14 November 2024
Dear Fellows and Members,
I write to you less than a week after the 2024 Millin Meeting, which saw almost 400 Members and Fellows, surgical trainees, NCHDs and researchers gather at RCSI for a varied and engaging meeting that focused on surgical research and training. The highlights of the meeting included the formal launch of the RCSI Early Career Surgical Network as well as the 47th Millin Lecture.
In recent weeks, we also celebrated the successes of RCSI Fellows at the recent Clinical Congress of the American College of Surgeons held in San Francisco. Looking ahead, the final edits on the 2024 edition of Surgeons Scope are underway, and it will be arriving in post-boxes and mailboxes worldwide in the coming weeks. Keep an eye out for it.
Millin Meeting 2024
The Millin Meeting is a very special event in the surgical calendar and there was a huge turnout for this year’s meeting, which was held in RCSI on Friday, 8 November.
Fellows and Members had the opportunity to start the day with a hearty breakfast that was provided as part of a Networking Meeting, supported by Fáilte Ireland. There was a great buzz around the College from as early as 7:45am as members of RCSI Council, consultants, and surgical trainees at all stages caught up with each other over coffee and bagels.
The formal proceedings got off to a great start with a keynote address from surgeon scientist Dr Ayesha Noorani. Dr Noorani’s talk was about the power of autonomy, creativity and discovery in academic surgical training. Taking us through her own career pathway, she highlighted the importance of aiming high and of collaboration, but also the need to persevere, because success is rarely linear. Dr Noorani was recently interviewed as part of our Beyond the Theatre podcast series.
The morning continued with a superb programme from the National Surgical Research Support Centre (NSRSC) organised by Professor Stewart Walsh, Clinical Lead of the NSRSC and Professor of Vascular Surgery at Galway University, and Dr Anne-Marie Byrne, Operations Director of the NSRSC. Dr Byrne provided an overview of the NSRSC’s work to support clinical trials in surgery and set out the Centre’s vision for the future.
In the short time since the NSRSC was founded, it has already made a huge impact on the surgical research ecosystem, building on our capacity to perform surgical clinical trials in Ireland. Our most active clinical research site in 2024 was University of Galway, and Mr Sami Abd Elwahab FRCSI received an award for working with his team to recruit over 110 patients to the PROPEL-2 surgical trial.
We also had five outstanding research presentations, and a large range of research posters, in a tight competition to receive the RCSI National Surgical Research Medal. The session was judged by our visiting keynote lecturers, Dr Ayesha Noorani and Dr Ori Rotstein. The presentations were a testament to the huge range of surgical research being undertaken in Ireland with topics including traumatic hand injuries; management of the obstructed urinary tract; extended pharmaco-prophylaxis in patients undergoing bariatric surgery; and how AI can reduce risk during thyroid and parathyroid surgery.
The winner of the 2024 National Surgical Research Medal was Dr Patrick Boland MRCSI, who presented research evaluating whether intratumoral variability of fluorescent signals can accurately classify rectal neoplasia. We hope to interview Patrick for a forthcoming edition of Surgical Bulletin but, until then, congratulations to Patrick and his research collaborators including Ashokkumar Singaravelu (UCD Medical Student), Dr Philip McEntee MRCSI, Dr Alice Moynihan MRCSI, and Prof. Ronan Cahill FRCSI, RCSI Council Member.
The mid-morning session focused on the impact of patient involvement in surgical research. Some of the most thought-provoking contributions came from patients like Krista Costello from Cancer Trials Ireland and Ciarán McCarthy, a PPI Contributor in Spinal Cord Injuries Research who supports a collaborative project with the IRFU, led by Prof. John Quinlan FRCSI and Mr Cliff Beirne FRCSI on behalf of RCSI.
A key takeaway, emphasised by Prof. Michelle Flood, RCSI PPI Ignite Lead and an expert on patient and public involvement in research, was the importance of using existing networks to build capacity. For those of you who wish to learn more about PPI and how it can be integrated into your research, I recommend you visit ppinetwork.ie, which is an excellent online resource.
