BIPA Newsletter - June 2011

British Indian Psychiatric Association

Newsletter

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

BIPA Organizing Committee Members : Subodh Dave, Giri Nimmagadda,

A.N.Ramakrishnan, Bhavana Chawda, Sridevi M, Jp Rajendran
BIPA Newsletter - June 2011

Editorial : Dr Piyal Sen & Ranjith Baruah

As BIPA moves from strength to strength under the

able guidance of its leadership, we hope to use the
newsletter to convey some of the themes that are
currently relevant for the community of Indian
psychiatrists in the UK, whose voice is represented by
BIPA .

The article from the chair reflects the current priorities

for BIPA and a road-map for the way forward. There Visit Us Online For the Latest Updates
is also an article from the vice-president reflecting on and Presentations : www.bipa.org.uk
his involvement with the activities of The Royal
College of Psychiatrists and how best BIPA can work
with the College. It needs to be remembered that in
terms of membership strength, BIPA is second only to
The Royal College of Psychiatrists as an organization
speaking up for psychiatrists in the UK.

We have also tried to cover some other themes in this

newsletter that are of importance to psychiatrists from
India. To reflect some of the difficulties around
passing the MRCPsych, we have included an article
written by someone who has run a very successful
MRCPsych examination revision course for many
years in Cambridge, elucidating some of the possible
reasons for the failings of overseas graduates and also
suggesting ways to rectify this. An increasing number
of Indian doctors are also choosing the Certificate for
Equivalence of Specialist Registration pathway, also
known as the Article 14 route, to work as a Consultant
in their chosen speciality. We have included an article
from such a doctor, who is currently going through
this process, sharing her experience and offering
guidance. There is also an article providing
information on the activities of the BIPA Trainees’
Forum.

In keeping with a trend started from the last

newsletter, we have included an interview of Dr. Ajit
Avasthi, President of Indian Psychiatric Society(IPS),
who visited the last BIPA annual conference and
kindly consented to be interviewed for the newsletter.
There is also an account of some inspiring voluntary
work carried out by a BIPA member in the Solomon
Islands. We have also included lots of photographs,
like last time! Please tell us what you think about it.
Your honest feedback helps us to improve the quality
of this newsletter, and also to ensure that it meets the
needs of the membership.

