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  • Become a psychiatrist

    Become a psychiatrist

    • Choose Psychiatry

      Choose Psychiatry

      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • What next?
      • On a break from training?
      • Choose Psychiatry 2021 video
      • Continuing to choose psychiatry
      • Hear more from the stars of our 2022 film
      • Choose Psychiatry – Guidance for Medical Schools
      • Choose Psychiatry research 2023
    • Sixth formers and school students
    • Medical students

      Medical students

      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National Student Psychiatry Conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
      • The Student Psychiatry Audit and Research Collaborative (SPARC)
    • Foundation doctors

      Foundation doctors

      • Foundation doctor associates
      • Making the most of your psychiatry placement
      • Opportunities for foundation doctors
      • FuturePsych - the associate magazine
    • Help us promote psychiatry

      Help us promote psychiatry

      • How can I help?
      • Ideas to inspire you
      • Resources to help you promote psychiatry
      • RCPsych Recruitment Strategy 2022-2027
    • Supporting Medical Students: Medical Schools
    • Careers past events
    • Choose Psychiatry
      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • What next?
      • On a break from training?
      • Choose Psychiatry 2021 video
      • Continuing to choose psychiatry
      • Hear more from the stars of our 2022 film
      • Choose Psychiatry – Guidance for Medical Schools
      • Choose Psychiatry research 2023
    • Sixth formers and school students
    • Medical students
      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National Student Psychiatry Conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
      • The Student Psychiatry Audit and Research Collaborative (SPARC)
    • Foundation doctors
      • Foundation doctor associates
      • Making the most of your psychiatry placement
      • Opportunities for foundation doctors
      • FuturePsych - the associate magazine
    • Help us promote psychiatry
      • How can I help?
      • Ideas to inspire you
      • Resources to help you promote psychiatry
      • RCPsych Recruitment Strategy 2022-2027
    • Supporting Medical Students: Medical Schools
    • Careers past events
  • Training

    Training

    • Exams

      Exams

      • Can I take an exam?
      • Contact the Exams team
      • Preparing for exams
      • Applying for your exam
      • Exam results
      • Special notices
      • Exam FAQs
      • A fair exam
      • Examiners and exam panels recruitment
      • FAQs about applying for exams
      • FAQs about preparing for exams
      • FAQs about the day of the exam
      • FAQs about assessment and results
      • Exams news and updates
    • Curricula and guidance

      Curricula and guidance

      • 2022 Curricula Implementation Hub
      • 2014 GMC approved curricula (ending July 2024)
      • Specialty guides
      • Dual Training
      • Assessment Strategy Review
    • Portfolio Online
    • Your training

      Your training

      • Psychiatric Trainees' Committee: supporting you
      • Time out of training
      • Training resources
      • Run-through training
      • Prizes and bursaries for trainees
      • Training less than full time
      • Routes to Registration
      • Cost of Training
      • Leadership and Management Fellow Scheme
      • Understanding Career Choices in Psychiatry
      • Industrial action FAQs
      • Distribution of medical training posts
    • Medical training initiative (MTI)
    • International Medical Graduates
    • Deanery/LETB Hub
    • Undergraduate education forum
    • Quality Assurance in Training
    • Credentialing
    • CPD eLearning
    • Dean's updates

      Dean's updates

      • Dean's update - 2022
      • Dean's update - March 2023
      • Dean's update - June 2023
    • Neuroscience in training

      Neuroscience in training

      • About the project
      • Neuroscience resources
      • Multimedia learning
    • Building Capacity in Perinatal Psychiatry

