Professional Documents
Culture Documents
Dear Friends, It has been a busy year as the Chair of BIPA. We have made significant progress on many issues
that we had identified as key challenges. Broadly, I had identified 4 key areas in my inaugural message
“Fairness and Responsibility” 1) trainees issues including poor pass rates in MRCPsych exams 2) poor mental
health outcomes for BME communities in the UK 3) overrepresentation of non-UK trained doctors in fitness
proceedings and suspensions 4) Link projects in India. As we know, suicide rates in India are 10 times higher
than in the UK while the duration of undergraduate psychiatric training (currently only 2 weeks) is being
threatened with further reduction.
In the past year, BIPA has been able to make steady progress in all those areas.
BIPA managed to persuade the College to re-examine the issue of the withdrawal of exemption from Part I exams for those who had
passed the old style MRCPsych written exam. This was a significant victory as it involved the College doing a U-turn on its policy.
We have also asked the College to share with us data on trainees’ MRCPsych examination results.
In March this year BIPA organized a conference in Birmingham on “Improving Mental Health Outcomes in BME Communities”.
BIPA is now contributing to a national consultation on this issue. Later this year BIPA will carry out a pilot project aimed at
improving mental health access in primary care for BME communities.
BIPA contributed to the consultation by GMC on fitness to practice procedures. BIPA was invited by the GMC for further
discussions following this consultation. BIPA is aware of the challenges facing its members once revalidation is introduced next year
and I am glad to report that Dr. J S Bamrah who authored BIPA’s response to the GMC will also be leading BIPA’s strategy on
revalidation.
BIPA’s members have been very keen to participate in link projects in India. Last year, BIPA participated in the Global Association
of Physicians of Indian Origin (GAPIO) conference in Delhi, which was a meeting aimed at improving health outcomes in India.
BIPA’s role in the mental health stream was appreciated and our project aimed at enhancing the teaching of psychiatric skills and
attitudes to medical undergraduates was endorsed as a demonstration project. This project is being done as a randomized study with
some batches of students receiving the new curriculum. The study has received ethics approval and a batch of BIPA members will be
going to India later in the year to conduct a Train the Trainers program.
It is obvious that all of the above could not have been achieved without the support of a large number of active BIPA members. In fact, I do not
recall such a large number of members working actively at any stage of my membership in BIPA, which is very good news. Another good
news, is the close working relationship we have developed with key organizations including the RCPsych, BAPIO, Indian Psychiatric Society
and other diaspora psychiatry organizations in the UK. However, it’s not all good news. I feel that misconceptions about BIPA remain. I still
get asked (sometimes even by BIPA members) – “what is BIPA; what does it do?”
Let me answer this question in very clear terms. BIPA above all is a professional organization. We are an association of psychiatrists first and
foremost. This then raises the question- why BIPA when we have RCPsych? There are two reasons for this. 1) There is strength in numbers –
we are better able to represent and solve issues specific to us if we deal with them as a cohesive group rather than alone. There are key areas
(outlined above) that concern our members, which I feel, are not adequately dealt with by the College. BIPA’s role, I believe, is vital to deliver
on these objectives. 2) There are obvious cultural and social factors that tie us and I do not feel any reason for us as a professional organization
to be embarrassed about it. I hope that BIPA members are able to talk about their BIPA membership with pride. Indeed, I have found that
Trust Boards are very positive about the diverse sets of skills that BIPA members are likely to offer.
Another misconception, I have come across is that BIPA is an old boys’ network. In fact, the number of members actively engaged in BIPA
projects has doubled over the past year. However, I do think that we are not always able to clearly answer the question that many have
“What’s in it for me”.
The clear answer to this question is that BIPA offers its members opportunities to develop their leadership role whether through its association
with the College, GMC or through its international links or indeed through its patient-care orientated projects. There are various projects that
have commenced and many more that remain unexplored and are crying out for input of dynamism and enthusiasm. BIPA is a happy inclusive
family. Come join us on www.bipa.org.uk
How to pass the MRCPsych CASC Group study: Most hospitals have a number Work place based assessments are a
Exams of trainees who have failed the CASC exam helpful way of doing this and are more
on numerous occasions and are preparing useful when made by Consultants.
The pass rates in the MRCPsych CASC exam together for future exams. Many of them
for those who had their Primary Medical seem to have entrenched opinions about Observe others
Qualification (PMQ) Outside the Western reasons for their failures. The also have
Europe is disappointingly low compared to notions about the best ways to pass the exam Make a long list of possible
those who qualified in the Western Europe. A and what to do and what not to do in scenarios
significant proportion of the failing candidates particular examination scenarios. They share
have had their PMQ from Asia, especially, the horror stories and tend perpetuate learned
Indian subcontinent. Hence, this is a matter of Develop Strategies
helplessness.
grave concern for BIPA. Let us look at the
possible reasons. Develop Schedules
Spoken English: For many failing candidates
English is their 2nd or 3rd language. The
Racial discrimination: This is the first reason patients as well as the role players speak Practice
that springs to most people’s minds. However, colloquial English. Improving familiarity
Asian doctors who have Western PMQ attain with the local population would improve Physical examination stations
high CASC pass rates. their communication skills. Trainees use
many techniques to achieve this e.g. going Improve Strategies and
Those who had their PMQ from Asia have poor out socially to restaurants and pubs with Schedule
skills and knowledge: This is unlikely because colleagues as well as watching soap operas.