We wish to thank the BIPA executive for their

continued help and support in producing it. A very
special word of thanks to J P Rajendran, whose
considerable IT skills ensured that it was formatted
properly. For those of you attending the annual
conference, hope you have a great meeting.
BIPA Newsletter - June 2011
My experience of being involved with the Royal
College of Psychiatrists
Dr Sab Bhaumik , Vice president BIPA
When I was approached by the BIPA news letter editor to
gather some thoughts around my experience on the
workings of the Royal College, I did not realize that it
would be so difficult to do justice to the task of describing
the relevant areas in a few paragraphs succinctly.
As a trainee and then as a junior consultant, the College
appeared large and distant. At that time, I had no inkling
that I would have to spend so many years in the latter part of
my career with the College affairs. My first sojourn came
when I became an executive committee member of the Trent
Division of the College in the year 1999. Gradually, I
became aware of the issues that the College deals with,
although I was directly not yet directly connected to it at the
time.
I became the Chair of the Trent Division in 2003 and that
was the first time that I started attending the College
Council meetings. At the same time, I became involved with
the Learning Disability Faculty, having already been elected
to the Executive Committee in the year 2002. I was
appointed as the Academic Secretary of the LD Faculty in
2003 and subsequently elected as the Chair of the Faculty in
2006.
As I grew familiar with the College machinery, I also
became aware of the apparent divide that existed between
the Division and Faculty Chairs and this did surprise me.
Through Mike Shooter’s initiative, I saw how power was
devolved to the Divisions and this worked much better than
the previous model of central control. Through my
initiative, I organised regular meetings between the Division
Chairs and another set of meetings between the Faculty
Chairs at the College. I also arranged occasional joint
meetings between Divisional and Faculty Chairs.
However, the latter did not progress as much as I had
hoped and I realized that it was mainly because of the
differences in the priorities of the two groups.
There was a degree of lack of awareness of each others’
functioning and I still wonder whether this model of
having Faculties and Divisions existing separately is
ever going to work effectively for the College
machinery.
Over the years, I also became aware that it was about
individual leaders’ personalities rather than the system
that makes it work. During my involvement with the
College, I learnt two key things: the first one being “we
are the College” and that “we need to consistently put in
extra effort to become involved in the College matters to
bring about the necessary changes”. In the past ten
years, I have worked with three different Presidents,
with three different styles, each having their own vision
and priorities. I believe that a tenure of three years as
College President is too short to effectively bring their
vision to reality and a total shift of vision every three
years does not bode well for the longer term objectives.
In the context of organizations like ours (BIPA), the
only close relationship that exists with the College
machinery is through the International Advisory
Committee (IAC), and despite our best possible efforts,
a real partnership model between the Royal College and
the Diaspora Organizations has not yet evolved. This is
one area I wish to spend some time on when I take up
the role as the Chair of BIPA. A joined up approach to
influence policies and decision making of the
Department of Health on mental health issues is only
possible through such a forum. The partnership model
can extend to different parts of the College machinery
including Research and Training and CRTU.
In conclusion, I intend to persuade the College
machinery to have a MoU with the Diaspora
Organisations with a clear platform to influence the
policies and drivers that shape the mental health
services. I also think that a section should be created
within the College to look at the ongoing issues faced by
the BME workforce including the challenges they face
at work and other related areas, in addition to the
professional support mechanisms that can be arranged
jointly with the College.
BIPA Newsletter - June 2011
How to pass the MRCPsych CASC
Exams
The pass rates in the MRCPsych CASC exam
for those who had their Primary Medical
Qualification (PMQ) Outside the Western
Europe is disappointingly low compared to
those who qualified in the Western Europe. A
significant proportion of the failing candidates
have had their PMQ from Asia, especially, the
Indian subcontinent. Hence, this is a matter of
grave concern for BIPA. Let us look at the
possible reasons.
Racial discrimination: This is the first reason
that springs to most people’s minds. However,
Asian doctors who have Western PMQ attain
high CASC pass rates.
Those who had their PMQ from Asia have poor
skills and knowledge: This is unlikely because
the pass rates in theory exams are much more
similar in the two groups.
Doctor-patient relationship: In Asian countries
the doctor-patient relationship is more
paternalistic. However, in the UK patients like
to be treated as equals. This could cause
difficulties in clinical relationship especially for
those who have had long medical careers in
their country before coming to the UK.
Communication skills: This is an essential
component of every station in the exam. From
the very beginning of the station, many Asian
candidates communicate in a very ‘formal’ and
stilted manner. This would give the role player
an impression that the candidate would be
difficult to communicate with. The examiner
may conclude that this candidate is neither an
effective clinician nor a good team player.
Preparation for the CASC exams
In the CASC exam one of the skills tested is the
way the candidates interact with patients in
clinical situations. However, the way many
candidates prepare for examinations in fact
reduce their chances of passing the exams. Let
us review some common strategies they adopt
with suggestions for improvement
Group study: Most hospitals have a number Work place based assessments are a
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.
together for future exams. Many of them
seem to have entrenched opinions about  Observe others
reasons for their failures. The also have
notions about the best ways to pass the exam  Make a long list of possible
and what to do and what not to do in scenarios
particular examination scenarios. They share
horror stories and tend perpetuate learned
 Develop Strategies
helplessness.
 Develop Schedules
Spoken English: For many failing candidates
English is their 2nd or 3rd language. The
patients as well as the role players speak  Practice
colloquial English. Improving familiarity
with the local population would improve  Physical examination stations
their communication skills. Trainees use
many techniques to achieve this e.g. going  Improve Strategies and
out socially to restaurants and pubs with Schedule
colleagues as well as watching soap operas.
 Plan and Organize In the
CASC Courses: Attending one or few weeks before the exams
courses should give them some idea about
the courses and exams. However, some  At the exam: Carefully read
candidates believe that attending courses is the Problem and identify the
the only thing they need to do in order to Issue.
pass the exams. Most candidates pass the
CASC exam without attending any courses.
All the Best
Courses are never a substitute for clinical
experience. V Sunil Babu
Director of Medical Education
CASC Books: Many books are good sources Surrey and Borders Partnership NHS
of information on the types of scenarios that Foundation Trust
might come up in the exams. Many give
useful information for developing Strategies
Sadgun Bhandari
and Schedules, but seeing patients and Clinical Tutor and Clinical Tutors for
learning from them is more important than SAS Doctors
reading books. Hertfordshire Partnership NHS Trust
Routine clinical work: The trainees should Albert Michael
see as many patients as they can, assess Director of Medical Education
them including doing physical examinations, Suffolk Mental Health Partnership NHS
answer their questions and explain things to Trust
them. They should do these occasionally in
front of colleagues and ask them for [ For a fuller Version of the same
feedback. It may be difficult in the please Visit www.bipa.org.uk ]
beginning and especially if they are not used
to honest feedback. The trainees should see
as many patients as they can, assess them
including doing physical examinations,
answer their questions and explain things to
them.
BIPA Newsletter - June 2011

