17 January 2022

17 January 2022

Dear Fellows and Members,

As I write in the first weeks of January, I have a sense of optimism about the coming year – a feeling that I certainly did not have this time last year. Then there was early hope that vaccination would lift the dreadful shroud of COVID-19 and that something resembling ‘normality’ would emerge. Sadly, late winter and early spring last year brought untold pressures and widespread cancellation of scheduled services. While the summer and early autumn brought some respite, the delta and now the omicron variants have again brought the HSE to an elective standstill. Doctors, nurses and all healthcare staff are weary, however vaccination and public health measures have acted as a flood barrier to intensive care admission and overall there is a sense that the worst may be behind us.

No specialty was more acutely affected by cancellations of scheduled care than surgery. The surgical community has shown resilience and true commitment by continuing to support emergency, urgent and time critical surgery while taking every opportunity for our trainees to gain experience from scheduled ‘training’ cases.

In time to come we will look back at the past two years in much the same way as we look back at seismic events in the 20th century. ‘There is no education like adversity’ (Disraeli). The revolution in remote access and connected health forced upon us by the pandemic, will be transformative. Separation of scheduled from acute care, so long argued for, is now so self-evidently required that reconfiguration of surgical services is inevitable.

While we wait for COVID restrictions to ease, the Charter Meeting scheduled in February has been postponed to 21/22 April in the hope that a face-to-face meeting will be possible and that honorary conferrings can proceed on the evening of Friday, 22. The Millin meeting which has in the past been stand-alone held in November but was combined with the virtual Charter Meeting last year, will this year be held on Friday, 4 February. This will be a hybrid meeting that will feature the 29th Carmichael Lecture on ‘Education as a driver for sustainable development goals’ to be delivered by Ms Amina J. Mohammed, Deputy Secretary General of the United Nations and the 44th Millin Lecture to be delivered by Professor Joseph Butler on ‘The evolution of spine surgery: a paradigm shift to precision medicine’.

RCSI Council meets this week. The major agenda item will be consideration of a draft report from the working group on career development and support for non-training scheme doctors. The working group under the chair of Mr James Geraghty was tasked with providing recommendations on how RCSI could better support non-consultant doctors not enrolled in specialty training programmes. Membership of the working group reflected the current surgical workforce and included representation on non-training scheme doctors.

It is very clear that the health service depends on non-training scheme doctors for service delivery, indeed, 64% of surgical non-consultant hospital doctors are in short term ‘non-training’ posts. As Dr Rita Doyle, then President of the Medical Council, put it at last year’s Charter Meeting, “these are our friends and our colleagues, we must do more”.

The report, to be discussed at the Millin Meeting, acknowledges the major contribution that non-training scheme doctors make to the running of the health service. It will serve as a template for better governance, recruitment processes, quality assurance and career development while advocating reduction in over dependence on international medical graduates.

The programme of Wednesday evening webinars will recommence on January 26 with a presentation from the Irish Surgical Training Group on ‘Trainee perspective: Update on the introduction of the new surgical curriculum’ and will continue on February 9 with an update on international fellowships.

So in this New Year let us celebrate, there are better days ahead. The translation of genomic science into heart xenotransplantation may herald a new golden age. Oh that I could start afresh!

Best wishes and keep safe,

Professor P. Ronan O'Connell
President, RCSI