Royal College of Physicians London urged to start holding MRCP Clinical Exam for PACES in Pakistan


Dr. Faraz Mir Associate Director South Asia RCP London
meets senior Fellows, Members in Pakistan

Royal College of Physicians London urged to start
holding MRCP Clinical Exam for PACES in Pakistan

Senior Fellows also call for holding Workshops and Training
programmes to enhance their professional expertise

RCP London Regional Conference being planned at
Lahore during 2015 - Prof. Akbar Chaudhry

From our special correspondent

LAHORE: Dr. Faraz Mir Associate Director for South Asia from Royal College of Physicians London recently visited Pakistan and met senior Members and Fellows at Lahore, Rawalpindi & Islamabad to discuss matters of mutual interest and further enhance collaboration and cooperation between the RCP Members and Fellows in Pakistan and the Royal College of Physicians London. Prof. M. Akbar Chaudhry Regional Advisor for Royal College for Physicians London in Pakistan organized a meeting at Lahore on October 9th which was very well attended by senior Fellows and Members.

Briefing the visiting guest from RCP London Prof. M. Akbar Chaudhry said that after lot of struggle MRCP Examination started in Lahore in 2007 and since then to date two thousand one hundred eleven candidates has appeared in MRCP Part-I and One thousand one hundred thirty eight in MRCP-II examination. Clinical Examination in PACES was supposed to start in 2009 which could not commence for various reasons which have come as a great disappointment for the candidates appearing in MRCP Exam. Our students have to travel to UK, Singapore, Abu Dhabi or India with lot of incontinence as well as financial loss.


Prof. M. Akbar Chaudhry Regional Advisor of RCP London presenting a mementoe
to Dr. Faraz Mir Associate Director South Asia RCP London during a meeting
with the Fellows and Members at Lahore on October 9th 2014.

Yet another disappointment for us in Pakistan has been regarding Educators Courses. Despite the fact that these courses were advertised and many Members as well as Fellows got registered for the course to be organized at University of Health Sciences Lahore by the RCP, it did not materialize. Higher Education Commission, Prof. Akbar Chaudhry stated had also sanctioned special grant of Rs. 3.5 Million for this course. A large number of e mails were exchanged with the College but the RCP showed its reluctance which was a great disappointment for all the Fellows and Members. MRCP Revision Course was planned which was sponsored by the HEC. The College demanded the course fee which was fairly high for a low income country. However, the Higher Education Commission of Pakistan had promised maximum financial assistance but RCP was reluctant to organize this course due to law and order situation.

International Advisors, Prof. Akbar Chaudhry further stated are very important link between the College and its Fellows, Members overseas. They act as focal persons for the College in their respective countries and represent the College at all appropriate level. They promote the RCP viewpoint, policies in the medical profession in general and to the Fellows, Members in particular. He urged the RCP to reciprocate this and support the Advisors in their academic plans and activities. RCP should subsidize the academic activities, courses, workshops for low income countries and should not charge development expenditures. MRCP Part-II Clinical (PACES) has been delayed for too long. He suggested that it must be started in Pakistan without any further delay to help the candidates appearing from Pakistan.


Photograph on right shows Dr. Faraz Mir Associate Director South Asia RCP London along with
Prof. M. Akbar Chaudhry Regional Advisor of RCP in Pakistan addressing the Fellows and Members
of RCP at Lahore on October 9th 2014 while on left is a view of the meeting in progress.

In his presentation which was entitled “ Strengthening the Linkages” and the Role of International Advisors in Collaboration with the College in its overseas activities Prof. Akbar Chaudhry said that the RCP London and other Royal Colleges from UK have very close linkages with many countries of the world in the field of postgraduate medical education. However, these linkages started becoming weaker and weaker during the last few years due to various reasons and now there are almost no opportunities for the International Medial Graduates to get jobs and training in UK. International office at RCP London is playing an important role through its international advisors and associate directors to build the bridges between the Fellows and Members of the College all over the world. At present almost 20% of Fellows and Members live overseas and there are thirty seven International Advisors in thirty seven countries. RCP London was persuaded to hold South Asian Regional Conference by International Advisors from India and Pakistan during the meeting held in 2004. These conferences were co-hosted by Kerala Postgraduate Institute in India and Fatima Jinnah Medical College in Pakistan. In Pakistan it was organized from March 7th to 9th during 2006 and was a great success. The Government of Pakistan extended its full support for this academic activity which was attended by higher government officials. Prof. Perveen Kumar and Ms. Mary Armitage had specially come for this conference and made tremendous contribution to the scientific programme. He also referred to the visit of Prof. Neil Dewhurst who visited Pakistan for the formal launch of MRCP Examination in Pakistan. Prof. Akbar Chaudhry also disclosed that the Superior Group of Colleges, Superior University administration has also promised to give a financial grant of rupees thirty lacs for organizing the Regional Conference in Pakistan and we are hopeful to generate some more funds as well, he remarked.