“Psychiatry in the Solomon Islands”

Dr Ashok N Singh, Consultant Psychiatrist in
Boston, Lincolnshire spent three months from 15
February 2010 to 14 May 2010 in the Solomon
Islands as a Royal College Volunteer and WHO
external consultant.

Country Background : The Solomon Islands is

situated in the South Pacific Ocean and is a low
income country. It comprises nearly one thousand
islands with the land area of 304,000 kilometres
spread over a sea area of about 1.5 million
kilometres making communications, travel, and
service delivery difficult and creating inequities in
access. The population of Solomon Islands was During the three month period he also performed direct
estimated at about 581,318 in 2008, is young, with clinical work at out patient clinic, ward rounds, liaison
42% aged less than 15 years (SIMOH 2006). The psychiatry consultations and family visits. Finally, the
majority of the people are Melanesian (93%), and Community Mental Health Team (CMHT) was
98% of the population belongs to a Christian inaugurated on 6 May 2010 by a service user in the
church. The population is extremely diverse with presence of more than 50 invited guests from Ministry
some 91 indigenous languages and dialects being of Health, Solomon Islands, INGOs, NGOs,
spoken in addition to Solomon’s Islands pijin (the Department of Police and the local media. The
most common language) and English (the official ceremony was addressed by the WHO country director
national language). Over 83% of the population for the Solomon Islands.
live in rural areas where subsistence agriculture,
fishing, and food gathering are the main income
source (statistics of the Solomon’s Island
Government 1999), there is not a tourist industry
and the gross domestic product (PPP) of $1.5
billion and per capita income $2.800
approximately (international monetary fund
2009). Total expenditure on health represented
5.6% of GDP and only one percent of total health
budget represented mental health budget
expenditure. (WHO Mental Health Atlas 2005).

