A message from the President of RCSI

29 May 2020

Dear Fellows and Members,

With a certain degree of sadness, I have to inform you that this will be my last President’s newsletter. Council elections will take place next week. The incoming Council will be led by Professor Ronan O’Connell as President and Professor Laura Viani as Vice President. I wish Professors O’Connell and Viani every success in their respective roles, particularly understanding the challenges that lie ahead.

In recent months, and in the final chapter of my two-year tenure as President of RCSI, our world has literally been upended by the COVID pandemic. Many of us have come to question not only our own personal life values but also the true meaning of our professional commitment to healthcare education and delivery. Two years ago, RCSI as a health sciences institution looked secure in the midst of delivering on a five-year strategic plan incorporating a transformative educational experience for our students, postgraduates and trainees, cutting-edge health science research and a strong commitment to societal engagement at local, national and international levels.

While our mission value of ‘Leading the World to Better Health’ must remain as strong as ever, we clearly will need to re-evaluate each priority in our strategic plan in the coming months. I know our Senior Management Team, under the direction of our CEO/Registrar Professor Cathal Kelly and Dean Professor Hannah McGee, have engaged widely to prepare for all eventualities.

Planning for the return of both new and continuing students to all of the RCSI Campuses clearly poses considerable challenges, understanding possible international travel restrictions, the need for social distancing and the resumption of hospital access for students, all of which will require an adept understanding of the rapidly moving COVID landscape. I wish our Senior Management Team and all RCSI academic and professional staff well in their endeavours in this regard over the coming academic year.

While many of our ambitious plans for the future such as Project Connect, our planned academic building on St Stephen’s Green, and the Connolly Hospital Academic Centre must, of necessity, be put on hold, I believe we can congratulate ourselves on some remarkable achievements over the last two years, these include:

  • Building a world-class Campus with state-of-the-art education and training facilities on York Street and Beaumont Hospital
  • Satisfactory progression of THEP, the new Undergraduate curriculum in Medicine
  • Appointment of new Heads of School in Pharmacy and Physiotherapy, Director of Research and more recently a Chair in Global Surgery
  • Awarding of University status in Ireland
  • Major developments in gender equality measures across RCSI with the ‘Women on Walls’ series of portraits, Amelia Stein portraits of female academics and the J&J Progress Fellowship programme for female surgical trainees
  • Achieving first in the Times Higher Education World Ranking domain for Good Health and Well-Being
  • Development of the Institute of Global Surgery and ongoing collaboration with COSECSA

Our surgical training programmes have successfully undergone a significant change programme over the past few years. Our programmes were one of the first postgraduate training programmes to be accredited by the Medical Council. While I now feel that many of the initial teething problems have been satisfactorily addressed, we all understand that the training environment is dynamic and ‘fine tuning’ may be necessary in the future to address changing circumstances.

The Surgical Training pathway continued to innovate in response to evolving training needs, particular innovations of note include:

  • The Equivalent Standards Route (ESR), which was activated last year. The ESR provides an alternative opportunity to suitably qualified and experienced candidates to apply for places on in specialty training.
  • The new Specialty Training Post Quality Standards, which were launched across the 12 specialties in 2019. Established in the interests of trainers, trainees, the hospitals themselves and, ultimately, patients, these standards set the benchmark for training site quality in line with the requirements of the College and the Medical Council’s criteria for quality assurance mechanisms in place at training bodies.
  • The Faculty of Surgical Trainers was established in June 2019, with the objective of providing a structured academic support framework and appropriate recognition for the work of surgical trainers.
  • Over the course of this year, along with our intercollegiate partners, we will implement the new surgical training curriculum, which is an exciting development.

I am pleased that the implementation of the recommendations of the report by RCSI’s Working Group on Gender Diversity continued. It is particularly encouraging that the proportion of female trainees commencing surgical training has continued to grow from 40% to 50% in the past two years. In postgraduate education and training, RCSI also continues to provide a comprehensive CPD programme for both those on the formal training pathway and those in non-training posts.

