19 June 2020

Dear RCSI Members and Fellows,

It is now 16 weeks since Taoiseach Leo Varadkar asked the country to “forego our freedoms” and Ireland commenced a period of lockdown in response to the evolving COVID-19 pandemic. Thankfully, the initial surge in cases that started in late March seems to have passed. Bed occupancy rates, particularly in critical care, are returning towards pre-COVID levels, leading to a growing imperative to reintroduce scheduled services.

COVID-19 now provides the opportunity to rethink how scheduled care is delivered. RCSI, working with the National Clinical Programmes in Surgery, has consistently emphasised the need to place the patient at the centre and the inescapable logic of separating acute from scheduled care. With at least 230,000 patients on elective waiting lists pre-COVID, the default option of cutting elective admissions in response to a winter bed capacity crisis cannot continue to be seen as a solution. Year-round protection of surgical beds and adequate theatre staffing would go a long way in alleviating this annual crisis. The National Clinical Programmes in Surgery and Trauma and Orthopaedics will advocate for implementation of strategies for acute and scheduled care detailed in published guidance and policy documents.

A growing concern for RCSI is the potential that trainees may be disadvantaged by transfer of low and medium-complexity cases into the private sector through ‘supercharged’ NTPF initiatives. Together with the Presidents of the other Postgraduate Medical Colleges, I have written to the HSE and Department of Health making strong representation that training opportunities must not be lost and that, in as much as is possible, trainees should continue to have the best access to those procedures and training opportunities. I was able to make further representations on this matter during a webinar with the Medical Council on Thursday afternoon.

In recognition of the importance of training opportunities to our Fellows and Members, the next webinar in the weekly surgical practice series will focus on ‘Sustaining surgical training programmes during the COVID-19 pandemic’. Speakers will include, Prof. David Healy, Council Member and incoming Chair of ISPTC; Mr Rustom Manecksha, Urology Training Programme Director; Prof. Oscar Traynor, Dean of Postgraduate Surgical Education and Training; and Ms Christina Buckley President Irish Surgical Training Group (ISTG) and SpR in Plastic and Reconstructive Surgery. This will take place on Wednesday, 24 June at 6pm. View more information and register for the webinar here.

On Wednesday we held our 14th weekly evening webinar during which we heard how our colleagues overseas are managing the reintroduction of scheduled care following COVID-19. Our speakers were RCSI Honorary Fellows Professor Frank Frizelle, University of Otago NZ; Conor Delaney, Cleveland Clinic USA; and Professor Mike Griffin, President Royal College of Surgeons of Edinburgh. If you were unable to attend the webinar, you can view it here.

I am delighted to let you know that this week Professor Mark Shrime, co-author on the Lancet Commission on Global Surgery, was appointed O’Brien Chair of Global Surgery at RCSI University of Medicine and Health Sciences. Professor Shrime will lead the University’s Institute of Global Surgery in its work to address the provision of surgical care in low and middle-income countries. Professor Shrime joins RCSI from Harvard Medical School and the Massachusetts Eye and Ear Infirmary, where he was Director of the Center for Global Surgery Evaluation.

Professor Shrime’s work focuses on surgical delivery in low and middle-income countries, where he has a specific interest in the intersection of health and impoverishment. He is the author of a number of seminal papers on the global burden of surgical disease, the financial burden facing surgical patients and the number of people who cannot access safe surgery worldwide.

RCSI University of Medicine and Health Sciences faculty held their International Educational Forum online over three days this week culminating in a Town Hall Meeting addressed by CEO, Prof. Cathal Kelly, Dean Prof. Hannah McGee and Heads of School in Dublin, Bahrain, Penang and Perdana. The online attendance of over 300 staff, the quality of the presentations and the commitment to student engagement was uplifting. I have little doubt that academic year 2020/21 will be transformative and successful.

On Thursday, RCSI Postgraduate conferrings took place virtually and included conferring degrees of Bachelor of Science (BSc) in Pharmacy, Master of Science (MSc) in Physician Associate Studies, Master of Science (MSc) by Research, Master of Surgery (MCh) by Module, Master of Surgery (MCh), Doctor of Medicine (MD), Doctor of Philosophy (PhD) and the NUI Degree of Doctor of Science (DSc) on Published Works. Conferrings are a time to celebrate the RCSI academics, faculty and supervisors who have supported the graduates throughout their studies and for the graduates, their families and friends. All in RCSI are immensely proud of their achievements. I was delighted to join (virtually) in their celebrations.

Finally, I want to address the issues which have emerged across the world since the killing of George Floyd by a police officer in the United States. We have all been horrified by Mr Floyd’s death and so many other appalling events. Black Lives Matter is an important movement, not just for the United States, but worldwide. Racial discrimination is a global problem, and, whether overt or not, it exists in every country, every organisation and in every individual.

The culture at RCSI is formed by our values of respect, collaboration, scholarship and innovation. Respect is the foundation of our commitment to equality, diversity and inclusion (EDI). Our faculty are in discussion with our student union to understand their experience and views. Our EDI Unit and EDI Committee will be taking staff views and reviewing our unconscious bias training and other needed actions. I will lead an engagement with the other postgraduate training bodies and the HSE on addressing issues in the healthcare workplace.

Every organisation, and we are no different, has to look honestly at its actions to address racism in all its forms and challenge itself to say we need to do more.

I hope your week will be safe and productive and that, within the constraints allowed, you will have some time to share with family and friends.

Best wishes,

P. Ronan O’Connell