Dr Singh’s main role was to improve clinical skills

of the local psychiatrist and senior nurses in terms
of diagnosis, prescribing, psychosocial
rehabilitation and psychoeducation with patients
and families. Also to improve their management Dr A N Singh
skills by holding and chairing regular meetings, to Consultant Psychiatrist in Recovery, Rehabilitation & In-Patient
develop WHO model for CMHT and to establish Lincolnshire Partnership NHS Foundation Trust
individual care plans, to reduce relapse and re- United Kingdom
Tel: 01205 446863
admission rate and to improve mental health
services to local prison.
BIPA Newsletter – June 2011
BIPA Trainee and Core Group Members 2010
Diaspora psychiatrists and British
psychiatry: Travails and Triumphs
If you are attending the International Conference of
the RCPsych in Brighton please attend a symposium
on Diaspora psychiatrists organized by BIPA. .
Why do overseas trainees fare poorly in
MRCPsych? Why do overseas doctors get
referred to GMC more often?
BIPA Chair Dr. Subodh Dave will be leading a
symposium on "Diaspora Psychiatrists: Travails and
Triumphs" at the the International Conference of
RCPsych in Brighton on 29th June at 11: 30 am,
which will answer these questions.
Speakers include: Prof. Femi Oyebode and
Prof. Dinesh Bhugra.
Please attend.
BIPA For Trainees : [ Vijaya Murali ]
BIPA has been vigorously trying to sort out some
of the training issues that our International
Medical graduates face in the UK.
Most of you must be aware of the success we achieved in
resolving the problems faced by trainees following the
retrospective withdrawal of the life-time validity of a pass in
the old-style part I exams imposed by the College. BIPA made
a robust response to the College Council and also to the
College Ethics Committee, which led to the College re-
examining its stand.
However, there is another very important issue facing our
international trainees.- their pass rate in MRCPsych
examinations is significantly poorer compared to UK trained
graduates. BIPA had requested the Examination Department of
the Royal College of Psychiatrists to provide some data that
might illuminate the reasons for this disparity. This data has not
yet been made available to us. We have also tried to get more
information about the poor ARCP reviews for International
Medical Graduates. We seem to face a lot of obstacles in
getting the information needed but BIPA will continue to
endeavour to get to the bottom of the reason for these
disparities.
BIPA Youth Scientific Forum ( YSF) :
Welcome to the Youth Scientific Forum for all
Psychiatry trainees, Young scientists and
academicians organized by the British Indian
Psychiatry Association.
Youth Scientific Forum (YSF) is yet another initiative by BIPA
in a long list of concerted efforts to help trainees and academics
who have to come to work in the UK. BIPA will use the
excellent resources at its disposal to support the Young
Trainees and Scientists in all aspects of their Professional
career.
The Youth forum is a scientific platform which helps provide
answers to issues relating to Professional exams, Career
development, Research pathways in the form of lectures,
question and answer sessions, plenary discussions, and
workshops! The YSF conference places young scientists at the
forefront to encourage them to excel in their chosen field(s) as
clinician and/or researcher.
Highlights: Lectures from Eminent Professors In Psychiatry ||
Separate Workshop on Research for SHOs and SpRs||“Crack
the CASC” by well known CASC organizer DR SPM Murthy ||
“Ask the Panel”- chance to interact with successful
professionals ||Social Networking || Ongoing and Continuous
support to attendees through BIPA network .
[ BIPA's YSFcommittee: Venkatesh Muthukrishnan,
Vijaya Murali, Nora S Vyas ]
BIPA Newsletter – June 2011
How to apply for a Certificate of Eligibility for
Specialist Registration (CESR) under Article 14
of the General and Specialist Medical Practice
(Education, Training and Qualifications) Order
2003: Dr Suneetha Kovvuri
[Suneetha.Kovvuri@mhc-uk.com ]
At the start of the process, having looked at pros and
cons and alternatives, to take the important decision
that the CESR is ‘the route’ you want to take to attain
your specialist status.
Gain a thorough understanding of the Royal College
Curriculum in your chosen speciality.Write down all
the relevant experience you have acquired and compare
it with the Royal College Curriculum.
Speak to an SpR (CT4-6 trainee) and get hold of their
training timetable. Focus on the training ‘post
MRCPsych’. This is if you already have MRCPsych. If
not, it would be a lot more work, though the College
says possession of MRCPsych is not a must. Identify
the deficiencies in your experience compared with the
mandatory SpR training. If possible, speak to an SpR
and tailor your work and training to the requirements.
Job Plan: Come to an agreement with your
management to allow you to have protected time for
training in the areas of your identified deficiencies.
Time Span: Have a realistic dead line as to when you
want to submit your first application. Validation: start
