ANNUAL REPORT 2019 / 20 2 Royal College of 3 1.0 Physicians of Ireland

MISSION ANNUAL REPORT AND VISION 2019-2020

Contents

Our mission is to train, educate and 1.0 Mission and Vision 2 2.0 About RCPI 4 continuously develop doctors for current 3.0 Our Strategic Aims 6 and future world health needs. 4.0 Message from the President 7 4.1 Message from the CEO 13 5.0 Achievements against aims: Our vision is to lead excellence and quality 5.1 Deliver World-Class Specialist Training 17 5.2 Enhance Life-Long Learning and Professional Development 35 in medical practice through world-class 5.3 Promote Leadership in Patient Care 45 5.4 Be a Trusted, Authoritative Voice on Public Health Policy 57 training, education and healthcare 5.5 Build Our Global Presence 65 improvements in Ireland and internationally. 6.0 Membership and Fellowship of your College 75 7.0 Faculty Reports: 7.1 Faculty of Occupational Medicine 80 7.2 Faculty of Pathology 82 7.3 Faculty of Paediatrics 86 7.4 Faculty of Public Health Medicine 89 7.5 Institute of Medicine 93 7.6 Institute of Obstetricians and Gynaecologists 96 8.0 Celebrating our History 100 9.0 Governance 104 10.0 Financial Reports 116 4 2.0 5

ABOUT THE ROYAL COLLEGE OF PHYSICIANS OF IRELAND

Founded in 1654, RCPI is a not for profit organisation We also have two joint Faculties: Examinations Reducing health harm that is committed to helping doctors enhance their Our postgraduate examinations are internationally As an independent organisation representing thousands skills, competencies and professionalism throughout • The Joint Faculty of Intensive Care Medicine of recognised benchmarks of excellence, and help doctors of doctors, we are a united, powerful voice that can their working lives. We also advocate for the health Ireland, which is a joint faculty between RCPI, the to develop their skills and demonstrate competencies in: influence national health policies to ensure they are of the nation. College of Anaesthesiologists of Ireland and the in the best interests of people’s health. We have been Royal College of Surgeons in Ireland • General Medicine successful in advocating for policy and legislative We offer training programmes, examinations, diplomas • The Faculty of Sports and Exercise Medicine, which • Paediatrics change in a number of key areas, including: and educational courses to equip doctors with the skills is a joint faculty between RCPI and the Royal • Obstetrics and Gynaecology and knowledge they need to care for patients, and run College of Surgeons in Ireland • Public Health Medicine • Ageing safe and efficient healthcare systems. • Occupational Medicine • Tobacco What matters to us • Clinical Psychiatry • Cancer screening Our Faculties and Institute We value relationships and understand the value of • Open disclosure Six of Ireland’s 13 postgraduate specialist training bodies working collaboratively with all stakeholders in the Making healthcare safer and better • Obesity are housed within RCPI: healthcare system. We quality-assure standards in specialist medical • Alcohol practice. Simply put, we develop policies and procedures • Physical Activity • Faculty of Occupational Medicine But we will always remain true to our position as an to make sure that the delivery of diagnostics and patient • Sexual Health • Faculty of Paediatrics independent authority on specialist medicine. We care is of the same high quality no matter where you • Traffic Medicine • Faculty of Pathology are an advocate for what is right: what is in the best are in Ireland. interests of patients and those who care for patients. • Faculty of Public Health Medicine We lead 21 ground-breaking National Clinical • Institute of Obstetricians and Gynaecologists Educational opportunities for healthcare professionals Programmes in conjunction with the HSE. These • Institute of Medicine Today we offer a truly diverse range of courses and programmes are led by senior clinicians and are helping events. Our Postgraduate Medical Education Centre to transform healthcare in Ireland. continues to develop new and innovative lifelong learning and professional development opportunities for healthcare professionals. “A commitment to improving patient care lies at the heart of all we do” 6 3.0 4.0 7

