27 November 2020

Dear Fellows and Members,

As we approach the end of November, could there be some light at the end of what has been a very difficult and for many a very dark year? COVID-19 will still be prevalent in 2021 and the economic realities of the pandemic and Brexit are certain to be more evident. We risk losing hard-won gains and reintroduction of harsh measures again in January. As Richard Horton, Lancet editor and new RCSI honorary Doctor of Science, put it in his recent address: "COVID-19 has held a mirror to society; there is a moral dimension to what we have seen; we must hold ourselves to a higher level of accountability". Nevertheless, the welcome easing of social, retail and travel restrictions engenders anticipation of the festive season that should be embraced. Perhaps, for once, the true meaning of family, community and re-purposing (aka, New Year resolutions) will triumph over the commercial tsunami that often overtakes the ‘festive season’.

The HSE and National Clinical Programmes are embarking on a new Scheduled Care Transformation Programme that holds promise for the 51,000 patients waiting more than 12 weeks for a procedure. The initiative is very welcome, however the figures are stark, so stark that that radical changes are needed and resources will have to be found. Scheduled care must be protected, otherwise the legacy of COVID-19 will not be 2,000+ directly related deaths, rather the excess morbidity and mortality associated with untreated non-COVID-19 pathology. The Surgeon has just issued a special online edition dealing with surgery in the time of COVID-19. All articles will appear in subsequent issues of The Surgeon, but for convenience and to make sure that the articles are published quickly, they have been pulled together into this issue that can be accessed directly here.

The RCSI website has been redesigned and completely restructured. I am pleased to tell you that surgery features prominently on the front page with one-click access to the homepage for Surgical Affairs. This allows seamless access to all current and archived materials relating to training, exams, current affairs and news. If you have not recently accessed the site, do try it and I hope you will be pleased with the upgrade.

The National Office of Clinical Audit (NOCA) recently announced that Our Lady of Lourdes Hospital in Drogheda has been awarded the 2020 Golden Hip Award, which acknowledges the hospital with the highest proportion of patients achieving best practice care standards. Congratulations to Professor Anant Mahapatra and colleagues for their achievement. NOCA reminds us that most hip fractures occur in the home, which is all the more concerning during the COVID-19 restriction.

Our Wednesday webinars continue to attract large numbers of participants. On 18 November, RCSI Past-President Mr Kenneth Mealy and neurosurgeon Prof. Mohsen Javadpour presented a most important update on 'Neurosurgical Management of Patients Outside of Major Neuro Centres'. This is essential viewing for all surgeons and emergency physicians who may have to treat patients with head injuries, and is accessible here. An important issue raised during the discussion was the need to caution patients regarding safety and driving following a head injury and a recent Road Safety Authority publication on getting back to driving after injury.

This week’s webinar on 'Global Surgery and RCSI: Sustainable Collaborations and Partnership' was hosted by Prof. Camilla Carroll, Chair of the Committee for International Cooperation and Development. A large attendance heard excellent presentations from Prof. Godfrey Muguti, President of COSECA; Dr Gozie Offiah, NDTP Clinical Lead for Intern Training; Prof. Martin Corbally, Chief of Surgery RCSI Bahrain; Prof. Mark Shrime, RCSI O’Brien Chair of Global Surgery; and Dr Bharti Kewlani, InciSioN Ireland, which works to raising awareness of global surgery amongst Irish medical students and young surgeons in training.

Next week’s webinar will be a quarterly surgical research update ‘Surgical Research: Game Changer or Game Over’. This webinar will have contributions from Prof. Michael Kerin and Prof. Aoife Lowery, University Hospital Galway; Mr Jarlath Bolger, Irish Surgical Research Collaborative and Prof. Ronan Cahill, Professor of Surgery at University College Dublin. You can register for the webinar here. The Council Committee on Research is making excellent progress and the consultative forum continues to meet on a regular basis. It is hoped to have a plan to support a national surgical trials platform by early next year.

Following on the successful delivery of the MRCSI examinations, 43 new RCSI Members will be conferred at a virtual ceremony on Monday, 14 December. As always, some candidates will have been disappointed and will have to re-sit the examinations. I can reassure all who participated that every effort was expended to minimise the restrictions imposed by COVID-19 on both the MCQ and clinical components. The outcomes have been checked and rechecked to ensure the results were fair and that standards were upheld. Likewise, enormous efforts were invested in delivering the JCSE Intercollegiate Fellowship examinations, due to be completed in all specialties this week.

The 2019 annual NDTP report was published this week. It provides comprehensive details of medical education and training activities in Ireland, including valuable information on funding and fellowship opportunities open to trainees including training grants, the Aspire post-CSCST Fellowships, the ICAT Programme and the Dr Richard Steevens Scholarships. In addition, to take account of COVID-19 restrictions on overseas travel, the HSE has agreed to provide eight fully-funded post CSCST fellowships aligned to the RCSI for surgery and emergency medicine for the July 2021 - July 2022 training year. If you would like more details on these fellowships, please email fellowships@rcsi.com. Applications are open until 14 December 2020.

The NDTP report also outlines current workstreams regarding medical workforce planning up to 2028 and the need to increase the number of consultant appointments. In that context it is encouraging to know that applications for entry to the Core Surgical Training programme in 2021 are 42% higher than for 2020. The RCSI will engage with the Core Surgical Training Committee, specialty training programme directors and NDTP to establish if training numbers can be increased in 2021 commensurate with the increased interest in surgery as a career and NDTP workforce projections.

Considerable progress has been made in planning the Charter and Millin meetings that will be held virtually from 2-6 February 2021, and online registration will open in December. Now might be a good time to take note of the dates in next year’s diary. Online conferencing technology will allow easy access for Fellows and Members both in Ireland and around the world to a programme that we hope will be of interest to all.

Lastly, today we celebrated with Mrs Ger Conroy who retired from RCSI after 30 years’ service. Ger was the core administrator behind most of the major College Committees and was particularly engaged in training and continuing professional development. All Fellows and Members would have crossed her path at some stage. I join with you in wishing her a long and happy retirement.

Keep safe,

Professor P. Ronan O'Connell
President, RCSI