Club culture' in British medicine must be replaced, argues senior heart doctor.

The system that awards national and academic honors to doctors is called into question by a senior doctor writing in The BMJ.

Consultant cardiologist, Peter Wilmshurst, tells the story of Anjan Kumar Banerjee, a surgeon who spent the years 2002 to 2008 erased from the medical register for serious professional misconduct related to research fraud, financial misconduct, and substandard care.

Yet in 2014 he was awarded an MBE "for services to patient safety."

The MBE was forfeited two months later, but he remains a fellow of three medical colleges, explains Wilmshurst. The University of London has also ignored repeated requests to withdraw his Master of Surgery (MS) degree during the 15 years since it was confirmed to be based on fraudulent data.

"We need to get rid of the existing 'club culture' in British medicine and replace it with a culture that values integrity and transparency," he argues. And he warns that the inappropriate award of honours and medical qualifications to Banerjee "is not an isolated case."

British medicine has opaque procedures that can be manipulated to gain honours, advancement, and money (for example, clinical excellence awards), he writes. When errors occur, "the establishment would usually rather close ranks and silence whistleblowers than correct the error."

He says he is aware of other cases in which serious misconduct has been concealed and the culprits have received honours and awards, and calls for action to tackle a "systemic problem" in British medicine.

Peter Wilmshurst's story raises serious questions about the integrity of medical and scientific institutions, writes Richard Smith, in an accompanying editorial. Smith is former editor of The BMJ and now London-based Chair of the Board of Trustees for the international research institution icddr,b.

He argues that Britain has never taken the problem of scientific fraud seriously, and that "we have no way of knowing how many cases are successfully covered up."

"We need to move to a world where universities recognise the rightness of investigating allegations of misconduct and commit to punishing those found guilty and to publishing the results of their investigations, correcting the research record, and retracting fraudulent research," he writes.

And he says it's "shameful that the colleges do not retract Banerjee's fellowships, and their failure to do so raises questions about their competence and integrity."

"Something is rotten in the state of British medicine and has been for a long time. Statutory regulation is needed," he concludes.