      Building Capacity in Perinatal Psychiatry

      • Perinatal 2023 Masterclass Programme application and process details
      • About the Building Capacity Project
    • Exams
      • Can I take an exam?
      • Contact the Exams team
      • Preparing for exams
      • Applying for your exam
      • Exam results
      • Special notices
      • Exam FAQs
      • A fair exam
      • Examiners and exam panels recruitment
      • FAQs about applying for exams
      • FAQs about preparing for exams
      • FAQs about the day of the exam
      • FAQs about assessment and results
      • Exams news and updates
    • Curricula and guidance
      • 2022 Curricula Implementation Hub
      • 2014 GMC approved curricula (ending July 2024)
      • Specialty guides
      • Dual Training
      • Assessment Strategy Review
    • Portfolio Online
    • Your training
      • Psychiatric Trainees' Committee: supporting you
      • Time out of training
      • Training resources
      • Run-through training
      • Prizes and bursaries for trainees
      • Training less than full time
      • Routes to Registration
      • Cost of Training
      • Leadership and Management Fellow Scheme
      • Understanding Career Choices in Psychiatry
      • Industrial action FAQs
      • Distribution of medical training posts
    • Medical training initiative (MTI)
    • International Medical Graduates
    • Deanery/LETB Hub
    • Undergraduate education forum
    • Quality Assurance in Training
    • Credentialing
    • CPD eLearning
    • Dean's updates
      • Dean's update - 2022
      • Dean's update - March 2023
      • Dean's update - June 2023
    • Neuroscience in training
      • About the project
      • Neuroscience resources
      • Multimedia learning
    • Building Capacity in Perinatal Psychiatry
      • Perinatal 2023 Masterclass Programme application and process details
      • About the Building Capacity Project
  • Members

    Members

    • Membership

      Membership

      • Members login
      • Receipts
      • Pay Your Subscription
      • Direct Debit
      • Your subscription
      • Grades of membership
      • Benefits of membership
      • Fellowship and other Honours
      • Applying for Fellowship
      • Nominations for Honorary Fellows
      • Nominations for National Honours
    • Submitting your CPD
    • Workforce Wellbeing Hub

      Workforce Wellbeing Hub

      • Psychiatrists' Support Service
      • How the College supports workforce wellbeing
      • Top 10 tips for wellbeing
      • Mentoring and coaching
      • If a patient dies by suicide
      • If a patient commits homicide
    • Supporting your professional development

      Supporting your professional development

      • New consultants (StartWell)
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • Writing clinic letters
      • If a patient dies by suicide
    • CPD eLearning
    • Your Faculties

      Your Faculties

      • Academic psychiatry
      • Addictions psychiatry
      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic psychiatry
      • General adult psychiatry
      • Intellectual disability psychiatry
      • Liaison psychiatry
      • Medical psychotherapy
      • Neuropsychiatry
      • Old age psychiatry
      • Perinatal psychiatry
      • Rehabilitation and social psychiatry
      • Faculty job descriptions
    • Specialty and Specialist Doctors

      Specialty and Specialist Doctors

      • A message from the Chair
      • Who are SAS Doctors?
      • How to enter the SAS grade
      • SAS career development
      • SAS doctors resources
      • College SAS training and events
      • Startwell and Staywell
      • SAS Strategy
    • Devolved Nations

      Devolved Nations

      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg y Seiciatryddion
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions

      English Divisions

      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • South West
      • Trent
      • West Midlands
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members
    • Special Interest Groups

      Special Interest Groups

      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Digital psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice
      • Rainbow SIG
      • Spirituality and Psychiatry 
      • Sport and exercise psychiatry (SEPSIG)
      • Transcultural psychiatry
      • Volunteering and international (VIPSIG)
      • Women and mental health
      • Annual SIG Newsletters
    • Public members list
    • RCPsych Insight magazine

      RCPsych Insight magazine

      • RCPsych Insight Cover Art Exhibition
    • Publications and books
    • Members' eNewsletters
    • Posts for members
    • Jobs board
    • Committees of Council
    • President's lectures

      President's lectures

      • Declaration of competing interests (President's lectures)
      • List of president's lectures competing interests
      • Past President's lectures
    • Retired members
    • eLearning Hub
    • Obituaries

      Obituaries

      • Submit an obituary
      • Remembering Dame Fiona Caldicott
      • Memorial service for Professor Andrew Sims
    • Mindmasters quiz

      Mindmasters quiz

      • Attend Mindmasters 2023
      • Who won in 2022?
      • The rules of the quiz
      • Sample quiz questions 
    • RCPsych ceremonies

