3 December 2021

Dear Fellows and Members,

Last month I promised to be more upbeat in my next newsletter and I will do my best! Little did I realise that within a day of drafting this letter, Omicron would overtake us and yet again we face travel restrictions, social curtailments and an anxious wait to see how virulent the new COVID mutation will prove to be. I was due to deliver the Lars Pahlman Lecture to the European Colorectal Congress in St Gallen Switzerland this week, but sadly yet again I have had to record a lecture for a now virtual congress.

It has been an extremely busy month; somehow all the major College committees seem to meet in November. I am pleased to report that COVID notwithstanding, the College and the University are faring well – courses are being delivered and there is a sense of business almost as usual, admittedly with many working from home and on line. Human interaction is at the core of healthcare and I hope that this will be the last academic year so disrupted.

Last week, the National Clinical Programme for Trauma and Orthopaedic Surgery published its analysis of the impact of COVID-19. The report revealed an increase of 15% in those seeking an orthopaedic outpatient appointment with over 60% waiting 12 months or more. To address these difficulties our T&O colleagues had shown great initiative by introducing innovative solutions including Virtual Fracture Clinics and Active Clinical Triage which has made a dramatic and lasting impact in relation to the delivery of patient care.

This week ISPTC heard that COVID is yet again impacting on scheduled and urgent care. The media attention given to the unfortunate need to cancel an organ transplant due to lack of ITU capacity is but the tip of the iceberg. Chronic under-investment in the public hospital capacity, most especially in ITU and HDU beds, has been brutally exposed by the pandemic. One has to hope that, at last, the message will get through and that no longer will Irish bed capacity numbers languish in the lower tercile of OECD countries.

On a more positive note, I was pleased to chair the Colles Fellowship and RCSI Travel Scholarships awards committee. The standard of applicants was truly outstanding and a testament to the quality, ambition and work ethic of our surgical trainees. The committee’s recommendations will be brought to Council in December. All who applied deserve congratulations.

Applications for the 2022 intake of the national training programmes in surgery closed last week. In recent years, there has been a steady increase in the numbers of applications for Core Surgical Training. I am glad to say that this trend has continued again with 286 applications (42% female), a 14% increase on the previous year. This year applications were received from 38 nationalities, underlining Ireland’s international recognition for delivering high quality postgraduate training.

In addition to the accredited training programmes, RCSI is working to better support non-consultant doctors in so called ‘non-training posts’. A working group chaired by Council member Mr. James Geraghty will report to the December Council and I hope the report will be available to present to Fellows and Members at the Charter Meeting in February. In that regard, arrangements have been made with the HSE to introduce a structured education programme for SHOs not enrolled on a training programme in 2022. The programme will provide the core knowledge required to deliver surgical care within clinical settings while also supporting career development and professional needs. This structured programme of equivalent to 105 CPD credits has been brought together by educationalists and subject matter experts who have designed this intensive programme to cover a range of technical and non-technical skills required for safe practice. It is planned that a more advanced course which will be introduced in 2023 for NCHDs who are long-term posts and wish to enhance their skills and gain a qualification.

Next week the RCSI will publish an action plan aimed at advancing race equality and tackling racism. As one of the country’s most internationally diverse universities, RCSI’s Race Equality Action Plan will reinforce our commitment to ensuring that the experience of our students, trainees, trainers and staff is defined by respect, equality and inclusion. RCSI is the first higher education institution in Ireland to publish a race equality action plan, that outlines the steps we will take to improve the representation, progression and success of students, trainees and staff from minority groups at RCSI.

I had the privilege of representing RCSI at the Remembrance Day Choral Evensong at St Patrick’s Cathedral on Sunday, 14 November that was attended by President Michael D. Higgins, members of the diplomatic corps, politicians, military and Garda representatives. It is salutary to remember that Ireland lost more lives per head of population than any other country in Europe in World War 1, indeed Australia is only country to have lost more. The enormous loss to Ireland is captured by Prof John Horne in his book ‘Our War – Ireland and the Great War’ (Royal Irish Academy ISBN: 9781904890508) and in ‘Irish Doctors in the First World War’ (Irish Academic Press ISBN 9781785370045) by former Council Member Mr Joe Duignan, Patrick Casey and Kevin Cullen. Let us not forget.

I also had the privilege of welcoming the new ambassador of India H.E. Sundeep Kumar. On a short walk around the campus, His Excellency was able to meet students from several countries including India. I look forward to building on the close contacts that RCSI has developed though the large community of Indian surgeons currently working in Ireland and those who have undertaken some of their training in Ireland. The Ambassador has assured me of his willingness to support our endeavours.

On Wednesday, 10 November our Neurosurgical colleagues presented an excellent webinar on 'Neurotrauma'. This was a valuable update for all those in Emergency Medicine, General Surgery and Trauma services who look after patients with head injuries outside of the two major neurosurgical centres. Mr Mohsen Javadpour and his colleagues plan to run a regular series of grand rounds and CME updates for Fellows and Members that will be available through the RCSI website. This is a most welcome development.

The webinar on Wednesday, 24 November focused on hernia surgery and particularly on the difficulties of repairing incisional/ventral hernias. An excellent programme was arranged by Mr Dermot Hehir and included presentations from Mr Sean Johnson, Mr John Conneely, Ms Christina Flemming and Mr Liam Horgan, Past President of the British Hernia Society. The webinar is well worth viewing if you missed it.

I hope I have been more upbeat as promised at the end of October.
Keep safe

Best wishes