Dr. Faraz Mir said that he agreed with everything which has been said by Prof. M. Akbar Chaudhry. For the past few years Pakistan has been cut off from the international community and during the coming few months we can change and reverse this trend. We can start moving forward from where it was left few years ago and do our best to invigorate this relationship. I fully agree with holding Clinical Exam for PACES as well as the Regional Conference in Pakistan. It will benefit not only trainees, senior trainers as well. What you have achieved so far is indeed commendable, he remarked.

During the interactive discussion which followed the relationship between the Royal College of Physicians London and College of Physicians & Surgeons Pakistan also came under discussion. It was pointed out that in the past there has been some reciprocal arrangements. There was understanding on certain issues but since both are also competitors and there exists a conflict of interest, some problems do arise. However, it was emphasized that there is a need to have some collaboration between the RCP London and CPSP. Dr. Faraz Mir said that holding of PACES Exam is possible at two places, Karachi and Lahore. Failure to hold this exam is not a good reflection on the part of RCP as well. It was also pointed out that if PACES was not started in Pakistan soon, then there is a possibility that the number of candidates appearing in MRCP Exam will reduce. One of the participants suggested that RCP should facilitate the Candidates who wish to appear in PACES Exam in UK as regards their Visa. Dr. Faraz Mir said that the postgraduates from Sri Lanka have to spend one year overseas as a part of their training. Hence, once they have completed two years training in Sri Lanka, appeared in Part-II Exam and PACES, they get two yeas Visa. They then get paid jobs at Registrar level. Some of them are sponsored by the Government of Sri Lanka but after completing their two years training they have to return to Sri Lanka to ensure that there is Brain Drain. Once they are back in their country, they can again apply for fresh Visa if they so desire. Sri Lanka is far ahead of Pakistan because the candidates are paid and sponsored by their Government. It was also emphasized that some exposure of UK medicine was extremely important for all the candidates. Students should know how the history is taken and how to conduct the physical exam. Overseas candidates do face some difficulties due to cultural differences. Another participant felt that medical education training in UK is different. Experience and exposure is one thing but from examination point of view, holding the PACES exam in Lahore will be much easy for the candidates appearing from Pakistan.

Appraisal and revalidation of trainers also came under discussion. Dr. Faraz Mir said that appraisal by the local International Advisor for local Fellows is being discussed but it will be difficult to get revalidation if you have not worked in UK. Prof. Kh. Saadiq Husain said that Prof. Amir Ghafoor from Peshawar who is also an examiner for MRCP had informed him that no one from Pakistan could pass the exam in UK despite the fact that they had passed their FCPS-II. The reasons were that it is the method of examination, language, culture, disease pattern, hospital environment which are different. If these Pakistani doctors had some exposure in UK, they would do it much better. The nature of diseases and the way the examinations is conducted is very different in Pakistan. If the candidates can even watch the examination of patients being conducted and the manner of exam, they will do much better even if they are just observers.

Prof. Saeed Khokhar said that we should enlist what are the problems with holding the PACES exam in Pakistan? Are they logistic, financial or social and then efforts should be made to solve them one by one. Hence, it is important to first list these problems and then solve them. Dr.Faraz Mir said that his job was to convey the feelings and views of Fellows and Members in Pakistan to the RCP London and he will do it. We will have to train some local Fellows and some people can come from UK for this PACES exam. Prof.Akbar Chaudhry said that last time when the RCP team visited various institutions, they had selected Shaukat Khanum Cancer Memorial Hospital as first choice and Shaikh Zayed Hospital as the second chicer for holding this clinical exam. Prof. Nasir opined that if PACES is not started soon in Pakistan, then the number of candidates appearing in MRCP exam might drop in the days to come. It was also suggested that RCP should organize some educational workshops and training courses in Pakistan for Fellows and Members. Prof. Nadeem Hayat Malik said that we treat MRCP and CPSP at par but the pay of those who have done MRCP is much higher overseas as compared to those who have done FCPS. Problem is with logistics otherwise more and more doctors will be interested in getting MRCP degree. Dr. Faraz Mir said that in Singapore they have made some arrangements and the candidates appear in their MD as well as MRCP Exam at the same time the same day and those who qualify get both the degrees. Prof. Saeed Khokhar complained that in the past RCP gave Hony. Fellowship to some in Pakistan which was not liked by the Fellows who got it after examination and our views on this issue must be conveyed to the RCP London.

Prof. Javed Akram suggested that the RCP should have collaboration with other Universities and postgraduate medical institutions in Pakistan as well who are interested. We must strengthen our linkages and RCP should have some role in training programmes as well. Prof. Saulat Siddique also emphasized on having some workshops and training programmes besides train the trainers programme in Pakistan. We must start it early as we have already wasted quite a few years, he remarked.

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