      RCPsych ceremonies

      • New Members Ceremonies
      • Fellowship ceremonies
      • Specialist Registration Ceremonies
    • 2021 membership survey
    • Membership
      • Members login
      • Receipts
      • Pay Your Subscription
      • Direct Debit
      • Your subscription
      • Grades of membership
      • Benefits of membership
      • Fellowship and other Honours
      • Applying for Fellowship
      • Nominations for Honorary Fellows
      • Nominations for National Honours
    • Submitting your CPD
    • Workforce Wellbeing Hub
      • Psychiatrists' Support Service
      • How the College supports workforce wellbeing
      • Top 10 tips for wellbeing
      • Mentoring and coaching
      • If a patient dies by suicide
      • If a patient commits homicide
    • Supporting your professional development
      • New consultants (StartWell)
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • Writing clinic letters
      • If a patient dies by suicide
    • CPD eLearning
    • Your Faculties
      • Academic psychiatry
      • Addictions psychiatry
      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic psychiatry
      • General adult psychiatry
      • Intellectual disability psychiatry
      • Liaison psychiatry
      • Medical psychotherapy
      • Neuropsychiatry
      • Old age psychiatry
      • Perinatal psychiatry
      • Rehabilitation and social psychiatry
      • Faculty job descriptions
    • Specialty and Specialist Doctors
      • A message from the Chair
      • Who are SAS Doctors?
      • How to enter the SAS grade
      • SAS career development
      • SAS doctors resources
      • College SAS training and events
      • Startwell and Staywell
      • SAS Strategy
    • Devolved Nations
      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg y Seiciatryddion
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions
      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • South West
      • Trent
      • West Midlands
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members
    • Special Interest Groups
      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Digital psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice
      • Rainbow SIG
      • Spirituality and Psychiatry 
      • Sport and exercise psychiatry (SEPSIG)
      • Transcultural psychiatry
      • Volunteering and international (VIPSIG)
      • Women and mental health
      • Annual SIG Newsletters
    • Public members list
    • RCPsych Insight magazine
      • RCPsych Insight Cover Art Exhibition
    • Publications and books
    • Members' eNewsletters
    • Posts for members
    • Jobs board
    • Committees of Council
    • President's lectures
      • Declaration of competing interests (President's lectures)
      • List of president's lectures competing interests
      • Past President's lectures
    • Retired members
    • eLearning Hub
    • Obituaries
      • Submit an obituary
      • Remembering Dame Fiona Caldicott
      • Memorial service for Professor Andrew Sims
    • Mindmasters quiz
      • Attend Mindmasters 2023
      • Who won in 2022?
      • The rules of the quiz
      • Sample quiz questions 
    • RCPsych ceremonies
      • New Members Ceremonies
      • Fellowship ceremonies
      • Specialist Registration Ceremonies
    • 2021 membership survey
  • Events

    Events

    • Conferences and training events

      Conferences and training events

      • Register your interest - CESR in Psychiatry Training
      • MHA Section 12 and Approved Clinician Training
      • Register your interest - Present State Examination Course 2022
      • Subscribe to receive the Events eNews
      • Register your interest - ICD-11 events
      • RCPsych Certification Courses
      • Grand Rounds
    • International Congress 2023

      International Congress 2023

      • Register your interest - Congress 2023 exhibitors
      • Travel and accommodation guidance 
      • Registration
      • Congress 2023 FAQs
      • Poster Presentations 2023
      • Programme
      • Social Media
      • Exhibition opportunities 2023
      • Your guide to Congress
      • Social and Fringe Events
      • Congress 23 Webinar Package
    • International Congress 2024
    • In-house training

      In-house training

      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Events held by other organisations
    • Free webinars

      Free webinars

      • Free webinars for members
    • Recruitment events
    • Claiming expenses
    • Terms and conditions
    • Speaker guidance for online events
    • Conferences and training events
      • Register your interest - CESR in Psychiatry Training
      • MHA Section 12 and Approved Clinician Training
      • Register your interest - Present State Examination Course 2022
      • Subscribe to receive the Events eNews
      • Register your interest - ICD-11 events
      • RCPsych Certification Courses
      • Grand Rounds
    • International Congress 2023
      • Register your interest - Congress 2023 exhibitors
      • Travel and accommodation guidance 
      • Registration
      • Congress 2023 FAQs
      • Poster Presentations 2023
      • Programme
      • Social Media
      • Exhibition opportunities 2023
      • Your guide to Congress
      • Social and Fringe Events
      • Congress 23 Webinar Package
    • International Congress 2024
    • In-house training
      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Events held by other organisations
    • Free webinars
      • Free webinars for members
    • Recruitment events
    • Claiming expenses
    • Terms and conditions
    • Speaker guidance for online events
  • Improving care

