Doctor to challenge medical hierarchy

A CONSULTANT anaesthetist from America who has moved to Britain is to challenge the "closed shop" run by the medical royal colleges which have refused him consultant status in the United Kingdom.

Dr Richard Kaul, who qualified as a doctor in Britain before moving to work in the US, alleges that the system for admitting doctors from overseas to the register of specialists who can apply to be consultants is shrouded in secrecy and operates unfairly and arbitrarily.

He is appealing against a decision of the Specialist Training Authority, which operates on behalf of the royal colleges, to refuse him consultant status. He returned to the UK in 1995 and is now working as a locum anaesthetist - below consultant level - in London.

Dr Kaul's solicitor, Oliver Mays, of the medical lawyers Le Brasseur J Tickle, said Dr Kaul wanted to open up the UK system for approving foreign doctors for consultant posts to public view. Mr Mays said: "He wants to know what criteria are being used and what comparisons made. If it is fair and reasonable that's fine, but let us see what is being done."

The appeal is the first to be held in public and is expected to cost Dr Kaul pounds 10,000 to pounds 15,000. He plans to fly witnesses over from the United States to attest to the quality of his postgraduate training, which included time spent working in the south Bronx area of New York where patients with gunshot wounds were a frequent occurrence, and is gathering records to compare with the training histories of UK-trained consultants.

The Specialist Training Authority was set up in 1996 to guarantee patient safety by ensuring that all doctors admitted to the specialist register, from which consultants are appointed, were properly trained.

The rules specify that a UK-trained doctor must have spent at least six years in an accredited specialist training post and have passed the relevant college exams. Doctors from overseas have to show that their training matches this standard.

It is understood the au- thority argued that Dr Kaul's training in the US was shorter at four years instead of six and not equivalent in content to that received by an anaesthetist in Britain.

Lesley Hawksworth, chief executive of the authority, said 2,000 doctors had applied to join the register since 1996, most from the UK. Among those who had been turned down, four had made appeals, but Dr Kaul was the first to request a public hearing.

The case is expected to be held in October, and will be heard by a panel of two consultants and the director of appeals, who is a retired circuit judge.

Ms Hawksworth said: "To succeed, a doctor has to convince the authority that their training and qualifications are equivalent to those of a UK- trained doctor."