collecting your evidence as you go along and get it
signed off. Do not leave it to the end. I divided my
application into separate sections and started collecting
evidence under different sections. Having separate
sections definitely made me reflect and focus on
collecting the evidence.
Choose your referees: One has to be your current
medical/clinical director. My personal advice is to
choose referees from the medical profession and from
your own specialty, i.e. from consultant psychiatrists
who are on the specialist register.
Do not stop collecting your evidence after the
application is sent off! Stay in touch with your
certification officer in the GMC. In my experience,
they are extremely helpful
Cultural wing of BIPA - Bhavana Chawda
More than 10 years ago at my
first BIPA annual general
meeting, I was in the midst of a
hundred other Indian
psychiatrists. My feelings of
disappeared swiftly. loneliness, along
At the evening with dinner
social lowering
I experienced pangs of joy very similar to those at
any social or family gathering back in India. Since
then I have never failed to attend any of our BIPA
annual general meetings. As an executive member
my interest lies in organizing social and cultural
events.
BIPA is incomplete without the participation of
the spouses and children. BIPA families make our
social evenings a complete, enjoyable success in
their bright colorful sarees, lehangas, kurtas,
chudhidhars and jewelleries; along with the tasty
Desi food.
At the last annual general meeting and also at the
greater partnership the children were entertained
by a professional entertainer with non competitive
participative games, magic show, balloon displays
and musical disco while the families enjoyed
henna painting by professional Mehndi artists.
At BIPA we aim to keep the spirit of our Indian
culture and customs alive and welcome any
suggestions to enhance this idea. This chance
offers us to remain in contact with our culture and
gives us the sense of Indian-ness at our home in
England.
BIPA would also like to offer its platform to the
families to display their skills in art, poetry,
music, writing, singing, dancing etc. These talents
can be captured and show cased through active
participation in future and we can even consider
competitive shows.
I am proud to be a BIPA member and am thankful
to the committee for offering me the responsibility
of organizing our cultural program. I look forward
to working with your ideas.
BIPA Newsletter - June 2011
INTERVIEW OF PROFESSOR
AJIT AVASTHI,
LAST PRESIDENT OF IPS
Tell us a bit about your early life.
I was born in the city of Srinagar,
Jammu and Kashmir, and thereafter I
had my initial schooling, as well as my
education in the city of Jammu, in
Jammu and Kashmir. I completed my
graduation in medicine from the
Government Medical College, Jammu,
and thereafter I got my placement in
PGI, Chandigarh, Post Graduate
Institute of Mental Education and
Research, followed by Post Graduation
in Psychiatry, and after doing my Post
Graduation MD in Psychiatry by the
end of 1981, I joined there as a Senior
Resident, and after completing three
years of my training as a Senior
Resident I left for Libya, and there I
joined as a lecturer in the Anab
Medical University in Benghazi,
Libya. There for two years and
thereafter I returned back to PGI and
joined the Faculty, and continue there
now as Professor of Psychiatry.
If I can ask you, how did you end up
choosing Medicine and later psychiatry
as a profession?
The interests are many, one was that
the doctors, physicians and surgeons,
were really looked up to as something
unique at that time, so they were the
role models, and those were the careers
at the time, medicine as a career at the
time was a very prized career. I have a
family tradition of physicians,
although they were AyurVedic
practitioners, but that was the tradition
that my father in fact influenced me to
continue. He felt that one of us as
children should take up medicine and
continue with the family legacy.
I was also interested in a way because
it appealed to me that looking after
patients and kind of helping them in
this hour of need, and when they are
suffering, would be a good idea to have
a meaningful life, and I chose
medicine.
Psychiatry is interesting because I
always thought that it is not only the
science which would interest me, but
also the art of the practice of science. I
had my interest in literature, I was a
good communicator, that is how I
believed myself to be at that time. I
felt that this will be one of the
specialties where I will be able to
pursue, not only just the pure science,
but also the humanity view, and
therefore this combination of science
and humanity which psychiatry offered
as a good opportunity. So it attracted
me toward it, so I joined. At that time
it was a difficult choice of a career.
Psychiatry hadn’t really come up at
that time, and when I said that I wanted
to pick up psychiatry many people
raised their eyebrows, including my
teachers. Eventually, I persevered, and
I said no, this is what I want to do. I
was encouraged by my family, and
actually my father was very supportive.