    Improving care

    • College Centre for Quality Improvement (CCQI)

      College Centre for Quality Improvement (CCQI)

      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
      • CCQI news
    • Campaigning for better mental health policy

      Campaigning for better mental health policy

      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • Cross-government mental health and wellbeing plan 
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position Statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • Reforming The Mental Health Act
      • Don't overlook mental health campaign
      • The Mental Health Policy Group (MHPG)
    • Planning the psychiatric workforce

      Planning the psychiatric workforce

      • About workforce
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
      • Job description approval process
    • Public Mental Health Implementation Centre

      Public Mental Health Implementation Centre

      • Our partners and first partnership activity 
      • How to work with the Public Mental Health Implementation Centre
      • Who's involved in the Public Mental Health Implementation Centre?
      • Aims and objectives
      • Reports
      • About public mental health
      • PMHIC Parliamentary Launch 
    • National Collaborating Centre for Mental Health

      National Collaborating Centre for Mental Health

      • About NCCMH and our work
      • Clinical guideline development
      • Competence frameworks
      • Quality improvement programmes
      • Reports and research
      • Service design and development
      • Work with us
    • Physician Associates

      Physician Associates

      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
      • The Competence Framework for Physician Associates in Mental Health
    • Act Against Racism

      Act Against Racism

      • Tackling racism in the workplace
      • Adopt the guidance and join our network
      • Act Against Racism: a toolkit to support the campaign
      • If you're experiencing racism at work
      • Allies: information and signposting
      • FAQs about the campaign
      • Act Against Racism campaign films
    • Sustainability and mental health

      Sustainability and mental health

      • Why is sustainability important?
      • In your community
      • In your practice
      • In your trust
      • Sustainability at RCPsych
      • Nature matters
      • Sustainability scholars
      • Sustainability resources
      • College position on sustainability
      • RCPsych at COP26
      • The eco-crisis and CAMHS
    • Invited Review Service
    • Public Health and its role in mental heath
    • RCPsych Course Accreditation
    • Using quality improvement
    • Net Zero Mental Health Care Research, Resources and Education
    • Mental Health Awareness Week
    • College Centre for Quality Improvement (CCQI)
      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
      • CCQI news
    • Campaigning for better mental health policy
      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • Cross-government mental health and wellbeing plan 
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position Statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • Reforming The Mental Health Act
      • Don't overlook mental health campaign
      • The Mental Health Policy Group (MHPG)
    • Planning the psychiatric workforce
      • About workforce
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
      • Job description approval process
    • Public Mental Health Implementation Centre
      • Our partners and first partnership activity 
      • How to work with the Public Mental Health Implementation Centre
      • Who's involved in the Public Mental Health Implementation Centre?
      • Aims and objectives
      • Reports
      • About public mental health
      • PMHIC Parliamentary Launch 
    • National Collaborating Centre for Mental Health
      • About NCCMH and our work
      • Clinical guideline development
      • Competence frameworks
      • Quality improvement programmes
      • Reports and research
      • Service design and development
      • Work with us
    • Physician Associates
      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
      • The Competence Framework for Physician Associates in Mental Health
    • Act Against Racism
      • Tackling racism in the workplace
      • Adopt the guidance and join our network
      • Act Against Racism: a toolkit to support the campaign
      • If you're experiencing racism at work
      • Allies: information and signposting
      • FAQs about the campaign
      • Act Against Racism campaign films
    • Sustainability and mental health
      • Why is sustainability important?
      • In your community
      • In your practice
      • In your trust
      • Sustainability at RCPsych
      • Nature matters
      • Sustainability scholars
      • Sustainability resources
      • College position on sustainability
      • RCPsych at COP26
      • The eco-crisis and CAMHS
    • Invited Review Service
    • Public Health and its role in mental heath
    • RCPsych Course Accreditation
    • Using quality improvement
    • Net Zero Mental Health Care Research, Resources and Education
    • Mental Health Awareness Week
  • Mental health