OUR STRATEGIC AIMS MESSAGE FROM 2015–2020 THE PRESIDENT

Professor Mary Horgan

I am delighted to present our annual report for knowledge on COVID-19 out to our Members and to Deliver World-Class Specialist Training 2019/2020. It has been an exceptionally challenging a wider medical and healthcare audience. I am hugely 1 year for all of us working in healthcare and I am appreciative of the work that went into this, both from immensely proud of all we have achieved this year, the clinicians who gave their time, and the staff of the both in the context of the COVID-19 pandemic and college who provided the technical and administrative Enhance Life-Long Learning and Professional Development prior to that. support remotely to make these webinars happen. 2 Our Members and Fellows have been to the forefront The Institute of Medicine Promote Leadership in Improving Patient Care of the COVID-19 response, treating patients on the The establishment of the Institute of Medicine in Jan 3 frontline, putting in place preparedness plans and 2020 as a training and professional body for Internal working tirelessly on providing vital public health advice Medicine and its specialties was a significant action to decision-makers at government level. They have under the Governance change programme. The Institute, Be a Trusted, Authoritative Voice on Public Health Policy published specialty-specific guidance, contributed to chaired by Prof Anto O’Regan, will continue to build 4 expert panels and provided much needed reassurance and expand upon the extensive work done by the Irish and information to the public throughout the course of Committee on Higher Medical Training (ICHMT) which the pandemic to date. had its last meeting in November 2019. 5 Build our Global Presence COVID-19 Clinical Updates Increase in training posts The COVID-19 Clinical Updates, which began in In June 2020, we saw the creation of 90 new training March 2020, were a major initiative for the newly posts which expand RCPI’s specialist medical training established Institute of Medicine. These Wednesday programmes. The recruitment and retention of doctors webinars brought clinicians’ expertise both national and has been a key focus of my Presidency for the past two international, across a range of specialties, to a wide years and remains a priority for RCPI, so this was a audience, with the opportunity to watch the webinars significant development for me. It means we will have in real time and to view recordings. These webinars were more highly trained medical specialists in areas such viewed over 30,000 times to date and were a critical as general medicine, infectious diseases, occupational means of quickly getting up to date scientific and clinical medicine, public health, clinical microbiology and 8 4.0 9

MESSAGE FROM THE PRESIDENT

paediatrics throughout the country. As a result, we will of Health for expert medical opinion, drawing on the Supporting trainees Trainee representation on the College Council has be in a better position to respond to future public health expertise of our doctors. Indeed, in recent months our In July 2019, we welcomed 527 doctors onto our training doubled with 2 trainees joining in 2019. challenges. In the past, we have lost medical graduates doctors in key specialities stepped up to the mark to programmes, including 38 doctors onto our International who go abroad to work and do not return home. Now advise us through expert groups, knowledge sharing at Programmes. In addition to maintaining high standards Supporting your lifelong learning there are more opportunities for doctors to advance their webinars and by speaking in the media. All of this has in training, we’re also continuously improving health We’re committed to delivering medical education for medical careers while remaining within the Irish health helped us as a country to chart our way through the and wellbeing supports for all of our trainees. In 2019 all stages of your career. We know it’s important to service. RCPI will continue to advocate for expansion pandemic. We have also actively advocated for doctor we launched our Health and Wellbeing Department, you to explore new ideas and perspectives, so we aim of our training posts. recruitment and retention and to protect training. led by Professor Gaye Cunnane, Director of Health to provide diverse subject matter in our educational and Wellbeing at RCPI. This Department provides events and courses. In 2019/2020 we hosted new Supporting your health and wellbeing In 2019, we highlighted doctor burnout and challenges support and referral pathways for Trainees who are conferences on Person Centred Care, Digital Health Supporting the health and wellbeing of our members in doctor retention. Our Faculties of Public Health and struggling to meet the training requirements or reach and a Green Health Symposium in partnership with The has long been a priority for the college. I know that Paediatrics have spoken up for marginalised communities the competencies required for reasons related to their Irish Heart Foundation and APC Microbiome. We hosted many of our doctors have experienced extraordinary in the context of both homelessness and those living in health or overall performance. masterclasses, courses and diplomas in different physical pressure as a result of the COVID-19 pandemic. Our Direct Provision. We engaged with media to promote locations, and online. Health and Wellbeing department has shared guidance the HPV Vaccine and to support Cervical Check and We’ve also appointed mentors to support trainees, on how to cope at this time for our Members working on other cancer screening initiatives. In 2020, our Faculty launched a buddy system for NCHDs in the UL hospital the frontline. Our research department has also engaged of Paediatrics and Faculty of Public Health Medicine also group and we’ve hosted a number of health and in work to capture the experience of hospital doctors collaborated with the National Clinical Programme for wellbeing- focused events, including welcome nights during the pandemic. Paediatrics and Neonatology to produce a report outlining for NCHDs. the adverse effects COVID-19 restrictions have had on RCPI: Representing the doctor’s voice the lives of children in Ireland. In October we published a report from the first three in important public health issues years of the Training Post Evaluation. The report is based The Royal College of Physicians of Ireland, representing To ensure we focus our advocacy efforts on issues that on feedback from doctors in Basic and Higher Specialist a combined membership of 12,000 doctors, is a well- are important to you, we sought your views on priorities Training programmes in 86 training sites across Ireland. respected voice in public health debates. We continue to for the next Minister for Health in January, and we’ve put We’re using these findings to improve postgraduate represent your voice to influence public health policies and in place guidance to support you in collaboration with training, inform training site inspections, and identify we are the “go-to” place for the HSE and the Department your peers within the College, to highlight policy issues. potential areas for further research. 10 4.0 11

