New Era for Child Psychiatry in Pakistan

Jan-March 2015 Volume 12(1)


M. Waqar Azeem, Mowadat H. Rana, Dorothy Stubbe
Page No:


New Era for Child Psychiatry in Pakistan


Muhammad Waqar Azeem1

Mowadat H. Rana2

Dorothy Stubbe3


The start of Second Fellowship in Child Psychiatry by College of Physicians and Surgeons, Pakistan is a dream coming true. It reminds one of the famous “I have a Dream”, speech by Martin Luther King Jr. His promise to the minority children of America in 1963 was realized many years later. The “rain of freedom, equality and justice” that was part of his dream took many decades to “fill the rivers of North America”. At this momentous occasion in history of psychiatry in Pakistan, we are reminded of King’s dream. It has taken “scores of years” for the realization of the dream of setting up scientific and modern mental health services for the children of Pakistan. In its official notification on 15th December 2014, the College of Physicians and Surgeons Pakistan (CPSP) announced the approval of Child Psychiatry FCPS in the country. Indeed, a dream has come true.  Pakistan is one of the first countries in Asia to start child psychiatry fellowship at national level. This fellowship is based on US model of 2 year training in child psychiatry after finishing 4 year FCPS in general psychiatry. For a country with 43 percent of its population below age 181, it is indeed a promise that had waited too long for its fulfillment. There are only a handful of child psychiatrists in Pakistan, and hardly any formalized mental health services for children that can be considered at par with the developed world. This fellowship is expected to be the vanguard of such a service in Pakistan. The second fellowship training will start in 3 major academic institutions in the country in 2015, namely, Institute of Psychiatry, BBH, Rawalpindi Medical College, Rawalpindi; Department of Academic Psychiatry, Mayo Hospital, KEMU, Lahore; and Department of Psychiatry, Aga Khan University, Karachi.


Many people have played a major role in developing this fellowship. The leadership of Prof. Fareed Minhas (Chair of Psychiatry at Institute of Psychiatry Rawalpindi) and Prof. Mowadat Rana (Dean of Psychiatry CPSP) was instrumental. First step was developing curriculum for child psychiatry training which started about 3 years ago by Prof. Fareed Minhas with input from Professor Atif Rehman (University of Liverpool), Dr. Muhammad Waqar Azeem (Albert J. Solnit Children’s Center / Yale University), Dr. Dorothy Stubbe (Yale University) and Prof. Mowadat Rana. The curriculum is based on 2 year child psychiatry fellowship curriculum of Yale Child Study Center / Yale University with modifications according to the Pakistani system and FCPS training. The curriculum was submitted to CPSP. In this regard there was a major meeting in December 2013 in Rawalpindi including Prof. Mowadat Rana, Prof. Fareed Minas, Dr. Muhammad Waqar Azeem, Dr. Ayesha Minhas (Institute of Psychiatry Rawalpindi), Dr. Nazish Imran (Chair Person , Department of Child and Family Psychiatry, King Edward Medical University / Mayo Hospital Lahore) and Dr. Ayesha Mian (Chair of Psychiatry, Agha Khan University Karachi). Some of the main issues were discussed in this meeting and future goals were set.


As the CPSP requested pool of multiple choice questions (MCQ’s) for child psychiatry fellowship, we are thankful for all the hard work done by Dr. Dorothy Stubbe, Dr. Nazish Imran, Dr. Ayesha Mian, Dr. Ayesha Minhas, and Dr. Imran Khawaja for preparing the brand new MCQ’s to be used for examination of the fellows who will participate in this fellowship.  The process of preparing a pool of MCQ’s was led by Dr. Muhammad Waqar Azeem. The examination will include both written and oral examinations.


It is important to remember that first Child Psychiatry Department in Pakistan was developed by Prof. Khalida Tareen decades ago. She has played a major role in developing child psychiatry in Pakistan since 1970s. Sporadic initiatives in child psychiatry in 1980s and 1990s were also observed. Prof Malik H Mubbashar had set up the School Mental Health Services in Northern Punjab highlighting the role of children as “eyes and ears of community” to enhance mental health literacy. Pakistan Armed Forces had initiated specialized child psychiatry services through Prof Major General Salim Jehangir in 1990s.


