I fully understand, sympathise with and appreciate Dr Khan's cri de coeur regarding the award of MRCPsych without examination. There are two streams to this award. The first is to consultants of ‘international eminence’ who are practising overseas, and no more than eight can be awarded in a year, which is the group to which Dr Khan refers. The second is to those who have been recruited through international fellowship and global recruitment and seduced by the promises of MRCPsych by people who have/had no power to make such promises. To this end on several occasions I have been challenged vociferously by both sides. In the last year the Court of Electors became gravely concerned about this route and asked a small group to come up with recommendations to amend these bye-laws.

The decision to award MRCPsych without examination to consultants practising in the UK was approved at the College Annual General Meeting in Birmingham in 1999. Any such system will be open to abuse. We have received reports of Membership being awarded and the awardees migrating to other countries on this basis, and of applicants being sacked within a few weeks of their applications for Membership. Some applicants have acknowledged privately that they want MRCPsych so that they can continue to practise in this country if their current contracts are not renewed. This College is the only Royal College which has tried to be inclusive and in the process has ended up upsetting a large number of its members and fellows.

I totally agree with Dr Khan's view that a basic psychiatric qualification is a must and we have introduced that. I also agree that the eminence of some sponsors is questionable, but the College relies on its members and fellows to uphold the standards and the status of the College on the basis of their probity and loyalty. The members form the College and have the responsibility for ensuring that the privilege is not abused. The College cannot act on the basis of rumour but only on the basis of fact. All applications are scrutinised seriously and thoroughly by various committees.

My personal view is that those who have failed either part of the MRCPsych should never be given the award, irrespective of their eminence - be it national or international. My personal view is also that the College must produce strict but transparent guidelines and criteria; we are working towards these at a number of levels. The award of honorary MRCPsych suggests an elevated status and the College is looking at other forms of recognition. I cannot comment on individual cases and certainly not on decisions taken historically, but I can assure Dr Khan and other readers that I am serious in my desire to uphold the standards of training and assessment and to this end several new initiatives are being developed and discussed within the College. However, the College must be in a position to continue to recognise and reward eminence and achievements of senior psychiatrists nationally and internationally and relies on the integrity of its members and fellows to do just that.