He said whatever you want to do, do it,
and my principal of the medical
college, he was also very supportive of
my choice,
Do you want to just share with us a bit
of your career highlights.
First of all the opportunity to have a
very unique kind of job in India, and
that was the PGI Chandigarh, had a lot
of reputation as an institution, and the
department also had a very good
reputation with Professor Wig,
Professor Verma there, Professor R.
Srinivas Murthy was working there,
and we had a psychiatrist as the Head
of the Institute at that time, Professor S
Negi. There was also for some period
Professor Morris Carstairs, who was
with us as a Visiting Faculty for nearly
one year. I think the highlights have
been that I got a good opportunity to
pursue my interest in teaching, which
is a passion with me. I have been very
passionate regarding this, interacting
with my students, shaping their
careers, kind of contributing to their
growth in the profession and otherwise
too. Apart from that, the service is a
very high quality service that we
provide, and there are quite a lot of
challenges. Research was the third
highlight. It gave me all the three
exposure: research, teaching, patient
care, all three were put into one, that is
why I had multiple hats, you know
many hats which I could choose from
at the time, and it carried on. As it
happens, and you are there for a long
time, you start getting a number of
awards. Practically all the awards
which Indian psychiatry could offer
me, I have already won.
Do you want to share that with us, I
know you are very modest about it?
A number of times I have won the Best
Paper Award, which is called BP
Award, at least four times I have won
it, and the Marfatia Award, the PPA2
Award, and now I have also been
awarded the D.L.N. Murthy Rao
Oration, which is in fact the highest
award which Indian psychiatry can
award to anybody, and it was almost
given as a lifetime achievement award.
Apart from that, I had a lot of exposure
in setting up a few things, I am very
proud of having set up the very first
clinic in India which deals with the
psychosexual disorder, like marital
problems, psychosexual disorders, way
back in 1982. We have a host of
publications, a lot of the manuals that
we had developed, very proud of it,
and then with Dr Kulhara, my senior,
and others, the schizophrenia research
which we have continuously done for
say about 27-28 years. That is
something and it has been recognized
the world over. Our schizophrenia
research from PGI is largely clinical
research, has given quite a lot of
insight into the illness of schizophrenia
and the various dimensions associated
with it. I have been the convener of the
taskforce set up by the Indian
Psychiatric Society, which has come
out with clinical practice guidelines for
psychiatrists in India, and we came out
with five volumes actually. Constantly
for five years, one after the other, with
various disorders, we have come out
with clinical practice guidelines for
Indian psychiatrists [ Contd..]
 BIPA Newsletter - June 2011
Do you just want to tell us a bit about
the history of your involvement and
your key achievements in IPS ?
I have been involved in various ways.
I started with leading the state Chapter,
then I had headed the zonal branch of
Indian Psychiatric Society, that is the
North zone branch, and I have already
contributed quite a lot to the
educational programs of the Indian
Psychiatric Society. There were quite
a lot of initiatives, which I have told
you about, like the clinical practice
guidelines, very proud of that
achievement. Apart from that we have
come up with a publication division of
the Indian Psychiatric Society, and we
have come out with some good
publications. Last year we released
two books, which were distributed free
to all the members of the Indian
Psychiatric Society, about the physical
health of the mentally ill, and neuro
biology of psychiatric disorders, and
this year again, we are actually coming
out with some kind of a compilation of
these psychological instruments, which
are locally relevant, which have been
adapted in India, which have been
developed in India so that people can
have access to those and instead of
using instruments which have been
developed outside and there could be
methodological issues, they have the
local instruments and they can use
those for research.
The other thing ,that I am very
passionate about, and which partly
have succeeded is to start a research
division in the Indian Psychiatric
Society. We are now conceiving some
of the multi-centric research in India,
which is funded by the Indian
Psychiatric Society. So, apart from
just the continuing medical education
and the professional development, the
social aspects of the Society, we are
also now very heavily into the
intellectual inputs and some of the
organizational, and even now we are
flexing some kind of influence with the
Government of India. The President of
the Indian Psychiatric Society is now a
special invitee to the Central Mental
Health Authority of the Government of
India. They tend to have some kind of
inputs into the National Mental Health
