychiatry, 180, 307312.
Das, M., Gupta, N. & Dutta, K. (2003) Psychiatric training in India. Psychiatric Bulletin, 26, 7072.
Department of Health (2000) The NHS Plan: A Plan for Investment, a Plan for Reform. London: Stationery Office. http://www.dh.gov.uk/assetRoot/04/05/57/83/04055783.pdf
Department of Health (2002) International Recruitment of Consultants and General Practitioners for the NHS in England: Current Initiatives and Guidance to NHS Employers on an Infrastructure to Support International Recruitment. London: Department of Health. http://www.dh.gov.uk/assetRoot/04/06/71/45/04067145.pdf
Goldberg, D. (2004) The NHS International Fellowship Scheme in Psychiatry. Psychiatric Bulletin, 28, 433434.
Holsgrove, D. (2005) The International Fellowship Programme: some personal thoughts. International Psychiatry, 2, 79.
Jenkins, C. (2004) Ethical international recruitment. International Psychiatry, 1, 1819.
Kapur, N., Cooper, J., Rodway, C., et al (2005) Predicting the risk of repetition after self-harm: cohort study. BMJ, 330, 394395.
Khan, M. M. (2004) The NHS International Fellowship Scheme in Psychiatry: robbing the poor to pay the rich? Psychiatric Bulletin, 28, 435437.
Ndetei, D., Karim, S. & Mubbashar, M. (2004) Recruitment of consultant psychiatrists from low- and middle-income countries. International Psychiatry, 1, 1518.
Patel, V. (2003) Recruiting doctors from poor countries; the great brain robbery? BMJ, 327, 928.
Rathod, S., Roy, L., Ramsay, M., et al (2000) A survey of stress in psychiatrists working in the Wessex Region. Psychiatric Bulletin, 24, 133136.
Srinivasmurthy, R. (2000) Community mental health in India. In Mental Health in India 1950–2000; Essays in Honour of Professor N. N. Wig (ed. Murthy, R. S.), pp.150156. Bangalore: People's Action for Mental Health.
Verma, S. K. (2000) Clinical psychology in India from 1950–2000. In Mental Health in India 1950–2000; Essays in Honour of Professor N. N. Wig (ed. Murthy, R. S.), pp. 200208. Bangalore: People's Action for Mental Health.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
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Consultant recruitment from India: the best-fit model?

  • Vinesh Gupta (a1) and Nitin Gupta (a2)
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eLetters

we should not forget history, otherwise we will make the same mistake again and again

PREM K SRIVASTAV, CONSULTANT PSYCHIATRIST
29 March 2006



Conflict of interest: Came to UK on NHS International Fellowship Scheme in October 2003, Applied for College Membership in late 2004, received a consultation document few weeks back.

I have not read most of the published articles on this issue. My purpose of writing this is that those who do not know the background and history of NHS International Fellowship Programme should not comment on the Membership issue for the International Fellows.

When we were told by the Advisor on behalf of Department of Health, UK propagating this idea in our country, almost all of us refused to beleive him and questioned his authenticity. He quoted rules after rules from STA, GMC and the RCPsychiatry to convince us that he was a knowledgeable and genuine representative of UK Government and that the rules had been changed to provide us equality in international recruitment and status once we pass the litmus test of being recommended by the College and accepted by the STA. We were told that once registered with STA on the Specialist register we would be eligible to be registered with GMC as a specialist and if we pass IELTS with band 7 in all four Academic Modules we will be fully registered with GMC without passing PLAB as was prerequisite for other Overseas doctors and our basic medical as well as specialist competency will be treated at par with those having trained themselves in UK.

Not only this he went beyond this and promised us on behalf of the College that all those who will be able to secure a Consultant Post through AAC where a College representative will be present will be awarded MRCPsychitry without exam since we would have proved our full worth of working as independent Consultant by this rigorous process. We were told that AAC is the benchmark and the most difficult and the fairest process of selection still in practice in UK and no one can influence its recommendation.

Therfore all of us who have undergone through this process and have not been awarded MRCPsychiatry by now, on one pretext or another, wonder whether we were right in the first place not to believe the representative from UK?

Any comments!
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Conflict of interest: None Declared

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Consultant recruitment from India -Ground Realities

RAJESH JACOB, Consultant Psychiatrist
02 March 2006

I read with interest the article by Vinesh and Nitin Gupta about consultant recruitment.There are additional points I need to raise.Firstly most of the jobs filled up by overseas consultants,have been jobs which have been vacant for a long period of time and managed by series of locums.Most of the overseas consultants are faced with a much larger catchment population compared to the average catchment poulation of other psychiatrsits. There have been areas where the catchment population have been more than 60000.Secondly, during the week long visit which was sponsored by the department of health to the UK, before the interviews, candidates were taken on whistle stop tours of different Trusts which had vacancies. I visited 4 different trusts in 4 days in different parts of the country.We spent more time on the road than at the hospitals andtalking to colleagues.During the time spent at some Trusts, we were not given adequate information about the job itself, the catchment population or opportunitiesto speak to the concerned community mental health teams.In one Trust visit, we were shown the hospital where we were supposed to work from a distance and spent the rest of the time in a hotel, where we were given general information about the Trust rather than the jobs itself. It seemed as if looking retrospectively, there was a considerable amount of secrecy and unwillingness to give more information about the jobs advertised. Personally, on the day I joined the Trust,I had to do 2 Mental Health Review Tribubal reports for patients I had not even seen and had to submitit within a week. I had no prior training in writing reports for Mental Health Review Tribunals or even going for any of them. I had to attend 3 MHRTs as the RMO in the first month of my job. I also had to go a mental health assessment of a patient in the community within 1 week of joining the Trust, in the capacity of RMO.In my Trust the first Section 12 course was 4 months after I joined but inthe interim period I had done atleast 8 reports for Tribunals and managershearings as well as attended them in the capacity of being the RMO. In one way it was a good learning expierence but very stressful during theperiod. During the 6 months of the job,I had done atleast 25 Tribubnal or managers reports well as attended atleast 90% of them. I was not involved in drawing up the job plan, but was asked to follow the same responsibilities of the previous locum.

I resigned from that job after 6 months and left the fellowship scheme and have joined another Trust where the experience had been much better probably due to the knowledge and the experience I had gained in the first job as well as the good induction programme and also an oppurtunity to work with the previous locum consultant for 2 weeks before taking over full responsibility.

There are many overseas consultant psychiatrists recruited internationally who have either left the fellowship scheme prematurely, or gone back home, mainly due to the above difficulties.

So to sumarise, in addition the the issues raised in the above article, internationally recruited psychiatrists need to be given more practical information about the jobs they are going to take over, make surethe jobs have reasonable catchment populations, give opportunities for themto work alongside the previous consultant in the same job for at least 2 weeks, provide a comprehensive induction programme, provide information and prebook candidates on section 12 courses as well as give more practical training in mental health legislation in the first few weeks of the job, rather than expect them to take over full responsibilies of the role straight away.We cannot expect British trained psychiatrists to become fully functionalconsultants in another country in which they have not trained, unless theyreceive the above mentioned inputs.

Dr Rajesh JacobConsultant PsychiatristKettering Community Mental Health TeamClarendon House8-12 Station RoadKetteringNN15 7HHPhone 01536 313802Fax 01536 313804

Declaration of interest None
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Conflict of interest: None Declared

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