Given the blood, sweat and tears involved in its acquisition, the fellowship postnominal holds a deep emotional value for many specialists.

So, the debate about the rights and wrongs of colleges preventing those specialists from using their postnominals should they ever stop paying the membership fees burns hot — even if it’s a heat that the colleges themselves would prefer to ignore.

But it is relevant now because of the rise of independent CPD homes.

In what is just one salvo by governments to dismantle what they believe are unjustified college monopolies, they were created so specialists can meet their CPD obligations to remain on the specialist register without being forced to pay thousands in membership fees to do their college’s CPD program.