Program, and into the policy
decisions that are taken. We have
developed a very good international
network, as part of it, right from the
time we had associates like the British
Indian Psychiatric Association, Indo-
American, Indo-Australian, Indo-
Canadian, so we have been part of it.
This culminated into another very good
initiative, that is the Indian Global
Psychiatric Initiative what is called the
IGPI. We had its launch in this year
only, at Jaipur, and this is just to bring
all together, the resources, the talent of
the psychiatrists of Indian origin, who
are either practicing in India or abroad,
under one umbrella. So, that is another
thing. I have been associated with the
launch of the Asian Journal of
Psychiatry. It is again very good. This
gives quite a lot of profile to the
research that originates from parts of
Asia, including south-East Asia.
Those are the kind of initiates which
have been done. I think I see that the
Indian Psychiatric Society will
continue to grow and add various kinds
of activities.
In that context, what do you think are
the challenges and opportunities facing
Indian Psychiatry currently?
Well, I think the greatest challenge that
now faces us is that we have to evolve
with some kind of strategy, we are still
very acutely short. We have just about
4,000 psychiatrists, and you know that
India is a very large country with quite
a lot of population, which is absolutely
untouched. There are no facilities.
There is no kind of way that these
4,000 people can reach to more than 1
billion population. So we had to think
of various strategies, and I think one of
the strategies which we are already
working on very seriously, is to
strengthen the under graduate
psychiatry training, and teaching and
training, and we have already
submitted this last month only, our
own recommendations for
strengthening the psychiatric syllabus
in the MBBS curriculum, and also to
suggest then the teaching method, the
course curriculum, the evaluation, so
that some basic knowledge of not only
psychiatry but health and behaviour is
imparted to the graduate courses,
medicine and surgery, so that we have
every doctor who even gets the basic
education can have some capacity to
deal with some of the morbidity in the
field.
. At least, if we can have some rational
referrals from them, that will be a great
achievement. We also want that
through the District Mental Health
Program, which has already covered
now over 120 districts in India, we
wish to increase more and more, so
through those District Mental Health
Programs we can at least start having
some semblance of a community
psychiatric program in India, so that
the people don’t have to really travel
long distances, and they can get
reasonably optimal treatment closer to
their homes. So, those are the various
kinds of challenges.
Just to move on to a slightly lighter
topic, to you as a person outside work,
what does Professor Ajit Avasthi do to
relax?
I do quite a lot of things. Other than
the medicine, literature is my passion.
It interests me quite a lot and I read
quite a lot of history, contemporary, in
India, as well as history of mankind
that it does interest me.
Music is something else, I sing myself.
I sometimes lock myself in my room
and even if the rest of the family like it
or not, I continue singing for hours
together. I am a very outdoor person, I
visit places, I see quite a lot of things.
I have a very good and supportive
family, my wife, my children, my
brothers, their children. I have a large
family with whom I keep in regular
contact, talking to them, contributing,
doing things together. I’m a very
social person, large number of friends.
I take holidays, I go in the hills and
spend some time out there. I like
travelling and I enjoy nature quite a lot.
These things I do in my free time.
Just coming back to the business of
psychiatry and Indian and British
psychiatry, what is your view about the
challenges and opportunities for Indian
psychiatrists in the UK?
Oh well, there are challenges of course
but opportunities are many. I think
you have a lot of racial mix, ethnic
minorities in Britain. [Contd..]
 BIPA Newsletter - June 2011
It is becoming a more multi-cultural
society, and in order to understand the
nuances of the cultures that people carry
with them, I think Indian psychiatrists can
be very good at that. It gives them a great
opportunity to learn quite a lot of things.
What I would say, is that it is not that I am
thinking that the psychiatrists from India
come straight from there after graduation,
they come and they get placed in the
system and then they just practice what is
being done here. But, I would love to see
that there is quite a lot of exchange, what
we are doing, what they are doing out
there, and I think that Indian psychiatrists
can contribute quite a lot to the
development of psychiatric services, as
well as the expertise, manpower
development, in India. At the same time
they can learn quite a lot from us, and the
insight that we have there, some of those
insights would be very helpful to shape
the practice of psychiatry here. That is
why I spoke on the family, and its
