Skip to main content
×
×
Home

The NHS International Fellowship Scheme in Psychiatry: robbing the poor to pay the rich?

  • Murad M. Khan (a1)
Extract

The NHS International Fellowship Scheme was launched in 2003 to recruit doctors from outside the UK to fill the shortage of doctors in the NHS. While the intended and stated primary purpose was to fill the service needs of the NHS, a secondary purpose appeared to be the opportunity the scheme would offer to overseas doctors to work in a ‘unique health care system’ (Goldberg, 2003). Doctors would be appointed at consultant level in the NHS for a maximum period of 2 years.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      The NHS International Fellowship Scheme in Psychiatry: robbing the poor to pay the rich?
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      The NHS International Fellowship Scheme in Psychiatry: robbing the poor to pay the rich?
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      The NHS International Fellowship Scheme in Psychiatry: robbing the poor to pay the rich?
      Available formats
      ×
Copyright
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
Hide All
Goldberg, D. (2003) The NHS International Fellowship Scheme for Consultant Psychiatrists. Newsletter of the Faculty of General and Community Psychiatry, 6 (Spring), 56.
Khan, M. M. (1998) Suicide and attempted suicide in Pakistan. Crisis, 19, 172176.
Mumford, D. B., Minhas, F., Akhter, F., et al (2000) Stress and psychiatric disorder in urban Rawalpindi. British Journal of Psychiatry, 177, 557562.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 7 *
Loading metrics...

Abstract views

Total abstract views: 122 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 19th July 2018. This data will be updated every 24 hours.

The NHS International Fellowship Scheme in Psychiatry: robbing the poor to pay the rich?

  • Murad M. Khan (a1)
Submit a response

eLetters

Of Schemes & Allegations

Hashim Reza, Consultant Psychiatrist, Chairman MAC
08 February 2005

Murad Khan (2004) deserves credit for forcing open a debate which has had echoes in the pages of International Psychiatry as well as in the deliberations of overseas psychiatrists associations in the UK.

The International Fellowship Programme (IFP) has been based on flawed assumptions that doctors working in one part of the world at senior level could be borrowed by NHS for two years for mutual benefit of all parties. While Khan and his respondents adequately highlight the cost being born byIndia and Pakistan’s healthcare systems, the weaknesses that are being created in the UK system have not been given sufficient mention.

After meeting a large number of short-listed candidates, interviewinga few in Advisory Appointments Committee and informal conversations with some appointed through IFP, I am satisfied that hardly any of these well qualified psychiatrists were prepared for the complexities of delivering mental health care through the NHS. They had no idea how the NHS is divided into various tiers, how primary care plays gate keeping role for mental health services and how CMHTs interact with several agencies/service providers in statutory, voluntary and private sectors forthe safe management of individual patients. These doctors, irrespective ofwhat they claim to know about multidisciplinary teams, have previously worked only in medical models of service delivery. They do understand the Mental Health Act. Thus, their appointment as consultant psychiatrists puts them in a leadership role for which they are ill prepared. Once appointed, they are required to learn through their induction programmes what other equally bright and hard working doctors learn about systems and management in the NHS over a few years of higher training.

There is no doubt that rigorous scrutiny of overseas training and qualifications takes place to determine equivalence of qualifications of these International Fellows (Holsgrove 2005). But these decisions do not automatically establish their suitability for the role of consultants in the NHS. Apparently, it had been assumed that the Appointments Committees would adjudicate onthe latter issue which makes this a fudge of momentous proportions.

It does not serve any purpose to bemoan that a wider consultation on merits and demerits of this scheme would have identified these problems readily. Sadly, the College seems to have chosen to stand too close to theDepartment of Health on this issue rather than safeguarding their independent advisory role. The College members therefore find themselves debating an issue riddled with dilemmas of ethical, moral, strategic and operational nature.

It seems appropriate to expect a willingness in the College as well as the DoH to learn from this exercise. I hope that the progress of these International Fellows is being monitored and the resultswill be shared transparently. It will be even more interesting to see how the trends change when PMETB comes into life later this year.

While the politicians will surely go back to their select committees and constituencies to report the magical rise in number of senior doctors working in the NHS, some one ought to advise us how these doctors, their teams, their patients and patients’ carers benefited from this imaginativescheme.

Holsgrove, G. J. (2005) The INterantional Fellowship Programme: some personal thoughts. International Psychiatry, issue 7: p. 8.

Khan, M. M. (2204) The NHS International Fellowship Scheme in Psychiatry: robbing the poor to pay the rick? Psychiatric Bulletin, 28: 435-437.

Thematic Papers: International Recruitment. Bulletin of the Board of International Affairs of the Royal College of Psychiatrists, issue 7, 7 January 2005, pp. 3-9.
... More

Conflict of interest: None Declared

Write a reply

Serious concern

Prabhat K Chand, Senior Resident
20 January 2005

I fully agree with Dr Khan's apprehension regarding the NHS scheme. The condition is very similar in India. In a number of premier institutes there is no faculty left to teach resident psychiatry trainees. Clinical work has increased many fold for those who stay back, speciality clinics are closed and students are searching for thesis guides. Day by day the situation is worsening. I am not against recruitment by the NHS but it should not be at the cost of patient care or teaching, which are in a precarious state in developing countries like India and Pakistan. I sincerly hope that the current "brain robbery" will find a new meaning in the coming year and the NHS will understand the issue in more empathetically. ... More

Conflict of interest: None Declared

Write a reply

NHS International Fellowship Scheme

Tayyeb Tahir, Specialist Registrar
14 December 2004

The NHS International Fellowship Scheme (Khan, 2004) is discriminatory against UK trainees and Non Consultant Career Grade (NCCG) psychiatrists. Those who choose to come to the UK and train for membershipof the Royal College of Psychiatrists should feel aggrieved.

Some of the members of our college have a valuable NCCG experience. Unfortunately, European legislation doesn’t permit any NCCG experience to be counted towards CCST. In contrast many doctors from overseas can get onthe Specialist Register without any UK experience.

Reportedly, these NHS International fellows are experienced psychiatrists with overseas qualifications. Goldberg (2004) mentions of strict selection criteria but what evidence do we have of accreditation oftraining from where NHS International Fellows are recruited? Does their training reflect the standards and strict time limits set for post membership training in the UK? This accreditation seems to be a flexible paper exercise. Also, we must not forget that psychiatric higher training is not about management of mental illnesses alone. Practice and higher specialist training of psychiatry involves understanding of culture, social impact, management, research and last but not least the Mental Health Act. Mental Health Act is unique to the UK and its understanding complex. Many senior psychiatrists from overseas find it difficult to workin a multi-disciplinary team setting.

Our Royal College shouldn’t forget NCCGs, who have filled a gap in NHS psychiatry and have a wealth of experience in the UK. PMETB is likely to bring a change. Our college should pre-empt this and show leadership byforward thinking and acknowledge NCCG experience of their members towards CCST.

Overseas doctors should be welcomed. However, they should undergo a period of intense SpR training in the UK commensurate with their experience. Following this training they should be appointed as consultants. Their appointments should be in open competition against homegrown trainees.

Tayyeb A Tahir, SpR in Psychiatry, Whitchurch Hospital, Cardiff, CF147XB

References: Goldberg D (2004) The NHS International Fellowship Schemein Psychiatry. Psychiatric Bulletin, 28, 433-434.

Khan M M (2004) The NHS International Fellowship Scheme in Psychiatry: robbing the poor to pay the rich? Psychiatric Bulletin, 28, 435-437.
... More

Conflict of interest: None Declared

Write a reply

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *