off record
Shaukat Ali Jawaid

Degrees and boastful
chain of letters


Prof. Alaf Khan and Prof. Lala Rukh is a lovely couple from Peshawar. Both retired as Professor of Medicine and Prof. of Obstetrics & Gynaecology respectively and went on Leave Preparatory to Retirement (LPR) a year before retirement so that younger people could get chance of promotion rather than sticking to their jobs and even running after those in the power corridors seeking extension which is the case in Pakistan quite often. It is only a few who prefer and retire gracefully after playing their innings and thus earn lot of respect not only in the medical profession but also the society at large.

I was immensely impressed with a young handsome lady talking about ethical medical practice at a conference of obstetricians and gynecologists held at Peshawar in the early 70s. In her presentation she dealt at length how the obstetricians and gynecologists were themselves responsible for maternal deaths by not following the aseptic conditions in the operation theatre and following the Standard Operating Procedure for ethical medical practice. That was my first introduction with the young lady who is Prof. Lala Rukh. Later I also met Prof. Alaf Khan and he too was very keen and always talked about ethical medical practice. Another unique quality in this couple was that they were not at all infected with materialistic virus and soon I became their family friend. Over the years I have had numerous meetings with them, enjoyed their hospitality in Peshawar and learnt a lot from Prof. Alaf Khan. He was even very kind to write Foreword for one of my book but also made very useful corrections after going through the manuscript very minutely. After retirement they have gone to United States where their children who are all doctors live but do visit Pakistan from time to time. Prof. Alaf Khan always remains in touch. Being a keen reader he often points out my mistakes of English language in the publications I edit and thus constantly keeps coaching me for which I am extremely grateful. I wish everyone should have such friends and well-wishers.

 Recently he has sent me a communication regarding “Degrees and boastful chain of letters” which makes an interesting reading. People in the developing Third world countries are very fond of adding all sort of letters, English alphabets after their name to befool patients and members of the society who are ignorant about the real value of these letterings. With his permission I have decided to use it in this column to show the mirror to many in the healthcare profession hoping that some of them will learn some lesson.

“Many doctors, like the public at large, are not aware of the difference between a Register able Professional Qualification and a job description.  Assistant Professor, Associate Professor, Professor, Consultant, Director, CEO, Chairperson etc. are career designations, not qualifications.  You may lawfully prefix such a title to your name as long as you are holding that post.  These titles end with your retirement, the expiry of your contract or getting kicked out.  It is unethical and unlawful to continue to call oneself Professor after retirement.  A university or other recognized institution may grant a person special privilege to continue using the title Professor Emeritus for life.  All others cease to be Professors the day they retire, quit the job on their own accord or get sacked.  They, incidentally, also lose the authority of being a Gazetted Officer for the purpose of attesting any document under Pakistani law.   Many Indo-Pakistani doctors decorate themselves with triple barrel guns such as Dr. This man Shah, MBBS, MRCP, FRCP,   or Dr. Good lady Afridi, MBBS, MRCOG, FRCOG.   The Membership bits (MRCP and MRCOG) should go away once one is elected a Fellow.   You can’t be a Fellow without having been a Member of an institution any more than being M. A. without having done B. A.  before it.  My own letterhead, while in service till 03 March 1996, read as follows:

Professor of Medicine
G.P.O.  Box 363
Peshawar Cantt.                                                                                     
Postgraduate Medical Institute                                                     
Lady Reading Hospital, Peshawar.

I practiced privately for a short period after my retirement, using the following new particulars on my letterhead:

Alaf Khan, MBChB DCH FRCP,
Dabgari Gardens
Peshawar Cantt.

An amusing aspect of British medicine is the years of hard work as a student to change oneself from Mr to Dr. and then several more years of even harder work in order to become plain Mr once again. This aspiration is fulfilled when one passes one’s FRCS (now MRCS) examination and becomes a qualified surgeon. It is probably harking back to the olden days when surgeons and barbers formed one fraternity as Master Barbers.   Mr W. Fraser does sound more dignified than Master Barber William Fraser.

A scholar of global repute served as Pakistan’s High Commissioner in London for a relatively short period long ago. He is still being addressed by the western media as Ambassador ASA with his apparent approval.  This appendage has no legal or ethical basis.  He should be content with Dr. ASA which he is.”

As a matter of fact all those who use all sort of these alphabets after their name suffer from some sort of inferiority complex. Like the drum which makes lot of noise even with a small touch is hollow from within, these persons have the same characteristics and by adding all sort of register able and even non-register able qualifications, dubious alphabets, they try to impress others posing as highly qualified person with so many degrees some of which are definitely dubious. I have seen letterheads of some doctors with half the page filled with all sort of associations or societies of which they are members. Similar is the case when people who belong to this group make a presentation, in the first slide they have their introduction and mention all sort of their associations, present and past etc., just to impress the audience. Little do they realize they cannot insult the intelligence of everyone present and many among the audience start laughing at that but the presenter will keep on talking something which may or may not make any sense for a few minutes to ensure that everybody has read the slide fully. You go to any function and the artists who cannot perform well always requests the audience to clap. However, if the performance is good, no one has to make such a request and every one present appreciates such artists spontaneously. Similarly if the presentation is good, the speaker makes the presentation interesting,  all those present will enjoy that and this will earn lot of respect to the speaker. Good speakers who have mastered the art of making presentation and also have good contents and a message to convey, get recognized and also earn appreciation. They do not have to indulge in such dramas.

Tail Piece: With the twin elements of Knowledge and Courage, all things are possible.