MESSAGE FROM THE PRESIDENT

In July 2019, we launched our new e-learning Making RCPI more accessible to our more accessible and supportive services to trainers Through our RCPI Global Health Initiatives, we donated environment, RCPI Brightspace, which allows for easier doctors in Ireland and internationally and trainees. We now have four site offices, with the a consignment of resuscitation training equipment to access to our e-learning platform for all our Trainees, In 2019 we began a process of introducing a new newest office opened at the Dublin Midlands Hospital the Paediatric Acute Intervention Resuscitation Skills Members and Fellows. This new virtual learning corporate governance structure to allow us to operate Group in March. These offices provide local support to (PAIRS) Group. environment will allow us to expand what we can offer more effectively and to provide a better service to our you, our Trainers and the Trainees, on site, where you in education and continuous professional development Members. Among the actions under this Programme, most need it. New Members and Fellows now and in the future. we now have a more visible active presence on training I’m proud to say that our College continues to grow in sites across Ireland, so that we can provide a better, It is very important for us to connect with our Members strength. In total, we welcomed 428 new Members this The annual St Luke’s symposium took place in October and Fellows around the world. Our CEO, Dr Terry year. Membership of the College is a major achievement 2019. Over the three days, over 700 attendees had the McWade travelled extensively to meet college Members for doctors aspiring to become fully qualified specialists, opportunity to hear the latest evidence and advice on this year and we regularly meet with Ministries, health and a clear sign that you are ready to enter Higher issues such as brief interventions, allergies, medical authorities and medical bodies around the world to Specialist Training. We also admitted 147 new Fellows and humanities, doctors treating doctors, gender neutral promote the value of MRCPI and the high standard of we welcomed six Honorary Fellows, the highest honour HPV vaccination and adolescent cannabis use at our doctors who achieve Membership of RCPI. the College can bestow, in a ceremony on in October. Advanced Masterclass. We also welcomed Paul Reid, Director General of the HSE, Dr Andrew Padmos, CEO Our international training programmes and overseas Because of the pandemic, conferring ceremonies for April of the Royal College of Physicians and Surgeons of examinations are something I’m very proud of. In 2019, 2020 had to be cancelled. Instead we were able to offer Canada and Professor Jackie Taylor, President of the 7 doctors started International Clinical Fellowship the opportunity for conferring in absentia at no extra Royal College of Physicians and Surgeons Glasgow at Programmes, 27 doctors joined us on the College of cost, which was taken up by many of our new Fellows. The Future of Medicine on Saturday 19 October. Physicians and Surgeons Pakistan (CPSP) Postgraduate Scholarship Programme and 4 doctors joined us on New prizes and awards RCPI also hosted the International Medical Leaders the Sudanese Medical Specialisation Board training A number of new prizes and awards to recognise Forum-Europe (IMELF-Dublin) in October with delegates programme. We had graduation ceremonies for contributions to healthcare were established this year. from Europe, North America and Australia with the international training graduates in both Dublin and In 2019 we announced the Laura Brennan Advocacy theme of Modern day Workforce and Modern day in Oman, and also in 2019, we opened a new MRCPI Medal to honour the work of the late Laura Brennan and a Workplace and Modern day patients. clinical exam centre in Riyadh. number of other patient advocates who sought to engage with the public and build confidence in the HPV Vaccine. 12 4.0 4.1 13