The launch of the RCSI Early Career Surgical Network (RCSI-ECSN) was a real highlight of the day for me. Training and supporting surgeons is central to our mission at RCSI. Early career Fellows have enormous potential to improve patient care and to move our discipline forward. I am committed to increasing the supports that RCSI can offer early career surgeons as they navigate the career transition from training into independent practice.
I was delighted to welcome Ms Christina Fleming FRCSI, the recently elected Chair of the Early Career Surgical Network, to officially launch the network. Ms Fleming highlighted the role of the RCSI-ECSN in ‘the continuum of support' available through RCSI. There is also a new section for the RCSI-ECSN on the Fellows and Members Portal here. The committee would love to hear from you by email at ecsn@rcsi.com.
During lunchtime and throughout the breaks, attendees had a chance to meet with delegates from HSE NDTP and the clinical research centres from around the country, to speak with industry exhibitors and to view the Poster Exhibition, featuring almost 60 different posters. I would like to extend my thanks to the sponsors who were in attendance and whose support is critical to the success of the Millin Meeting. The team at RCSI worked hard to improve our exhibition hall so we would love to hear your feedback.
After lunch, an excellent keynote lecture from Dr Ori Rotstein provided his professional and personal perspective on the role of Patient and Community Engagement in surgical research. Dr Rotstein noted that effective planning and knowledge translation is imperative to community engagement, highlighting that co-creation is an essential step when mapping a project plan. He highlighted the fact that research that includes PPI is held in higher regard by funding agencies, assists with reputation building and empowers patients to act as advocates for the research.
The afternoon symposium was devoted to the work of the Faculty of Surgical Trainers. Surgical trainers are critical to the future of our discipline and the session provided an opportunity to acknowledge their contribution, while also discussing some of the challenges faced by trainers.
Co-chaired by Professor Carmel Malone FRCSI, RCSI Council Member and Mr James Geraghty FRCSI, RCSI Council Member, the symposium included several speakers. We were delighted to welcome Professor Anthony O’Regan to RCSI for the first time in his new role as Director of National Doctors Training and Planning. He acknowledged that while training is complex, in surgery and other craft disciplines there will always be a role for the apprentice model.
The symposium also included an important contribution by Professor Kilian Walsh FRCSI, RCSI Council Member on the second victim in clinical incidents and how this has the potential to impact the training relationship, recognising that the trainee/trainer relationship requires trust on both sides.
Dr Czara Kennedy MRCSI, shared the trainee perspective. She commented on the evolution of priorities across generations of trainees citing the need for training to reflect the realities of the age and life stage of trainees while also highlighting the two-way nature of a positive trainer-trainee relationship.
The symposium concluded with an update from Professor Kevin Barry, Director of the National Surgical Training Programme, who recognised how HSE NDTP-funded improvements have been key in supporting RCSI to continue to train skilled surgeons who are prepared to meet the evolving demands of healthcare, with benefits to both the trainees and the broader healthcare system.
After a long day, you might be forgiven for expecting energy levels to dip. However, the penultimate speaker of the day, Enda McNulty, former All Ireland winning footballer and GAA All Star, was not about to let this deter him. From the session ‘throw-in’, Enda had everyone in the lecture theatre on their feet performing stretches to music - a first for the Millin, I suspect. He certainly got the attention of all present before delivering an interactive and energetic keynote on ‘Supporting High Performance Teams and Individuals.’ He emphasised the importance of having an honest mentor, highlighted the importance of mental skills training and spoke about the zone of optimal functioning – a must for all high-performers.
On a practical note, Enda spoke of the importance of having a pre-surgery ritual, that might incorporate diet, meditation, stretching, exercise and sleep, as well as having a mental plan for the day. When the topic of the unpredictability of a day in surgery was raised from the floor, he challenged the audience by reminding us that even in such circumstances, many aspects remain under our control, and that we can work to counteract that unpredictability by starting the day right at home.