    Mental health

    • Mental illnesses and mental health problems

      Mental illnesses and mental health problems

      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety and generalised anxiety disorder (GAD)
      • Avoidant/restrictive food intake disorder (ARFID)
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Catatonia
      • Club drugs
      • Cocaine dependence
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Depression
      • Depression in older adults
      • Feeling overwhelmed
      • Gambling disorder
      • Heroin dependence
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Memory problems and dementia
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Perinatal OCD for carers
      • Personality disorder
      • Physical illness and mental health
      • Postnatal depression
      • Postnatal depression key facts
      • Postnatal depression: information for carers
      • Postpartum psychosis
      • Postpartum Psychosis in Carers
      • Post-traumatic stress disorder (PTSD) 
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self-harm
      • Shyness and social phobia
      • Sleeping well
    • Support, care and treatment

      Support, care and treatment

      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Antipsychotics in pregnancy
      • Being sectioned
      • Benefits, financial support and debt advice
      • Benzodiazepines
      • Caring for someone with a mental illness
      • Children's social services and safeguarding
      • Cognitive behavioural therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Guide to mental health tribunals
      • Hypnosis and hypnotherapy
      • Liaison psychiatry services
      • Lithium in pregnancy and breastfeeding
      • Mental capacity and the law
      • Mental health in pregnancy
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Mother and baby units (MBUs)
      • Neuromodulation
      • Perinatal mental health services: what are they?
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Social prescribing
      • Spirituality and mental health
      • Stopping antidepressants
      • Valproate in women and girls who could get pregnant
      • What to expect of your psychiatrist in the UK
      • COVID-19: for patients and carers
      • Veterans' mental health
    • Young people's mental health

      Young people's mental health

      • Bipolar disorder for young people
      • Cannabis and mental health: for young people
      • Club drugs
      • Cognitive behavioural therapy (CBT) for young people
      • Coping with stress for young people
      • Depression in children and young people
      • Drugs and alcohol for young people
      • Eco distress: for young people
      • Physical activity, exercise and mental health for young people
      • OCD for young people
      • Psychosis in young people
      • Schizophrenia: for young people
      • When a parent has a mental illness
      • When bad things happen
      • Who is who in CAMHS?: for parents, teachers, young people and carers
      • Anxiety: for young people
      • Weight, exercise and eating disorders in young people
      • Preparing for a blood test or vaccine for young people
      • Use of digital media for young people
    • Translations

      Translations

      • Arabic عربى
      • Bengali বাঙালি
      • Chinese 中文
      • French Français
      • German Deutsch
      • Greek Ελληνική
      • Gujurati ગુજરાતી
      • Hindi हिंदीहिंदी
      • Italian Italiano
      • Japanese 日本語
      • Kurdish Kurdî
      • Lithuanian Lietuvių kalba
      • Pashto پښتو
      • Persian (Farsi) فارسی
      • Polish Polski
      • Portuguese (Brazil) Português (Brasil)
      • Punjabi ਪੰਜਾਬੀ
      • Romanian Română
      • Russian Pусский
      • Sindhi سنڌي
      • Somali
      • Spanish Español
      • Swahili Kiswahili
      • Tamil தமிழ்
      • Turkish
      • Ukrainian украї́нська
      • Urdu اردو
      • Welsh Cymraeg
    • Order mental health resources

      Order mental health resources

      • Order mental health packs for schools
    • About our mental health information
    • Mental health information disclaimer
    • Mental health and psychiatry FAQs
    • Mental illnesses and mental health problems
      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety and generalised anxiety disorder (GAD)
      • Avoidant/restrictive food intake disorder (ARFID)
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Catatonia
      • Club drugs
      • Cocaine dependence
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Depression
      • Depression in older adults
      • Feeling overwhelmed
      • Gambling disorder
      • Heroin dependence
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Memory problems and dementia
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Perinatal OCD for carers
      • Personality disorder
      • Physical illness and mental health
      • Postnatal depression
      • Postnatal depression key facts
      • Postnatal depression: information for carers
      • Postpartum psychosis
      • Postpartum Psychosis in Carers
      • Post-traumatic stress disorder (PTSD) 
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self-harm
      • Shyness and social phobia
      • Sleeping well
    • Support, care and treatment
      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Antipsychotics in pregnancy
      • Being sectioned
      • Benefits, financial support and debt advice
      • Benzodiazepines
      • Caring for someone with a mental illness
      • Children's social services and safeguarding
      • Cognitive behavioural therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Guide to mental health tribunals
      • Hypnosis and hypnotherapy
      • Liaison psychiatry services
      • Lithium in pregnancy and breastfeeding
      • Mental capacity and the law
      • Mental health in pregnancy
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Mother and baby units (MBUs)
      • Neuromodulation
      • Perinatal mental health services: what are they?
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Social prescribing
      • Spirituality and mental health
      • Stopping antidepressants
      • Valproate in women and girls who could get pregnant
      • What to expect of your psychiatrist in the UK
      • COVID-19: for patients and carers
      • Veterans' mental health
    • Young people's mental health
      • Bipolar disorder for young people
      • Cannabis and mental health: for young people
      • Club drugs
      • Cognitive behavioural therapy (CBT) for young people
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South Asian History Month: Dr Raghunandan Gaind

