Dear President and members of BOD,

There have been reports that some APPNA member physicians are charging medical students and young graduates for the opportunity to rotate at their offices as observers.

This practice goes against our core values and mission statement. Our organization exists to facilitate Pakistani descent medical students and young graduates, not profit off them. Charging medical students and young graduates damages the trust of our newer generation and the reputation of our organization.

Most worryingly, there have also been allegations of inappropriate conduct and sexual harassment, which make the need for clear action and guidance even more urgent.

I suggest that the BOD consider the following:

1. Publicly Denounce the Practice

Issue a formal statement condemning the act of charging medical students and graduates for rotations or observerships in APPNA member offices and hospitals.

2. Code of Conduct Commitment

Require that all nominees to APPNA Board-appointed committees affirm that they do not charge students or graduates for observerships and will not in the future. This undertaking should be part of the committee code of conduct. Nominees for Council appointed committees also be asked for such disclosure and commitment as well, prior to their election by the Council.

3. ⁠Communication with Medical Schools in Pakistan

Send a letter to principals and deans of medical schools in Pakistan, making it clear that APPNA does not approve of this practice. Ask them to share the letter with their students. The letter should clarify that if any APPNA member asks them for money for observerships, they should report it to the APPNA Board or the Ethics and Grievance Committee.

4. ⁠Guidance for Students and Graduates

Develop and publish guidance for students and young graduates that outlines their rights regarding clinical observerships and training, provides clear instructions for filing complaints with state medical boards in the United States and offer resources on how to handle and report inappropriate behavior, including cases of sexual harassment.

5. ⁠Consolidated Volunteer List

Task the APPNA Young Physicians’ Committee with developing a consolidated list of volunteer members who are willing to accommodate students and young physicians for observerships, ensuring equitable and transparent access to opportunities.

6. ⁠Task the YPC and the Committee for Liaison with Professional Organizations to identify hospitals that charge, in addition to insurance, fees for rotations; and to work with other professional and ethnic organizations to persuade these hospitals and institutions to stop the practice of charging students or young graduates for rotations or observership.

By taking these steps, the BOD will reaffirm APPNA’s role as an organization that stands for the welfare of students and young physicians, while upholding its mission of service, compassion, and professional integrity.

I urge that the BOD act decisively and swiftly in this matter. APPNA’s silence risks emboldening exploitative practices, while a strong and public stand will demonstrate the organization’s unwavering commitment to its values.

Sincerely,

Nauman Ashraf,

Lifetime APPNA Member