Partha Kar: The RCP leadership elections are an opportunity for a fresh start

The year 2024 could be described as an annus horribilis for the Royal College of Physicians (RCP). There’s no question about the impact the debate around physician associates has had on the college’s reputation. In the broader scheme of things this could have been a minor issue, but the way it was handled has taken a toll—including a lack of transparency, a damaging extraordinary general meeting called by fellows, and the resignations of many senior leaders. Further problems have continued to brew, such as the recent disaster involving exams for membership of the RCP.1

Amid all this controversy, we can hope that the college’s 2025 elections will be a turning point. But it’s astonishing that, even in these fractious times, RCP members don’t have the right to choose who will lead them and that the responsibility falls on fellows alone.

The college has failed to protect the interests of resident doctors—whether in career progression, job security, or exams—yet these doctors are the least likely to have a say in who will lead them. The responsibility on fellows, therefore, is huge. Without a directional change by the college or a belief that appointed leaders will be committed to the future of doctors, problems will persist. Some may believe that changes in certain posts will enable dramatic improvements, but disillusionment is still expressed, including on social media. I say this as someone who’s been intrinsically involved with the college since August 2023, whose own disillusionment has changed only marginally, if at all.

Regarding physician associates, many people in leadership roles may not necessarily have been direct supporters of the role, but their silence or lack of opposition could be seen as complicity. Their reluctance to voice their views publicly resulted in further progression of problems that have angered the rank and file of the college. Thankfully, this year’s elections are an opportunity for a fresh start—whether that be the president, clinical vice president, or council elections—with a wide array of candidates from within existing leadership and beyond.

Although a recent report by the King’s Fund on the RCP’s handling of its extraordinary general meeting highlighted multiple areas of governance at the college,2 change is still not happening quickly enough to adapt to what members want. Changes in governance are acutely needed, and members want to see change now, yet everything seems slow. There’s still an entrenched belief about the need to be “inside the tent” rather than showing how the tent should be put up. It’s now down to fellows to decide on the future course of the college and its leadership—and to make decisions that will uphold its core values and who those values stand for.

The elections are a pivotal moment for this prestigious institution and offer an opportunity for the college to regain its standing in the public domain. A poor decision will risk it becoming yet another organisation with dwindling membership and financial strength, reduced to a relic pontificating about its glorious past. It will be fascinating to see how the wider fellowship makes its choices. In the absence of a right for members to vote, all that members can do is hope that their seniors keep them in mind when picking their preferred candidates.