At the current level of membership examination fees at the Royal College of Psychiatrists, a resident in psychiatry who passes every part first time pays a total of £2136. 1 These costs are intended to cover only expenses rather than to generate profit, a message which many of us have accepted and disseminated. Reference Bateman and Palekar2 We were therefore disappointed to learn recently that in 2010-2011, the College made a profit of approximately £1.5 million from exam fees. Some residents are understandably asking for candidates to receive a refund, a process for which there is historical precedent. 3
We have another suggestion for how this money could be put to good use for the benefit of residents, the College and psychiatry as a whole. The College's annual International Congress currently receives about £70 000 from pharmaceutical companies and other organisations in return for exhibition space (personal communication with the College's Conference Office). Such relationships are undesirable because drug company information affects prescribing. Reference Orlowski and Wateska4 Most doctors do acknowledge this to be true of their colleagues, although the majority believe they are themselves, of course, unaffected. Reference Steinman, Shlipak and McPhee5 Further, and particularly pertinent to psychiatry, is the effect that drug company relationships may have on our patients’ confidence in our treatment recommendations. Many detained patients are suspicious that psychiatrists’ prescribing is motivated by connections with the pharmaceutical industry rather than a genuine intention to improve mental health. We acknowledge the College's considerable progress in the right direction over the issue, but it is problematic to deny such allegations while promotional materials continue to be welcome at our annual congress.
If the surplus from examination fees were used to subsidise the International Congress, it would be possible to have no commercial exhibitor fees for at least 10 years, by which time alternative arrangements could be made. Furthermore, some of the surplus could be ‘given back’ in the form of bursaries for residents to attend the conference. This course of action would allow the College to lead by positive example, while providing wider benefits for UK psychiatrists and our patients.