Our Millin meeting concluded with the 47th Millin Lecture, delivered by Ms Christina Fleming FRCSI on the topic of ‘Future-Proofing Surgical Training – A Template for new Technologies.’ The lecture was standing room only laying out an ambitious vision for the future of surgical training and practice. I am pleased to say that this fantastic talk was recorded and will be made available to watch in coming weeks.
I would like to take this opportunity to express my gratitude to our speakers as well as our co-chairs who did a fantastic job facilitating questions and ensuring the programme remained on schedule. My thanks also to RCSI Council and staff for their enthusiastic support as well as to the organising committee who worked throughout the year to develop and deliver the event. A special thank each of you who attended - it was wonderful to hear the buzz around RCSI as surgeons from all generations caught up.
Honorary Fellows of the American College of Surgeons
In late October, eight highly esteemed RCSI-affiliated surgeons were awarded Fellowships in the American College of Surgeons (ACS) at the 2024 Clinical Congress, which I attended in San Francisco. Among those select few bestowed with an Honorary Fellowship were two RCSI Fellows - Professor P. Ronan O’Connell FRCSI, Past President of RCSI and Mr Emmanuel Adoyi Ameh FRCSI (Ad Eundem).
Prof. Ronan O’Connell FRCSI will be known to many in our community, particularly for the leadership role he played as President of RCSI during the COVID-19 pandemic. He is an internationally recognised colorectal surgeon and Emeritus Professor of Surgery at the University College Dublin. He has also served as President of the European Surgical Association. In addition, Prof. O’Connell has made significant contributions to education and research in his roles on the editorial board of the Journal of the American College of Surgeons and the Annals of Surgery, as well as associate editor and editor of the BJS, associate editor of Diseases of the Colon and Rectum, past editor in chief for the European Surgical Association, and joint editor of several surgical textbooks.
Mr Emmanuel Adoyi Ameh FACS, FWACS, FRCSI attained Fellowship Ad Eundem of RCSI in February 2024. He is Professor and Chief Consultant Paediatric Surgeon in the Department of Surgery at National Hospital in Abuja, Nigeria. A specialist in paediatric surgery and former Chief of Paediatric Surgery at Ahmadu Bello University in Zaria, Nigeria, he has an enduring relationship with the American College of Surgeons in his role as the first Board of Governors member representing the Nigeria ACS Chapter, which he has led and expanded successfully.
I was pleased to be present for the ceremony, which was a truly special occasion and on behalf of RCSI Council and our entire community, I wish to extend my congratulations to both Prof. O’Connell and Mr Ameh on this achievement.
Surgeons Scope
In the coming weeks, please keep an eye out for the annual Surgeons Scope magazine, which will be arriving on doorsteps and to email inboxes worldwide. It is a fantastic read that aims to tell the stories of our community with contributors from the United States, Australia, Malaysia and Ireland.
In addition to regular features such as Scope news and updates, articles include a spotlight on the role and purpose of the National Surgical Research Support Centre as well as piece highlighting the importance of peer support and the establishment of the Early Career Surgical Network. Readers can also learn more about the personal stories of members of our community from Cork to Cleveland to Ukraine. Furthermore, four surgeons based both in Ireland and internationally share their experience of balancing work and family priorities.
Before I sign off for another month, may I draw your attention to the HSE NDTP Workforce Plan for Surgery, published last week. Thank you to the surgeons from every specialty who contributed to this important piece of work. While an increase in surgeon numbers is welcome, it is essential that additional access to theatres and hospital beds is also provided.
As always, I look forward to hearing your feedback and hope to see as many of you as possible at our annual Charter Day meetings on Thursday, 6 and Friday, 7 February.
Yours sincerely,
Professor Deborah McNamara
President, RCSI