critical in ensuring that academic and research elements are not just
retained within the new programme, but enriched and deepened.
Another major challenge for us, as trainers and assessors, is to
establish a robust and rigorous assessment process which we can
stand over. Trainers, therefore, will be expected to do much more
assessment of the trainees in the work place and it is intended to
appoint Programme Directors for each specialty and also to put in
place local Hospital Programme Directors who will be very important
in terms of bringing with them institutional assessments of the
trainees in the various different jobs.
All these efforts, among many others, signify that we are now
entering a new phase of the programme and, while it is important
to recognise and assuage any concerns arising from the unsettling
effects of transformative change, it is evident that there is a new air of
excitement surrounding CST. This is demonstrated by a significant
surge in the numbers of applications 179 and the quality of the
successful applicants. It is clear the programme will be extremely
competitive and our implementation is progressing efficiently.
We have inherited from our predecessors a legacy of courageous
change implementation based on doing what is right for surgical
education and training. The leadership of the college, including
myself, are fully committed to ensuring that the development of the
new BST programme embodies, to the full extent, the principles
underlying that legacy.
NEW ACADEMIC EDUCATION BUILDING (NAEB)
Anticipation is growing as the date for commencement of
construction work on the NAEB nears. As the College continuously
upgrades curricula and educational practice to enhance the quality
of the student experience, it is only fitting that this is reflected in the
upgrading of our physical environment. With student numbers at a
maximum, it is timely, if not urgent, that we advance this project.
I only have space here to provide one example of the outstanding
features of the development. The construction of a surgical and
clinical skills simulation centre is particularly exciting and will open
up a wide range of new and innovative educational opportunities for
students. The centre will have two vital impacts. Firstly, it will allow
RCSI to implement our plans for surgery, facilitating an extended
focus on skills development and offering students another reason to
come to RCSI. Secondly, it ensures that students are equivalently and
highly trained to competency levels in the required skills before they
transfer to the hospital setting. This will relieve pressure on hospital
capacity and also recognises the reality that patients in hospital now
typically have a faster throughput.
These and many other exciting elements of the facility will all be
part of an overall design that maximises optimal running costs and
minimises maintenance requirements.
The NAEB is an essential investment in the future of RCSI, enabling
us to increase our student intake, enhance our physical infrastructure
and strengthen our position as a premier medical educator, not only
in Ireland but around the world.
DRIVEN BY TARGETS OR A VISION OF BETTER CARE?
As indicated above, RCSI highly values training outside the
hospital setting, backing this commitment with significant levels of
investment in innovative and groundbreaking developments such
as the construction of the surgical and clinical skills simulation
centre within the NAEB. Nonetheless, it is an inescapable reality that
surgical experience, in its truest meaning, can only be gained in a
An unthinking and insensitive approach to the implementation of the
European Working Time Directive (EWTD) will have a profoundly
adverse effect on the nature and quality of the surgical experience. The
HSE and the Department of Health should carefully weigh perceived
short-term financial savings against the real cost of adversely affecting
the health and capacity for work of NCHDs and, thereby, potentially
diminishing the quality of surgical care that can be provided.
The approach being taken to the EWTD is indicative of a wider
target-driven ethos within the HSE and the Department. This target
driven approach, in the absence of a coherent framework strategy,
can only have a deleterious effect on the quality of care provided.
The mid-Staffordshire scandal in the UK serves as a stark warning of
where this approach can lead.
At RCSI, we are wholly supportive of a focus on targets, but targets
that are conceived and delivered in the service of a wider vision
of excellence of care and financial sustainability. One of the most
significant steps the HSE and the Department can take to enhance
morale among surgeons and throughout the healthcare sector, is to
unequivocally commit to such a wider vision and to act on the basis
of that commitment.
Proposed new academic education building.
THE PRESIDENT WRITES