11 May 2022

Dear Fellows and Members,

April has been a busy month in RCSI. The Charter Meeting was a resounding success culminating in the award of Honorary Fellowships to Prof. Derek Alderson, past President RCS England; Prof.Trevor McGill, Otolaryngologist Boston Children’s Hospital; Prof. Stanley Goldberg, Colorectal Surgeon, University of Minnesota; and Mr Roddy Doyle, novelist, dramatist and screen writer. The meeting was held online from 20-22 April and and over 1,000 participants registered for the online events and 130 attended in person.

The format allowed participation by the National Office of Clinical Audit and parallel sessions for 13 surgical specialties and sub-specialties, the faculties of Nursing and Midwifery, Sports and Exercise Medicine, Radiologists and Dentistry as well as plenary symposia. The Johnson and Johnson lecture on ‘Artificial Intelligence – the next surgical revolution’ was delivered by Dr Ozanan Ricardo Meireles Director of the Surgical Artificial Intelligence Unit at Harvard Medical School. The 97th Abraham Colles Lecture was given by Dr John Alverdy, University of Chicago on ‘Examining the root cause of surgical complications through the lens of the microbiome’. Dr Melina Kibbe, editor-in-chief of JAMA Surgery gave a keynote address on ‘Publish or Perish’. Prof. Kevin Barry, National Director of Surgical Training hosted an excellent session, ‘So you want to be a surgeon?’ for Affiliate Members and those considering a career in surgery. All presentations and symposia have been recorded and are available to review online here.

I am pleased to report that work has begun on Project Connect – the largest capital investment ever made by RCSI. The project will deliver much needed space on the St Stephen’s Green campus on the site of the Ardilaun Block A office building (between 119 St Stephen’s Green (Shanahan’s Restaurant) and the Unitarian Church, connecting the 26 York Street building with St Stephen’s Green in a signature building designed by Henry J. Lyons architects. The building will house the new RCSI School of Population Health, the Graduate Entry to Medicine Programme, provide an extended footprint for the National Surgical Training Centre and most importantly bring the modern face of RCSI to the attention of the general public through a ground floor interactive exhibition and education facility.

The Joint Surgical Colleges Meeting (JSCM) has recently agreed that the ‘post-nominals’ to be used in conjunction with the award of Fellowship of one of the four Surgical Royal Colleges must clearly distinguish between the various routes to the award of Fellowship. In particular, post-nominals (e.g. FRCSI) must distinguish between success in the Intercollegiate Specialty Board Examinations (ICBSE) held in the UK and Ireland and the Joint Surgical Colleges Fellowship Examination (JSCFE) held internationally given the difference in the permissive status of the two examinations.

With effect 1 January 2023, the agreed post-nominal for Fellows who affiliate to a College following success in a JSCFE examination will include the prefix ‘int’ (e.g. intFRCSI). Fellows who have been successful in the ICBSE examination are reminded to use the correct post-nominal that identifies which of the 10 surgical disciplines the recipient is aligned to. It is important to note that the post-nominal in General Surgery does not include a subspecialty interest such as colorectal or breast surgery. Thus, the correct post-nominal is FRCSI (Gen. Surg.). Post-nominals may only be used by Fellows or Members in good standing with the College of their affiliation.

On 4 May I was delighted to introduce Prof. Deborah McNamara at the Annual Meeting of the Association of Surgeons of Great Britain and Ireland held in Liverpool where she delivered the Robert Smith lecture on behalf of RCSI. Prof. McNamara give an outstanding lecture that challenged current level 3 and 4 hospital service delivery models so brutally exposed by COVID, arguing that 70% of procedures on waiting lists are of low complexity that could be delivered in elective settings outside of acute hospitals. The challenge for the profession is to lead in this shift rather than to have it imposed, thus ensuring that standards are maintained and training opportunities are optimised.

The final meeting of the present RCSI Council took place on Thursday, 5 May. The election of the new Council will take place on Tuesday, 7 June. Fellows and Members in good standing will have received electronic ballot papers. I encourage all eligible to vote ahead of the election date. If by chance you have not received a ballot paper please contact the Fellows and Members office.

I am grateful to all who have put their names forward to serve on Council. I am especially pleased to see the geographic and specialty diversity of candidates. Five outgoing members of Council, including myself, have decided not to put themselves forward for re-election, thus the Council will have new faces, new ideas and renewed energy. I was very pleased to recognise the enormous contributions of Mr Kenneth Mealy, immediate Past-President, Prof. Paul Burke, Prof. Paul Redmond and Mr David Quinlan who, with myself, have given almost 50 years of voluntary service to RCSI and our surgical community.

At its meeting, Council approved reports of short life working groups (SLWG) on Cosmetic Surgery, Adrenal Surgery, and Career Development and Support Programme for Non-Training Scheme Doctors.

The SLWG on Cosmetic Surgery, chaired by Ms Margaret O’Donnell, was asked to provide recommendations on the principles of best practice in cosmetic surgery and to make recommendations on how cosmetic surgery services could be delivered in Ireland, to enhance patient safety and reduce the risk of complications.

The SLWG on Adrenal Surgery, chaired by Prof. Paul Redmond, provided recommendations on best practices in adrenal surgery with a particular focus on endocrine adrenal surgery. Centres undertaking adrenal surgery should offer seamless, timely and expert care within a multidisciplinary team. The SLWG recommended that adrenal surgery be performed by surgeons who undertake a minimum of six adrenalectomies a year; 12 per year per centre where adrenocortical cancers are being performed.

The work of the SLWG on Career Development and Support Programme for Non-Training Scheme Doctors (NTSDs), chaired by Mr. James Geraghty, was presented at the Millin meeting in February. The report recognises the major contribution of NTSDs to the delivery of surgical services in Ireland and identifies the need for support, career guidance, quality assurance and supervision for NTSDs, many of whom are recruited on short term contracts with little prospect for career development.

The three reports will be available on the RCSI Surgery site once the HSE and other relevant stakeholders have had the opportunity to review.

I was pleased last weekend to attend the annual scientific meeting of the American Society of Colon and Rectal Surgeons in Florida and to congratulate RCSI Honorary Fellow, Dr Conor P. Delaney, who was installed as ASCRS President. Conor, who trained as a Senior Registrar in Ireland, is CEO Cleveland Clinic Florida, becomes the first international medical graduate to lead ASCRS, a singular honour.

One of my last duties as RCSI President will be to attend the European Surgical Association annual meeting in Lisbon as ESA President. It will be the second occasion in which the RCSI President is also ESA President, the first was the late Prof. Gerry O’Sullivan. It is a real honour to follow in his footsteps.

Lastly, may I thank you, the Fellows and Members of RCSI, who have given so much to your patients, society at large and the College over two very difficult years. I have been enriched by your engagement and support. My thanks to the Vice-President and Council, the CEO Prof. Cathal Kelly, and the senior management team, Mr Kieran Ryan and his team in Surgical Affairs, Ms Catherine Jordan and her team in the Fellows and Members Office, my PA Mrs Kate Smith, Head Porter Mr Frank Donegan and his team, Ms Louise Loughran and her team in the Conference and Events office, the RCSI academic and administrative staff and most especially my family who have supported me through my two years as your President.

With kind regards,

Professor P. Ronan O'Connell
President, RCSI