Reviving CPSP: Unlocking the Potential of a Declining Institution

Abstract

The College of Physicians and Surgeons of Pakistan (CPSP), once the embodiment of medical excellence and a beacon of scholarly prestige, now stands at a critical crossroads. Established in 1962 with the ambition to emulate the prestigious Royal Colleges in the UK, CPSP became the leading institution for postgraduate medical training in Pakistan. It produced specialists whose contributions shaped national and international healthcare systems for decades. However, recent years have witnessed a troubling decline in the college’s standards and reputation, signaling an urgent need for reform. CPSP was synonymous with rigorous academic and clinical training during its formative years. The Fellowship of the College of Physicians and Surgeons Pakistan (FCPS), the institution’s flagship qualification, quickly became a hallmark of excellence. Known for demanding exams and high training standards, FCPS provided graduates with domestic and international recognition, mainly through affiliations with international institutions like the Royal Colleges in the UK. The success of CPSP reflected Pakistan’s potential to contribute significantly to the global medical landscape¹. Over the last two decades, CPSP has experienced a gradual but concerning decline. One of the primary issues has been the dilution of examination and training standards.2,3 To accommodate a growing number of candidates, CPSP began lowering its academic benchmarks. Critics argue that this has weakened the overall quality of training, producing specialists whose competencies do not align with the high standards of their predecessors. As the volume of graduates increased, the perception of CPSP as a premier medical education institution began to fade. This erosion of standards has been exacerbated by political interference.4,5 Decisions regarding faculty appointments, policy changes, and curriculum reforms have been influenced by external political pressures rather than academic merit. This politicization has compromised the college’s independence and alienated key stakeholders, further damaging CPSP’s credibility and undermining trust in the FCPS certification. The decline of CPSP has also fuelled a substantial brain drain. In previous decades, numerous specialists trained by CPSP pursued opportunities overseas, especially in the UK and the Middle East.6,7 However, with concerns over declining training standards, many countries have withdrawn recognition of the FCPS qualification. This loss of international recognition has further marginalized CPSP, discouraging many from pursuing its certification in favor of globally recognized alternatives. Compounding CPSP's challenges is the underinvestment in its infrastructure and faculty development. While the global medical education landscape has embraced new technologies and innovative teaching methodologies, CPSP has struggled to modernize. Its regional centers, once vibrant hubs of medical education, are now under-resourced and outdated.8 The lack of investment in research, which is essential for any leading medical institution, has also stunted CPSP's academic growth, leaving it isolated from the advancements seen in other medical institutions worldwide. To reclaim its status as a leading institution, CPSP must undertake bold reforms. Restoring the rigor of its examination and training programs is crucial to reviving the value of the FCPS qualification. CPSP should focus on enhancing its standards to ensure its graduates are competitive in Pakistan and on the global stage. Revitalizing international partnerships is equally essential. Collaboration with respected global medical institutions, particularly those that once recognized FCPS, is necessary to restore CPSP’s international standing. These partnerships could help ensure CPSP-trained specialists are better equipped to meet global medical standards and regain credibility. Investment in infrastructure and faculty is another critical area. To keep pace with global advancements in medical education, CPSP must modernize its training facilities, incorporate cutting-edge technologies, and enhance faculty development. This investment is vital to re-establishing CPSP as a center of excellence in medical education. Finally, CPSP must address the issue of political interference. Governance reforms promoting transparency, merit-based decision-making, and academic autonomy are essential for restoring credibility. Without these changes, the erosion of trust in CPSP will only deepen. The decline of CPSP is more than just an institutional issue. It’s a national concern. As the primary institution for postgraduate medical education in Pakistan, CPSP holds the future of the country’s healthcare system in its hands. Its challenges reflect broader problems within Pakistan’s healthcare and education sectors.9 However, with swift and decisive action, CPSP can still fulfill its immense potential and become a global medical education leader. The time for reform is now before the decline becomes irreversible.

Keywords

• CPSP