13 November 2020

Dear Fellows and Members,

I hope this letter finds you well and that as the the evenings darken you can reflect on how well we as a society have done in stemming the second surge of COVID. It is remarkable that in the short time since my last letter, Ireland has moved from having a really worrying rise in COVID cases – 17 October was the worst day on record – to now being the second best in Europe. Our hospitals continue to cope and scheduled care numbers are close to expected, nevertheless today Limerick, Letterkenny and Naas have had to suspend scheduled care. Your dedication, hard work and patient advocacy is remarkable and something I hope that you can look back on in years to come with satisfaction.

Internationally, it has been an extraordinary time. I for one was glued to CNN’s coverage of the US Presidential election which proved to be as compulsive as any Netflix serial. It brought home to me how fortunate we are in Ireland to have a system of proportional representation which, for all its vagaries, does reflect the will of the people. It also highlighted the fact that each of the states is quite autonomous and jealously guards its' degree of independence in electoral matters.

The other major news item was the Pfizer BioNTech announcement of efficacy from their phase 3 study of the COVID-19 vaccine they have developed. The science of using mRNA is fascinating and a potential game changer in terms of future coronavirus epidemics. It remains to be seen whether full scientific scrutiny of the results confirms initial optimism, but there is suddenly a lot more hope. The EU has secured 300 million doses of the vaccine. Ireland will have access to just over 1% based on our population relative to that of the other 26 states.

Many of our Fellows and Members based in the UK who read this letter find themselves in a more difficult position with regard to COVID and the effects on scheduled care. The Academy of Medical Royal Colleges, of which RCSI is a member, together with the GMC, NHS England and the four UK Chief Medical Officers issued a letter asking that doctors use their professional judgement to, understanding the considerable difficulties and resource shortages that they may face. A clear statement is made that the long-term prospects of doctors in training must not be compromised by a prolonged healthcare crisis. The letter can be downloaded and read in full here.

In response to growing concerns in the UK that logbook numbers are down as much as 50%, JCST with AsiT BOTA and the UK Confederation of Postgraduate Schools of Surgery (CoPSS) have also this week published a document on maximising training opportunities in surgery. We are more fortunate in Ireland, however the risks to training are real with a 25.6% increase in waiting lists for inpatient/day care numbers since February last. With that in mind, I have again written to Health Minister Stephen Donnelly to highlight our concern and asking that outsourcing of scheduled care to the private sector must take account of training requirements.

The Northern Ireland Liaison Committee under the chairmanship of Professor Thomas Lynch had its first meeting on 30 October. The aim of the committee is to establish how RCSI can better support Fellows and Members in Northern Ireland and to enhance collegiality between the surgical communities North and South, always acknowledging the allegiance of many surgeons to the other Royal Colleges. In that regard, the Presidents of the other Colleges and I are agreed that representations on behalf of surgeons in Northern Ireland will be on an intercollegiate basis. I felt the meeting, attended by Mr Trevor Thompson and Mr Niall McGonigle from Northern Ireland exceeded expectations. I am very hopeful that Fellows and Members in Northern Ireland will benefit from increased collaboration.

The webinar held on Wednesday, 11 November on vascular surgery was outstanding, dealing with recent NICE guidelines on EVAR, thoracic outlet syndromes and the JCIE Fellowship examination in Vascular Surgery. It made interesting viewing, even for a non-vascular surgeon and I highly recommend it. Next week’s webinar on 'Neurosurgical Management of Patients outside of Major Neuro Centres' is a must view for all general and trauma surgeons on emergency take. I strongly advise watching, and you can register to attend here. The RCSI Vice-President Professor Laura Viani is working on the programme of webinars for early next year. Suggestions for topics or offers to host are very welcome and can be submitted by emailing us.

Finally may I extend my very best wishes to all our Fellows, Members and friends in India and of Indian heritage on the Diwali Festival of Lights that celebrates the victory of light over darkness, good over evil and knowledge over ignorance. Never was the world so in need of such a celebration.

Keep safe,

Professor P. Ronan O'Connell
President, RCSI