MESSAGE FROM MESSAGE FROM THE PRESIDENT THE CEO

Dr Terry McWade

We also introduced a new award for doctors in training, education and business. He has given us great direction When I joined the Royal College of Physicians of experts to share expertise with doctors working in the Kate McGarry award, to be awarded annually to during this time of crisis. Ireland as Chief Executive Officer in 2019, the greatest hospitals throughout the country. Live broadcasts for the trainee doctor who has submitted the best review transformation on the agenda was moving to a new Members take place every Wednesday evening, and of a medical journal article. In October, the inaugural St Finally, I would like to thank the Officers, Deans/Chair Governance model to make RCPI more accountable, recordings, hosted on RCPI’s website, are made available Luke's Medal was presented to Professor Derek O'Keeffe of the Faculties and Institutes and the staff of RCPI more transparent and more responsive to its Members’ to other doctors. The clinical updates are also shared of NUI Galway. for their hard work and adaptability in what has been needs. In 2020, we have seen a transformation of a very with the other postgraduate medical training bodies and a changed working environment for all of us. It has different kind. the universities to allow interns and final year medical Celebrating our heritage not been easy, and I continue to be impressed by the students to view them. These webinars which have After more than 13 years’ service to the College, Dr Paul enthusiasm and dedication I have seen, both in rolling As a result of COVID-19, by the middle of March, our been viewed over 30,000 times, also provide us with a Darragh retired as Dun’s Librarian, with a legacy to be out new initiatives and continuing to support the central Members were on the frontline of a major national template for delivery of other high-quality educational extremely proud of. The Heritage Centre has grown to work of the college. This commitment and expertise are emergency, all of our events and courses had been events. become one of the best-known historic collections of integral to the growth and development of our College postponed or had moved online and all of our staff had medical history in Ireland and is the only medical museum in this time of crisis and beyond. transitioned to work from home. We’ve also had to innovate in how we deliver exams. in Ireland. Highlights this year included a celebration of We rapidly deployed new technology to become the 140 years of the Dublin Hospital Rugby Cup, Ireland’s Professor Mary Horgan We made it an immediate priority to provide essential first post-graduate medical college in Ireland or the oldest rugby cup competition, and a day of talks to mark President, Royal College of Physicians of Ireland clinical information and helpful resources via webinars UK to deliver a computer-based exam to a large-scale the centenary of the founding of St Ultan’s Hospital. We and through our website, and we found ways to deploy number of candidates using a remote invigilation received several donations which further strengthen our technology to continue our core work of delivering platform. We worked with educational experts and our rich collection, and we launched a new online archive excellence in medical education and training in Ireland exam boards to ensure the standards underpinning our and museum catalogue which will increase awareness and overseas and to support our Members in providing examinations were maintained. This allowed 470 doctors of and access to our collections. high quality care to patients. in 16 countries to take their Membership exam in their own home or place of work. Feedback from candidates RCPI is a College for doctors, run by doctors. Our CEO COVID-19 accelerated our plans to enhance how has been very positive, and all written examinations for Dr Terry McWade since his appointment in 2019, has we deliver medical education. Our newly established 2020 will be delivered using computer based testing and brought a depth of knowledge to RCPI which draws Institute of Medicine, led by Professor Anthony O’Regan, remote invigilation. This development is also in line with on his leadership roles in technology start-ups, medical hosted weekly webinars on COVID-19 Clinical Updates. RCPI’s green agenda to reduce our carbon footprint as These webinars brought together Irish and international an organisation. 14 4.1 15