Since 2000, there are number of other advancements regarding child and adolescent psychiatry that occurred in Pakistan. This includes opening of first inpatient child psychiatry unit at Mayo Hospital / King Edward Medical University Lahore in 20122. The new Autism Program started at Dow University of Health Sciences in 2013, in addition to already established Autism Program at Children’s Hospital Lahore. Various Universities and Hospitals have now dedicated child and adolescent psychiatry programs like at Institute of Psychiatry Rawalpindi, Agha Khan University Karachi and Mayo Hospital / King Edward Medical University Lahore to name a few. Increased awareness among parents has led to various parent organizations like “Pakistan Autism Meet Up” and “KAAT”.  Pakistani researchers are presenting their research on child and adolescent mental health topics at various prestigious International Conferences like Annual Conferences of American Psychiatric Association (APA), American Academy of Child and Adolescent Psychiatry (AACAP), Royal College Conferences as well as at International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP) Conferences. There are recent publications from Pakistan regarding autism and developmental disabilities in international peer reviewed journals3,4,5. Recently, Pakistan also became member of IACAPAP which is a huge step leading to Pakistan’s involvement with prestigious International Child Psychiatry Organization. In February 2015, Prof. Nasar Sayeed organized an international conference in collaboration with Dr Afzal Javed on the theme of development of child psychiatry services in Pakistan.


We are extremely thankful for all the support by APPNA, APPNA MERIT, President CPSP, CPSP Council and Executive Team of Pakistan Psychiatric Society. In addition, we are thankful to Prof. Atif Rehman, Dr. Babar Rao (Chair APPNA Merit), Dr. Salma Malik (Institute of Living, Connecticut) and President and Executive Team of APPNA.


With all of these heartening developments taking place in the country, child psychiatry fellowship is a step in the right direction. Starting child psychiatry fellowship in Pakistan is an amazing team effort by colleagues from Pakistan, USA and UK. For everyone abroad who is involved in developing this fellowship, it’s not just giving back to our motherland but an honor and privilege to contribute to produce next generation of child psychiatrists who will make a difference for children and families in most need.




1.      UNICEF Statistics (Internet). (Cited 2010 Mar 6). pakistan_statistics.html


2.      Imran N, Azeem,MW. Report from Pakistan. AACAP News 2014; 45(1): 5-6.      


3.      Imran N, Chaudry MR, Azeem MW, Bhatti MR, Choudhary ZI, Cheema MA. A Survey of Autism Knowledge  and Attitudes among the Healthcare Professionals in Lahore, Pakistan. BMC Pediatrics 2011; 11:107.


4.      Rahbar MH, Ibrahim K, Assassi P. Knowledge and attitudes of general practitioners regarding autism in Karachi, Pakistan. Journal of Autism and Developmental Disorders 2011; 41(4): 465-474.


5.      Azeem MW, Dogar IA, Shah S, Cheema MA, Asmat A, Akbar M, Kousar S, Haider II. Anxiety and Depression among Parents of Children with Intellectual Disability in Pakistan. Journal of the Canadian Academy of Child and Adolescent Psychiatry Nov 2013; 22:4, 290-295.               


1 Muhammad Waqar Azeem, MD, DFAACAP, DFAPA                                        

Chief of Psychiatry / Medical Director

Albert J. Solnit Children’s Center, Connecticut, USA

Associate Clinical Professor, Yale Child Study Center

Yale University School of Medicine

Associate Residency Program Training Director Yale Child Study Center / Solnit

Child & Adolescent Psychiatry Fellowship


2 Professor Mowadat Hussain Rana, MBBS, MCPS, FCPS, MCPS-HPE, DCPES-HPE,

MRCPsych (UK), FRCPsych (UK), D-CBT (Oxford)

Dean of Psychiatry

College of Physician and Surgeons Pakistan



3 Dorothy Stubbe, MD

Associate Professor, Yale Child Study Center

Yale University School of Medicine

Program Training Director, Yale Child Study Center

Yale University School of Medicine

Medical Director, ACCESS-Mental Health Yale Hub

Connecticut, USA