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I fully agree with the views expressed by Dr Khan and I appreciate the comments made by Professor Bhugra (Psychiatric Bulletin, January 2006, 30, 3-6). It is heartening to note that the College is striving hard to maintain the highest standards of training and ethics and that certain steps are being taken to establish new guidelines and criteria to uphold these standards across the board. MRCPsych is undoubtedly the most prestigious qualification and therefore it should not be awarded to those who fail to meet its standards.

Professor Bhugra mentions two groups of people who could be awarded this qualification without examination. However, there is another group which he fails to mention. Under Article 14, the Postgraduate Medical and Education Training Board (PMETB) can now consider the applications of many middle grade doctors for specialist registration who do not have the accredited higher specialist training or who have previously been unsuccessful in the MRCPsych examination. If some of these applicants are successful, then they will move on to the specialist register of the General Medical Council, thereby automatically qualifying for Membership of the College.

I suggest that the College sets up a tier system whereby these potential awardees, before being granted Membership, either take some form of modular examination or undergo a series of training workshops and courses. By implementing such a system the College will be able to appraise the knowledge and skills of these doctors objectively. It will also enable these doctors to match the standards achieved by those who acquire MRCPsych through normal means. If this is not possible then the College should seriously consider amending the Bye-Laws once again.