MESSAGE FROM THE CEO

In 2019, we held conferences on diverse topics outside strategy, working with our new Council and Executive of the traditional sphere of medicine, including events Board. This will enable us to develop our strategic on Green Medicine and Digital Health. We worked with priorities, taking account of the uncertainties that face the Abbey Theatre to provide training to doctors about us all as a result of COVID-19. caring and coping in difficult situations. And we plan to hold more educational events to enable our Members to This report outlines the progress made under the RCPI connect with peers and facilitate their career progression 2015 – 2020 strategic plan in the 2019/2020 academic in the year ahead. year. I would like to thank Council, the Executive Board, Deans, Directors and the many doctors who contribute We are increasing our global presence – last October to the RCPI and its Faculties and Institute for their we hosted the International Medical Education Leaders hard work, and resilience in the face of unprecedented Forum – and this is something we intend to remain changes. I would also like to thank the staff for their focused on in the future. In 2019, I travelled extensively commitment to delivering excellence in medical to meet with RCPI Members in India, Malaysia, UAE, education and training. Kuwait, Bahrain and Saudi Arabia and I am committed to continuing that engagement. Dr Terry McWade Chief Executive Officer, Royal College of Physicians of Ireland We also saw our international training programmes grow, with a total of 38 doctors joining our international programmes, we opened a new MRCPI clinical exam centre in Riyadh and for the first time, we had a graduation ceremony in Oman for our international graduates there.

We are approaching the end of RCPI’s five-year strategic plan, which outlined its goals and vision for 2015 – 2020. We are now in the process of developing our new 16 5.1 17

DELIVER WORLD-CLASS 4,402 SPECIALIST TRAINING doctors took exams with RCPI in 2019

Training doctors to meet current and future health To ensure that standards in postgraduate specialist needs is at the heart of what we do in RCPI. Through our training were, and continue to be maintained, we six training bodies, we are committed to helping doctors developed solutions to allow mandatory courses, study reach their full potential. Our training programmes are days, assessments and examinations to continue. We kept designed to equip doctors with the skills they need in regular email contact with Trainees and Trainers from 106 to become clinical leaders who will meet the rapidly March 2020 as these new arrangements were rolled out. doctors were evolving needs of society. For example, approximately 1,300 annual evaluations awarded a Certificate were conducted remotely using Zoom from May through of Satisfactory Our four Basic Specialist Training (BST) programmes are to early July 2020. Written MRCPI examinations moved to the first step towards specialisation, while our Higher being delivered by remote invigilation from March 2020. Completion of Specialist Training (HST) programmes, offered in 29 Many mandatory courses moved online. There are many Specialist Training specialties, are designed to produce confident specialists challenges ahead. Specialist training and education must who are leaders in their field. however continue insofar as possible, and the health and wellbeing of our Trainees and Trainers must continue to We work closely with the Medical Council, which regulates receive attention during this unprecedented time. medical practice in Ireland, the Health Service Executive (HSE) National Doctors Training and Planning Unit (NDTP) Finally, the approval of up to 80 additional Basic and others to ensure all the components of medical Specialist Training places in Ireland was announced training meet international standards of excellence. by the HSE on 24 June 2020. This is a very welcome 1,550 development. We had been working closely for some Trainees The COVID-19 pandemic hit in the second half of the time with the HSE to get these additional specialist training year 2019/20. Many of our Trainee doctors are training opportunities approved. The recruitment process on the frontline of this pandemic. We are mindful of the for these places began in July 2020 in General Internal enormous burden placed on these doctors as a result Medicine, Paediatrics and Obstetrics & Gynaecology, 1,150 of increased workloads, longer hours, and concern for with a view to places being offered officially in late Approved Trainers their patients, colleagues and loved ones. autumn 2020. 18 5.1 19

