CHAIRMANS NOTE - MRCGP/INTERNATIONAL QUALIFICATION, IS IT WORTH STRIVING FOR?

The important points related to, why a Family Physician in South Asia should take the MRCGP International South Asia examination are as follows: 1. To provide better care to his/her patients, as it is a well known fact that assessment drives learning. This may result in increased respect from the patients and the medical profession at large (This is our main objective, shared by our friends and colleagues in the RCGP, UK) 2. For self respect and enhanced competence, by achieving an internationally reputable qualification from RCGP, UK in the field of his/her chosen specialty with improved quality of patient care and earning capacity. This has been proved by a qualitative study. Better job opportunities, especially in the private sector with better salary, e.g. Sui Southern Gas Company and other private sectors in Pakistan, India and Sri Lanka. 3. Recognition by the PMDC as a specialist qualification in Family Medicine is under serious consideration. 4. Job and training opportunities abroad: A. MRCGP (INT) is recognized by the General Medical Council (GMC), UK as a necessary qualification for higher professional training in Family Medicine in UK for two years, under the sponsorship of the RCGP, at the request and financial support of a Family Medicine Organization or institution recognized by the MRCGP International South Asia Board B. The Royal Australian College of General Practitioners (RACGP) recognizes MRCGP International qualification in the category 3 (stated in its website). It will allow one to take the Australian College Part one Exam without any prior structured training in Family Medicine. Its Part 1 exam is to some extent similar to the MRCGP (INT) part 1 exam. As soon as one passes this part one exam he/she will become eligible for a supervised Family Practice job with an excellent salary package (better than most countries). After 2 years training one becomes eligible for the RACGP part 2 exam. If one wants to migrate to Canada after this RACGP part 2 exam, no further Canadian exams would be required. C. Canada also gives some preference to the MRCGP (INT) qualified Family Physicians

D. Saudi Medical Council is still considering in which category/ grade it should recognize the MRCGP International qualification. However those who have MRCGP (INT) qualification, easily pass the Saudi Family Medicine specialty MCQs exam. Some reputable medical Institutions are either giving improved salary or priority while offering a job. Some doctors are getting resident positions and others are getting specialist registrar positions. Those who have MRCGP (INT) are getting greater respect from their colleagues as compared to those who do not have such a reputable qualification. This situation is expected to further improve after the Saudi Council recognition. There are also examples in Saudi Arabia of some Family Physicians with MRCGP International qualification working as Associate Professor, Assistant Professor and Senior Registrars in the Universities set up . In other gulf countries there is variable recognition. For example in Oman some with MRCGP Int are working as Registrars and some other as Assistant Professor in a medical college E. In some other countries, such as Brunei the MRCGP International is very well recognized. It needs to be understood that MRCGP, UK is now a licensing exam in the UK to start practicing independently. This exam has substantial proportion of topics related to the UK National Health Service (NHS) only (of no relevance to countries outside the UK) and also has work place based assessments. Therefore it is not feasible for overseas graduates to take this exam without actually working in the UK

vocational training program. Even someone like me, with FRCGP, UK , a Distinguished Professor in Family Medicine at King Saud University, Riyadh, SA, having worked in the UK for 18 years as a qualified Family Physician (several years ago), will be expected to do 6 months of orientation training, if I want to work in the UK again.

F. The MRCGP International, South Asia Board has signed an MOU with the RCGP, UK Midland Faculty for training of FCPS and MRCGP (INT) qualified Family Physicians as future Family Medicine trainers and faculty. These UK university Certificate workshops will be held in Karachi, Lahore and some other cities of the South Asia region. There are plans ahead for PMDC to insist that every Medical College in Pakistan should have a department of Family Medicine These Family Medicine Trainers may become a faculty in these departments in the future, once the PMDC gives recognition to the MRCGP International qualification. G. In India, there is a recent upsurge in the need to establish Family Medicine Departments in the medical colleges. The RCGP is in the process of establishing Family Medicine training programs with the governmental supports of the states of West Bengal and Bihar. The candidates attending these programs will become eligible to take the MRCGP International exam in the future. An excellent news from Pakistan is that, all the Family Medicine Organizations of Pakistan have joined hands to form the Family Physicians Forum of Pakistan (FPFP). The leadership of this forum, with Prof. Riaz Qureshi as Patron and Prof. Waris Qidwai as its Chairman, had a meeting at the PMDC offices in Islamabad with its new administrator (Registrar) on April 5, 2013. He showed a positive response to try and implement the following suggestions put forward by the FPFP: a. There should be appropriate representation of Family Physicians in the important committees of the PMDC ( at present, there is none) b. The PMDC should insist that all the medical colleges in Pakistan must include a significant proportion of Family Medicine related course teaching in the MB BS undergraduate curriculum, as is happening at Aga Khan and Ziauddin Universities in Karachi c. Every medical college in Pakistan should have a department of Family Medicine. The faculty for these departments could come from the FCPS qualified Family Physicians with 4 years structured training. As there is great shortage of such doctors in Pakistan, for a 10- 15 years period of transition, those with MRCGP International or MCPS qualifications and certificates of trainers/teachers courses, could also be considered. Similar arrangements were successfully applied in the UK with great success

d. I the national interest, for better patient care and for the development and progress of Family Medicine in the country, an appropriate recognition should be given to the MRCGP International qualification. The MRCGP International South Asia Board members and examiners are trying their best ( in the spirit of giving rather than taking), to promote the cause of Family Medicine and overcome the challenges and substantial hurdles on the way, in the interest of improved quality of health care for the great mass of people of South Asia region. The Board is also open to guidance and support from all persons or institutions interested in supporting this worthy cause. Dr Riaz Qureshi Distinguished Professor Family Medicine King Saud University, Riyadh, Saudi Arabia Chairman MRCGP [INT] South Asia Board Visiting Professor FM Aga Khan University, Karachi Adjunct Professor FM University of Health Sciences (UHS), Lahore Date : 11 April 2013