Equality, Diversity and Inclusion blog, South Asian History Month

30 July, 2020

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Dr Raghunandan Gaind, Past-President and current Vice-President of the Indian Medical Association GB, and Patron of the Amritsar Doctors and Dentists Association, writes for South Asian History Month.

In February 2016, there were 273,853 doctors registered with the General Medical Council (GMC), of which 25,038 are of Indian origin, with 5,622 working in psychiatry. This is a remarkable figure given that ethnic minorities constitute only 8% of the population of the UK.

The NHS has seen substantial expansion since its inception in 1947. During the 1950s and 60s, it recruited large numbers of doctors from India with a further influx following the publication of the NHS plan1 by the Department of Health in 2000. The inclusion of Indian doctors in such large numbers is understandable given the historical relationship between the UK and India. The development of modern medicine in India owes much to British rule and the Indian Medical Service (IMS). The racism and challenges Indian doctors have endured here, despite being so crucial to the system, is in itself a poignant story.

A momentous decision

Lord Macaulay’s2 momentous decision to introduce English into the Indian school system was followed with a vigour never seen before or since for any language. He was a leading Parliamentarian and one of the commissioners of the Board of Control representing the Crown in its relations with the East India Company. Having accepted Membership of the Supreme Council of India, he arrived in Madras, in 1834 returning in 1838. A studious and learned man, his days at the Board of Control helped him to learn much about India – its religions, caste system, missionary work in the country and much more.

By the start of the First World War, a few score Indian doctors were working in the UK, mostly in industrial towns and poor neighbourhoods of London. Their number increased to 3,000 by the end of the Second World War. The period after 1947 saw a great influx. Many came to the UK to undergo training in varied specialities under Commonwealth and other scholarships and often were self-financing.

By the 1960s the number had increased to 15,000. They contributed to the backbone of the NHS. They had arrived full of hope and ambition to work in Medicine and Surgery in teaching hospitals and other Centres of Excellence. Soon they found the employment available to them was in “Cinderella” specialities. In certain areas up to three quarters of GPs and Junior Doctors came from India.

Professor Aneez Esmail3 wrote a seminal article on Asian doctors in the NHS. He observed that the pattern of medical education and training in India was geared towards “meeting the needs of the GMC and IMS”. He wrote, “The failure to produce a coherent medical policy and the absence of public health medicine and health facilities in rural areas meant that Indian doctors were quite suitable for working in England but probably totally irrelevant for working to the benefit of the vast majority of the Indian population... it was the South Asian doctors who have provided a service to these communities. I believe that without them the NHS would have collapsed”.

In 1961, Lord Taylor of Harlow stated in Parliament4 “the Health Service would have collapsed if it had not been for the enormous influx of Junior Doctors from such countries as India and Pakistan … they are here to provide pairs of hands in the rottenest, worst hospitals in the country because there is nobody else to do it”.

Racism and prejudice

An upsurge of racism surfaced within the profession. Enoch Powell5 as Health Minister had encouraged the recruitment of Indian doctors. However, in his speech “Rivers of Blood” he reflected the general prejudice that prevailed at the time about immigrants. Interestingly, when he appealed for help to staff his massively expanded health service nearly 50 years ago, about 18,000 Indian doctors answered his call.