the pass rates in theory exams are much more Plan and Organize In the
similar in the two groups. CASC Courses: Attending one or few weeks before the exams
courses should give them some idea about
Doctor-patient relationship: In Asian countries the courses and exams. However, some At the exam: Carefully read
the doctor-patient relationship is more candidates believe that attending courses is the Problem and identify the
paternalistic. However, in the UK patients like the only thing they need to do in order to Issue.
to be treated as equals. This could cause pass the exams. Most candidates pass the
difficulties in clinical relationship especially for CASC exam without attending any courses.
those who have had long medical careers in All the Best
Courses are never a substitute for clinical
their country before coming to the UK. experience. V Sunil Babu
Director of Medical Education
Communication skills: This is an essential CASC Books: Many books are good sources Surrey and Borders Partnership NHS
component of every station in the exam. From of information on the types of scenarios that Foundation Trust
the very beginning of the station, many Asian might come up in the exams. Many give
candidates communicate in a very ‘formal’ and useful information for developing Strategies
stilted manner. This would give the role player Sadgun Bhandari
and Schedules, but seeing patients and Clinical Tutor and Clinical Tutors for
an impression that the candidate would be learning from them is more important than SAS Doctors
difficult to communicate with. The examiner reading books. Hertfordshire Partnership NHS Trust
may conclude that this candidate is neither an
effective clinician nor a good team player. Routine clinical work: The trainees should Albert Michael
see as many patients as they can, assess Director of Medical Education
Preparation for the CASC exams them including doing physical examinations, Suffolk Mental Health Partnership NHS
In the CASC exam one of the skills tested is the answer their questions and explain things to Trust
way the candidates interact with patients in them. They should do these occasionally in
clinical situations. However, the way many front of colleagues and ask them for [ For a fuller Version of the same
candidates prepare for examinations in fact feedback. It may be difficult in the please Visit www.bipa.org.uk ]
reduce their chances of passing the exams. Let beginning and especially if they are not used
us review some common strategies they adopt to honest feedback. The trainees should see
with suggestions for improvement as many patients as they can, assess them
including doing physical examinations,
answer their questions and explain things to
them.
BIPA Newsletter - June 2011
How to apply for a Certificate of Eligibility for Cultural wing of BIPA - Bhavana Chawda
Specialist Registration (CESR) under Article 14
of the General and Specialist Medical Practice More than 10 years ago at my
first BIPA annual general
(Education, Training and Qualifications) Order meeting, I was in the midst of a
2003: Dr Suneetha Kovvuri hundred other Indian
[Suneetha.Kovvuri@mhc-uk.com ] psychiatrists. My feelings of
disappeared swiftly. loneliness, along
At the evening with dinner
social lowering
At the start of the process, having looked at pros and I experienced pangs of joy very similar to those at
cons and alternatives, to take the important decision any social or family gathering back in India. Since
that the CESR is ‘the route’ you want to take to attain then I have never failed to attend any of our BIPA
your specialist status. annual general meetings. As an executive member
my interest lies in organizing social and cultural
Gain a thorough understanding of the Royal College events.
Curriculum in your chosen speciality.Write down all
the relevant experience you have acquired and compare BIPA is incomplete without the participation of
it with the Royal College Curriculum. the spouses and children. BIPA families make our
social evenings a complete, enjoyable success in
Speak to an SpR (CT4-6 trainee) and get hold of their their bright colorful sarees, lehangas, kurtas,
training timetable. Focus on the training ‘post chudhidhars and jewelleries; along with the tasty
MRCPsych’. This is if you already have MRCPsych. If Desi food.
not, it would be a lot more work, though the College
says possession of MRCPsych is not a must. Identify At the last annual general meeting and also at the
the deficiencies in your experience compared with the greater partnership the children were entertained
mandatory SpR training. If possible, speak to an SpR by a professional entertainer with non competitive
and tailor your work and training to the requirements. participative games, magic show, balloon displays
and musical disco while the families enjoyed
Job Plan: Come to an agreement with your henna painting by professional Mehndi artists.
management to allow you to have protected time for
training in the areas of your identified deficiencies. At BIPA we aim to keep the spirit of our Indian
culture and customs alive and welcome any
Time Span: Have a realistic dead line as to when you suggestions to enhance this idea. This chance
want to submit your first application. Validation: start offers us to remain in contact with our culture and
collecting your evidence as you go along and get it gives us the sense of Indian-ness at our home in
signed off. Do not leave it to the end. I divided my England.
application into separate sections and started collecting
evidence under different sections. Having separate BIPA would also like to offer its platform to the
sections definitely made me reflect and focus on families to display their skills in art, poetry,
collecting the evidence. music, writing, singing, dancing etc. These talents
can be captured and show cased through active
Choose your referees: One has to be your current participation in future and we can even consider
medical/clinical director. My personal advice is to competitive shows.
choose referees from the medical profession and from
your own specialty, i.e. from consultant psychiatrists I am proud to be a BIPA member and am thankful
who are on the specialist register. to the committee for offering me the responsibility
of organizing our cultural program. I look forward
Do not stop collecting your evidence after the to working with your ideas.
application is sent off! Stay in touch with your
certification officer in the GMC. In my experience,
they are extremely helpful
BIPA Newsletter - June 2011