importance, in mental healthcare, that was
my idea. It appears to me as if we had
become just individual-centric, whereas
we need to have to have the individual
family together if we want to have a really
meaningful and worthwhile intervention.
And that brings me very nicely on to my
next question, which is what do you think
are the ways that the Indian Psychiatric
Society can work more closely with an
organization like BIPA?
That is very good. I think what I see is
that first of all there should be more
interaction between BIPA and IPS, not
only just sometimes, somebody from the
Indian Psychiatric Society coming here
and attending your conference, and people
going there and attending other
conferences. That is alright, but more
than that, what we need to have is some
kind of a joint project here. We should be
working together on the field. We should
have some joint project so that we can see
how you have your experiences and your
expertise and we have our experiences,
and how we can get together and
contribute something good. The other
thing is that we are aware that there are a
lot of areas which still need to be
developed, and you have certain kind of
abilities in there, and probably you can
Newsletter Editors : Piyal Sen / Ranjith Baruah
help us out in establishing those
specializations of various fields in
psychiatry, like learning disabilities,
forensic psychiatry. You see care of
the elderly, even community programs
where you have conceded may not be
directly applicable there. But you have
a wealth of experience there, the
organizational structures, that is
something very important, and it is
interesting how to make it more
organized, how to make it more
accountable, those are the kind of
things that I think BIPA and IPS
should sit together, more interaction,
not only with attending conferences,
and giving a few talks here and there,
but also sitting together and doing
things together. That is what I feel
what BIPA and IPS should aim at
doing.
Leading on from there, this is the last
question, what would be your key
message to the members of BIPA who
will be reading this newsletter where
your interview will appear?
Well I think the key message is that we
feel BIPA needs to not look at India as
just a place where they can go and visit
their families and go for pilgrimages
You know you get a sabbatical, if you
can take time off, spend a few weeks’
schedule there, IPS is one particular
body through which you can develop
and create a strategy for having a
greater say in mental health policy
discussions globally. Across the field,
this is a good way to influence global
health policies. [ Interview by Dr
Piyal Sen ]
CURRENT BIPA EC Members
Chair: Subodh Dave
Vice Chair: S Bhaumik
Gen Secretary: S R Nimmagadda
Joint Secretary: Pradeep Arya
Treasurer : Anand Ramakrishnan
Public relations : Sivaswami Nagraj
Executive committee members
Ashok Jainer / Balaraju / Bhavna
Chawda / Ipsita Mitra / JP Rajendran /
Karthik Thangavelu / Mallikarjun
Rapuri / Niruj Agrawal /Nora Vyas /
Rajnish Attavar /Shobana George
/Shrikant Srivastava /Srikanth
Nimmagadda / Thomas V /Venkatesh
M / Piyal Sen & Ranjith Baruah [
Newsletter Editors]
OTHER NEWS :
Dr. Subodh Dave, Chair, BIPA raised
£5000 + for a small charity providing foster
care to orphans in India
(http://www.helpchildrenofindia.org.uk/ind
ex.html). He completed 2 marathons in the
process (26.2 miles each) finishing 6th in
Mumbai with a time of 3 hrs 28 min and a
personal best time of 3h 23 min in New
York.
+++++++++++++++++++++++++++++
IGPI has recently launched its new website
http://indianglobalpsychiatricinitiative.org
The Indian Global Psychiatric Initiative
The Scientific Congress of the
Federation of Global Indo-Psychiatry
Associations
Objectives of IGPI:
To promote mental health care in India.
To facilitate networking between
psychiatrists of Indian origin.
To promote the interests of psychiatrists of
Indian origin. It was inaugurated at Jaipur
in January 2010, had its second meeting in
New Delhi in January 2011.
IGPI President: Prof. Russell D’Souza
(Aus) Secretary: Prof. D.Natarajan (Can)
IGPI COUNCIL: Prof. Ajit Awasti (India),
Prof. E. Mohandas (India), Prof. M.
Thirunavukarasu (India)
Dr. Anand Ramakrishnan (UK), Dr.
Subodh Dave (UK), Dr. Seshagiri Rao
Nimmagadda (UK), Prof. Dinesh Bhugra
(UK), Prof. Uma Rao (USA), Prof. Rohan
Ganguli (Canada)
Prof. Mohan Isaac (Australia), Prof. Shekar
Saxena (Geneva), Prof. Shiv Hatti (USA)
Prof. Rudra Prakash (USA), Prof. Ananda
Pandurangi (USA), Dr. Shailesh Kumar
(New Zealand), Dr. George Mathew (New
Zealand), Prof. Suresh Sundram (Australia)
Prof. Dilip Jeste (USA), Prof. Lakshmi
Yatham (Canada), Prof. M.P. Deva
(Malaysia)
Prof. B.N. Gangadhar (India), Prof. Dinesh
Arya (Australia), Prof. Mohan Gilhotra
(Australia), Dr. Carlyle Perera (Australia),
Prof. Mathew Yalto (Canada), Dr. Savalai
Manohar (Canada)
Member organizations:
British Indian Psychiatric Association
Indo American Psychiatric association
Indo-Canadian Psychiatric Association
Indo Australian Psychiatric association
Indian Psychiatric Society
Indian Association of Private Psychiatrists
www.bipa.org.uk