Psychiatric Body Faces Internal Rebellion Over Middle East Exam Centre
The Royal College of Psychiatrists is confronting significant internal opposition from its members over a contentious agreement with Qatar's state healthcare provider. More than 150 psychiatrists from leading UK hospitals and universities have signed a protest letter condemning the decision to host clinical examinations in Doha.
Human Rights Concerns Spark Member Outcry
The controversy centres on the college's contract with Hamad Medical Corporation, Qatar's state-owned healthcare provider, to establish an international exam centre in Doha. The arrangement, scheduled for November 10-13, will enable approximately 120 psychiatrists from across the Middle East and other regions to sit professional membership exams.
However, the choice of Qatar has provoked strong criticism due to the country's human rights record. The protest letter, sent to the college president in September, highlights that same-sex relationships remain criminalised and potentially subject to the death penalty under Qatari law. It further notes that women face significant legal inequalities and lack protection against domestic abuse.
Dr Bradley Hillier, a consultant forensic psychiatrist who signed the letter, expressed deep concern about the partnership. "I am really quite disturbed that the Royal College of Psychiatrists is seemingly entering a business relationship with a state that has significant challenges around human rights," he stated.
Exam Content and Moral Dilemmas
The controversy extends to practical examination concerns. The clinical exams involve simulated consultations with actors portraying patients, designed to assess real-world psychiatric skills. Critics question how candidates will navigate scenarios involving LGBTQ+ issues, gender dysphoria, or experiences of homophobia in a country where such topics are legally problematic.
Professor Michael Bloomfield, head of the translational psychiatry research group at University College London and another signatory, described the partnership as "completely morally unacceptable." He added: "It's extremely regrettable that our college is choosing to operate in a country which is constitutionally homophobic."
The letter also raises concerns about Qatar's treatment of migrant workers, who constitute over 90% of the workforce. It references the deaths and injuries of workers before the 2022 World Cup and subsequent accusations of worker exploitation.
College Defends International Expansion
In response to the criticism, the Royal College of Psychiatrists defended its decision, stating that expanding exam access for doctors from the global south aligns with its mission to tackle healthcare inequity. The college already operates an international exam centre in Singapore and emphasises that the Doha exams will maintain identical standards to those in the UK.
The college stated: "Our approach is anti-discriminatory and evidence-based, deliberately avoiding a colonial mindset of selectively deciding who we will or won't work with." It added that it focuses on working with doctors rather than governments and has received supportive feedback from many of its 22,200 members.
However, Professor Annie Bartlett from City St George's University, London, while supporting international exam access, questioned the specific choice: "There are lots of countries that you could have chosen that would avoid issues of women's rights, migrant workers and the death penalty on the statute for certain same-sex practices. I think it's a mistake."
The college maintains that exam content in Doha will include competency assessments for addressing mental health problems experienced by LGBTQ+ patients, matching the scrutiny applied to UK examinations.