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Developing Trainee-centred training programmes offered virtually or rescheduled. This includes 1,550 doctors enrolled on our training programmes in Delivering educational programmes The wellbeing and future career prospects of our Trainees mandatory courses, study days and annual hospitals across Ireland. through simulation are core priorities within RCPI. We continue to evaluate evaluations. Simulation is playing an increasingly important role in the quality of our training programmes to ensure they • The career progression of a Trainee will not be 106 doctors in 22 specialties met the criteria for medical education and the development of medical and offer a good experience and meet Trainees’ needs. adversely affected due to the service requirements Certificates of Satisfactory Completion of Specialist surgical skills. In the past year, the Paediatric Procedural during this major incident response. Training (CSCST) in 2020. Skills simulation course and Point of Care (POCUS) Bedside Training as a specialist requires a great deal of dedication • Any Trainee deployed to a different clinical area Ultrasound simulation course were developed and added and most Trainees will experience disruption to their must undergo appropriate induction and be Research underway to improve postgraduate training to the paediatric and general internal medicine training home life as they rotate to new hospitals and cities on a informed of who they are reporting to and who is Doctors Training Outcomes Research Project programmes. regular basis. In response to feedback from Trainees, we providing clinical supervision. The Doctors Training Outcomes Research Project was continue to work to make our training programmes more • RCPI will work with the HSE to ensure that established to review the training pathways in Basic • The Point of Care Ultrasound (POCUS) simulation flexible and predictable. For example, as part of our aim Trainees work within the limits of their competence Specialist Training and Higher Specialist Training on an course allows HST Trainees to gain essential to develop family-friendly training, we give pre-defined and appropriate to their stage of training/specialty. annual basis. It involves an anonymous review of the hands-on experience in key ultrasound procedures rotations for the first three years of HST in General • Trainees must be supported during this pandemic. application, interview and training processes (rotations, in simulated clinical settings, with a focus on Internal Medicine so that Trainees will know exactly The HSE and RCPI will work together to provide annual assessment, MRCPI for Basic Specialist Trainees, practical skills needed for the hospitalised where they will be based for that time. At least two health and wellbeing support to Trainees etc.), as well as the progression of Trainees into their patient. Trainees discuss cases to improve their Trainees are allocated per training site to facilitate peer • Disruptions in training or learning outcomes not next career stages. The data gathered will allow us understanding of how bedside ultrasound can support and efforts are made to minimise commuting achieved due to this major incident response will to create an on-going evidence base for continuous be used in real-world scenarios. They formally distance for Trainees. be taken into account at the annual evaluation of quality improvement of the main areas of postgraduate engage in several clinical scenarios in a simulation training. medical training within RCPI. Data collection and analysis suite to perform deliberate practice of skills to In terms of the pandemic, to minimise the impact on processes were established using retrospective data in pre-defined proficiency standards and receive training and education and in support of our Trainees, Training more doctors than ever 2019. Annual data collection commenced in 2020 and interactive sessions across the various stations RCPI developed and published the following guiding Both the number of applicants and the number of we expect to report the findings in 2020/2021. from the sim instructors leading each station. The principles in March 2020: doctors who secured a place on our training programmes panel of sim instructors are ultrasound experts have increased in recent years, reflecting the increasing ranging from Emergency Medicine Consultants to • All non-essential training activities and processes attractiveness of the training opportunities that we offer. Consultant Anaesthetist/Intensivists. Trainees are are under review and where possible will be For the 2019/2020 year, there were approximately, allocated time to practice ultrasound skills on live 20 5.1 21