In 1978, Prime Minister Margaret Thatcher expressed similar sentiments “this country is being swamped by people of different cultures.” Comments were published that the standard of overseas qualified doctors was poor. A survey carried out at the time indicated that 17% of overseas qualified doctors had problems communicating with their patients and professional colleagues. In the 1970s, advertisements would be published stating “Only British Graduates need apply for the vacant post”. Following the Race Relations Act., 1976 such overt racism ceased.

In 1927, four Indian doctors established the Indian Medical Practitioners Association later renamed Indian Medical Association (Great Britain).

Historically, Indian medicine owes much to the British Raj, but equally Britain’s National Health Service is today beholden to the Indian physicians who represent such a significant proportion of its staff. Mutual esteem has been established.

With the introduction of TRAB, PLAB and what followed, an era has ended. Immigrant doctors are now obliged to submit themselves to a test of clinical knowledge as well as fluency in English. Following two centuries of close co-operation between medical men and women in the two countries, Britain’s GMC has withdrawn its recognition of Indian Medical Qualifications and the Indian Government has reciprocated. It is possible that fewer Indian doctors may now come to this country and the history of mutually profitable working relationships may decline. It would be sad indeed if this were so.

The majority of Indian doctors came to acquire skills and return. However, from the outset it was obvious that the experience and training available to them would be very restricted. They remained at junior level and very few of them went on to become Consultants.

‘Racism in Medicine’ a report by Kings Fund, edited by Naaz Coker6, Race & Diversity Director, observed that “no aspect of a doctors working life is untouched by racism… discrimination begins in medical school and affects the whole career…” The Ethnic minority doctors are similarly discriminated in the allocation of Distinction Awards / Clinical Excellence Awards A Report by David Smith published in 1987 found that one third of the doctors arriving in the UK during the 1970s achieved their goal and returned home, but the majority did not. Some had married local women settling here but most became indentured workers of the NHS

The saviour of the pariah

The so-called problems of communication with overseas qualified doctors was a red herring. Once the immigrant doctor had worked in the UK for more than three years, the problem disappeared. The racism experienced by Indian doctors was at variance with the needs of the Health Service, which remained dependent on them. Were they, as Professor Esmail commented “the saviour or the pariah“

The work of the Professional Conduct Committee (PCC), shows that ethnic minority doctors are six times more likely to be investigated, twelve times more likely to be charged with sexual misdemeanour and thirty times more likely to be charged with improper demand for fees. Dame Janet Smith7 observed in her Report “thus in the three studies conducted over a period of nine years, the PSI (Policy Studies Institute) found unexplained differences in the treatment … of overseas qualifiers dealing with them more severely. This may, or may not, prove that there is a racial bias ...”

The NHS is described by most in this country as a unique British institution providing a meaningful and effective service to all citizens. The contribution of overseas qualified doctors is significant and sadly overlooked. Feeling treated as pariahs they were dissatisfied, stigmatised and demoralised.

Meanwhile in the context of the continued dependence of the NHS on the injection of carers from India, progress has been made. As talk continues of a further influx to meet the current unmet needs of the NHS, this new intake will hopefully not experience the same trials and tribulations of their predecessors.

Dr Raghunandan Gaind MB FRCP FRCPsych. DPM Lon
Vice-President Indian Medical Association GB
Patron Amritsar Doctors and Dentists Association
Past President Indian Medical Association GB 1972-79

References

  1. Department of Health: The NHS Plan: a plan for investment, a plan for reform, London: The Stationery Office; 2000
  2. Language in India: Volume 3: 4 April 2003: Lord Macaulay The Man Who Started It All, And His Minute. Editor M.S. Thirumalai Ph.D.
  3. Aneez Esmail PhD MRCGP MFPHM, Professor of General Practice
  4. Br J Gen Pract 2007 October 1,57(543) 827-834
  5. Taylor DJ, Esmail A, Retrospective analysis of census data on general practitioners who qualified in South Asia; who will replace them as they retire? BMJ. 1999-318(7179) 306-310
  6. Powell E “Like the Romans, I see the River Tiber foaming with much blood” 1968: Apr 20 The Telegraph
  7. Racism in Medicine An agenda for Change. Edited by Naaz Coker. King’s Fund Publishing. 2001
  8. Smith J Fifth Report. Safeguarding patients’ lessons from the past – proposals for the future, London. The Stationery Office 2004 cm6394
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RCPsych Digital Team

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