23 April 2021

Dear Fellows and Members,

I feel it appropriate to update you on activities as April has been a very busy period for the College. The Department of Surgical Affairs has dealt with 468 applications for core and specialty training in Surgery and Emergency Medicine. I am most grateful to the staff in Surgical Affairs for the enormous work undertaken to deliver over 400 virtual interviews, interviews that could not have taken place without the participation of 229 interviewers, a figure that truly reflects the strong commitment to training among our surgical community. The number of places in core surgical training has increased from 60 to 80 places. 37 trainees were appointed to specialty training posts across all surgical specialities. My congratulations to all who were successful at interview. The increased number of core training places will necessarily lead to a need for expansion in specialty training posts by 2023. The College will actively engage with the specialty programme directors and the NDTP to ensure those successful in core surgical training will be able to progress.

Council has directed that a working group be established to review progression from core to specialty training and how best to match the numbers of suitable specialty training posts to training needs and the specialty interests of core trainees. It is hoped that a more streamlined approach will reduce miss-matches between the number of applications and specialty training opportunities available, as there has been great disappointment among some trainees who, although appointable, found that they were unable to progress into their chosen specialty. Surgical Affairs will work with ISPTC to develop proposals and I hope to be able to report back to the Fellows and Members in due course.

The new Intercollegiate Surgical Curriculum will come into effect in August 2021. A key change is that assessment of surgical training will become outcomes-based against the fundamental capabilities required of consultants. The end of training will be reached when supervisors agree that a trainee is performing at the level of a day-one consultant, successfully managing the unselected emergency take, clinics and ward care, operating lists and multi-disciplinary working, while demonstrating the generic professional behaviours required of all doctors. The existing curriculum had attracted criticism for relying too heavily on competency-based training with not enough emphasis placed on the holistic professional judgement of clinical supervisors. Because of this, a new assessment called the Multiple Consultant Report (MCR) encompassing the new concepts of the Generic Professional Capabilities (GPCs) and Capabilities in Practice (CiPs) will be introduced. Fellows and Members may wish to visit the ISCP website, however Surgical Affairs will ensure that adequate information and training will be available for Irish trainees and trainers. By way of introduction, a Wednesday webinar is being planned for May.

This week’s webinar featured very interesting presentations by Professor Stephen Cheng (Academic Head, Department of Surgery, University of Hong Kong), Professor Premnath Nagalingam (Dean RUMC, Penang, Malaysia) and RCSI graduate Dr Atasha Asmat (Head of Thoracic Surgery, Tan Tock Seng Hospital, Singapore). As in Ireland, scheduled care was significantly reduced during the worst waves of COVID-19, but in all three countries scheduled services are returning to normal. The problems of waiting lists and deferred investigations, particularly radiological investigations, are common to all. Nevertheless, Hong Kong and Singapore, in particular, were much better prepared for a pandemic than we were in Ireland. Early introduction of strict travel restrictions and compulsory quarantine of close contacts greatly reduced viral spread. Harsh lessons from previous experience with SARS had clearly been learned. If you missed the webinar, you can access it here.

The news is much worse from India, and our thoughts go to our healthcare colleagues who are facing shortages of beds, oxygen and antiviral drugs that has led to chaos and panic. It can only be hoped that enforced public health measures and vaccination will bring some relief of the suffering.

The Forum of Postgraduate Training Bodies met this week under the chairmanship of Mr Kenneth Mealy, RCSI Past-President. The major item discussed was a proposal to develop a common charter for postgraduate education that would support a generic curriculum across all disciplines. In tandem, a generic logbook will be launched that will be available to NCHDs on the general register. This initiative will support career progression. The Medical Council has initiated a consultative forum on standards in professional education with the aim of ensuring that the highest standards are maintained and that there is consistency of quality standards across the continuum of professional education. No doubt there will be much to reflect on.

A Consultant Trainer Support Portal has been launched on www.msurgery.ie and a separate portal will soon be available for trainees in Northern Ireland. A training video library of 100 Surgical Procedures edited by Professor Tom Walsh has been released to trainees.

The spring JSCM (Joint Surgical Colleges Meeting) was held earlier this week. There was considerable discussion on the ICBSE and JCSE examinations format and delivery. The JCSE in Otorhinolaryngology took place this week and all remaining disciplines will be examined in coming weeks. It was agreed to continue with the COVID-19 imposed formats for the moment.

Since the last newsletter, I have had the sad task of sending condolences to the families of Ali Hejazi, an RCSI final year medical student who tragically died while swimming; John Daly, honorary FRCSI, who was a great friend and mentor of Irish surgeons; Professor Jim Dornan, Professor of Obstetrics and Gynaecology at RCSI Bahrain; and to Professor Cathal Kelly, our CEO, following the sudden death of his younger brother Raymond last week. May they all rest in peace.

Finally, may I wish all our Fellows and Members of the Muslim faith a prayerful and meaningful Ramadan.

Kind regards,

P. Ronan O’Connell