Islamabad: Pakistan’s College of Physicians and Surgeons Pakistan (CPSP) has rejected claims that Pakistani doctors were unfairly paid under a UK-based international fellowship programme, saying a recent article published by the British Medical Journal misrepresented an independent review, omitted key facts and drew conclusions not supported by evidence.
In a formal response, CPSP said the BMJ article’s opening assertion of “failures to ensure that doctors were paid fairly” had been widely and wrongly interpreted to mean that doctors were underpaid. The college stressed that the independent review did not establish that any International Training Fellow received incorrect or unfair payment and that none of its findings confirmed financial exploitation of individual doctors.
CPSP said the review, conducted by KPMG, contained 17 recommendations, all directed at governance and administrative processes of the UK hospital trust, not at confirmed payment discrepancies. It noted that a crucial statement within the report was ignored in the BMJ coverage, namely that reviewers did not interview any International Training Fellows and were not made aware of any complaints by fellows regarding the stipends they received.
According to CPSP, this admission fundamentally weakens any assertion about unfair pay. The college questioned how conclusions about payment fairness could be drawn without directly verifying stipend amounts with the doctors themselves, calling this a basic methodological failure that undermined the credibility of the review.
CPSP also expressed concern that the BMJ published its article without seeking the college’s comments prior to publication, saying the omission resulted in an unbalanced narrative. It said the selective interpretation of the review, combined with the exclusion of key contextual facts, caused reputational damage to Pakistan’s premier postgraduate medical training institution.
The college reiterated that it had already begun concluding its specific collaboration with University Hospitals Birmingham NHS Foundation Trust after receiving formal complaints from trainees regarding inequitable treatment and training-related concerns.
It clarified that the memorandum of understanding governing the programme was drafted by the UK trust and that CPSP had no role in commissioning or conducting the independent review, gaining access to its findings only after their public release.
In its investigation, the BMJ reported that the Birmingham trust’s fellowship programme, run between 2017 and 2025, recruited more than 700 overseas doctors, most of them from Pakistan, under the title of “International Training Fellows”. The scheme was promoted as a “learn and return” initiative but, according to the review, most participants remained in the UK rather than returning to their home countries.
The BMJ report, based on the KPMG review, highlighted multiple governance failures, including unclear pay arrangements, weak oversight of public funds, possible breaches of UK employment law and the use of a UK-based intermediary company to distribute stipends without a formal contract. Auditors said the trust could not confirm how much individual doctors were paid, though the review did not conclude that doctors were underpaid.
The review also found that fellows working full time in UK hospitals were classified as students rather than employees, which denied them standard employment rights under UK law. Following the findings, the Birmingham trust confirmed it had scrapped the overseas fellowship scheme, severed ties with CPSP and offered remaining doctors standard NHS contracts.
CPSP said it was conducting its own detailed inquiry into the circumstances surrounding what it described as a misleading and damaging narrative, while reaffirming its commitment to ethical international collaborations based on a “brain gain, not brain drain” principle, with overseas training placements capped at two years.
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