RCSI Professor of Postgraduate Surgical Education Oscar Traynor and Dean of Professional Development, Professor Sean Tierney in conjunction with the department of Surgical Affairs have developed an impressive portfolio of CPD credits available for all doctors working in surgical departments. I thank all for their important contribution to supporting our Members and Fellows.

Simulation has become a cornerstone of our students’ education experience at RCSI and the National Surgical and Clinical Skills Centre at RCSI has now completed its third year of operation. All Undergraduate Medicine students and Postgraduate Surgical Trainees now participate in simulation-based education throughout their time at RCSI and our Pharmacy, Physiotherapy and Physician Associate students also benefit. The Higher Education Authority’s grant to establish a Chair in Simulation is very welcome. It will enable RCSI to drive critical research in simulation-based education.

In terms of healthcare engagement, our National Clinical Programmes in Surgery collaborate positively with the offices of the HSE Chief Clinical Officer and the National Group Lead of the Acute Hospital Division, in facilitating ‘best practice’ in surgical care. This mutually beneficial relationship has been supported by HSE funding for specialty leads in general surgery, urology, otolaryngology head and neck surgery, vascular surgery and more recently in plastic surgery and OMFS.

Following on from the successful launch of the Otolaryngology Head and Neck and Urology Models of Care we can expect to see each of the surgical specialties publish specialty specific models of care in the coming years. It gives me great pleasure to acknowledge all those working on the clinical programmes. Who would have thought a few years ago that each surgical specialty would have the opportunity to define best practice in their own specialty and publish a national road map to inform service delivery in the years ahead?

One of the consequences of the COVID pandemic has been the remarkable ability and willingness of so many within the health service to respond to the unprecedented challenges posed by the influx of such a large cohort of highly infectious patients into our hospital system. Numerous examples of leadership has been shown in embracing new ways of working, networking using digital technology and understanding that the demands of the overall system must take precedence over the any individual group or vested interest.

Not unsurprisingly perhaps, some ‘home truths’ have readily became apparent. For instance, the pivotal role of primary care in protecting the acute hospital system from ‘overload’, the importance of the integration of community, secondary and tertiary care with greater ease of patient progress along the total patient journey and perhaps most of all and of particular interest to surgeons, is the necessity for protected surgical capacity for scheduled surgical care.

The almost complete cessation of planned surgical work reflects to a certain extent what happens each winter. All of us have too many examples of patients unable to avail of timely surgical care because of the constraints forced on us due to the COVID pandemic. This clearly demonstrates the need for the complete separation of acute from elective surgical services. RCSI and our Clinical Programmes in Surgery have been campaigning for this for many years and will now continue to do so with greater resolve.

As I now come to the end of my RCSI Presidency, I hope that some of the lessons learnt from the management of this crisis will inform health service planning into the future. I look forward to this College continuing to take an active part in constructive engagement with our health services building on the work carried out by our training programmes, National Clinical Programmes in Surgery and the National Office of Clinical Audit.

One of the great privileges of my role as President has been the engagement with our Fellows and Members. I am pleased to say this has been very positive. I thank each of you for your support, for making contact over the last two years and, in particular, I thank those who have contributed to making RCSI the institution that it is, with a clear mandate to advocate for and support of surgeons and for those in training.

Ironically, it has been the COVID crisis that has perhaps allowed us explore new ways of Fellowship engagement; the webinars, videoconferencing and online learning platforms offer huge potential for enhance interaction with surgeons at all stages of their careers and I look forward to Surgical Affairs building on these developments in the future.

To finish, we have to believe that the lessons learn from our current difficulties will not only strengthen us as a surgical community and increase our resolve to bring our creativity and innovation to the forefront and to plan a better future for all of our surgical patients.

I hope you and your families remain well as we face the coming challenges that lie ahead.

Yours,

Mr Kenneth Mealy, RCSI President