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student models and stable patients with symptoms, expert panel of Consultant Paediatricians, Senior under the instruction of the experienced faculty. SpRs, and Advanced Nurse Practitioners explain The course setup allows familiarisation with the and guide the Trainees through the various equipment as well as haptic feedback on the procedures. A key aim of the course is to increase impact of hand movements on ultrasound image. Trainee confidence in the identified procedures and allow more time for questions and discussion, • The Paediatric Procedural Skills simulation as the opportunity to perform these skills in a course was designed to ensure that all Basic structured environment and receive feedback Specialist Trainees have been provided with optimises the learning of the Trainees over formal instruction in the core procedures that workplace learning alone. are expected of them by the end of the BST programme and prior to starting on the Higher Collaborating with the Abbey Theatre Specialist Training scheme. The course is delivered on applied drama techniques in wet and dry simulation laboratories and an RCPI and the Institute of Obstetricians and Gynaecologists have collaborated with the Community and Education Department of the Abbey Theatre, Féileacáin (National Stillbirth Society) and Patient Focus to develop an innovative educational intervention for Obstetricians and Gynaecologists who are currently in training in the Irish maternity services.

The Approach to Caring and Coping- applied drama workshop- allows SpRs and Registrars in Obstetrics and Gynaecology to gain an empathic understanding of, and a more compassionate response to stillbirth and POCUS simulation course Paediatric Procedural Skills Course pregnancy loss so that they feel confident in providing the highest level of care to bereaved parents during a 22 5.1 23

DELIVER WORLD-CLASS “I am delighted that RCPI now has four training site offices to provide support to SPECIALIST TRAINING our Trainees and trainers in those hospital groups. It is very important for us that our Trainees are supported locally, where they are training.” Professor Mary Horgan, President RCPI

very difficult time. As well as learning how to care for to this model, we are working on the development of useful indicators of the training environment. By and programmes, we have begun to increase our engagement bereaved parents, the workshop provides Trainees with a online generic and specialty specific standards for large, training is a positive experience for our Trainees, with interns and final year medical students. We organised greater insight into their own emotional responses when training sites. All training sites are subject to inspection but we have identified situations where we can improve an event in September 2019 as part our Trainee Day for faced with these tragic and often unanticipated events, to ensure high standards in training are maintained. This training on particular sites in particular areas. The most interns and final year medical students to allow them to enhancing their abilities to cope with the personal new model should inform us of training site strengths and accurate barometer of the overall quality of training on find out about our Basic Specialist Training Programme. consequences. This workshop ran in October 2019 and weaknesses and not just in the specialty. We continue any given site was deemed to be whether Trainees in Attendees had the opportunity to meet experienced RCPI February 2020. It is now a mandatory course for Trainees. to work in consultation with the Medical Council on this that hospital would recommend their training post to Trainers and Trainees, ask about our specialties and get A play entitled ‘Singing in the Dead of Night’ is also being process to minimise the impact on the sites. other Trainees. In 69% of BST posts and 86% of HST expert advice on postgraduate training with RCPI. We also developed dealing with these issues. A first reading of the posts, Trainees indicated that they would recommend spoke at several hospital-based careers talks in training play took place to a limited audience in November 2019. Training Post Evaluation three-year their post to colleagues. The Training Post Evaluation sites, including Cork University Hospital, University The play is now undergoing editing following feedback aggregate report published will continue to operate each year, providing us with a Hospital Waterford, University Hospital Limerick and from this reading. Once the COVID-19 restrictions are We value our Trainees’ perspectives – their input is method of collecting regular feedback on individual posts University Hospital Galway and also at a Medical Careers lifted, there will be another reading to a wider audience. crucial as we strive to continually improve the quality and the ability to track Trainees’ satisfaction with posts Day at the Aviva Stadium in Dublin. of specialist training. Since 2016 we have been asking and sites over time. As part of the 2020 evaluation, we The Open Disclosure Workshop using applied drama doctors in Basic and Higher Specialist Training to also sought feedback from Trainees about the impact of Bringing the College closer to Trainees and Trainers involved three pilot workshops for Senior Fellows in complete a short, anonymous Training Post Evaluation COVID 19 on their training experience. We opened the RCPI Dublin Midlands Hospital Group the College in the 2019/2020 academic year. It is now for each of their training posts. This allows Trainees office in Tallaght University Hospital at the start of available for all Consultants. to give honest feedback on the training and working In time, the findings from these annual reports will allow 2020, bringing the number of RCPI training site offices conditions related to each rotation and the support and us to benchmark each RCPI training post nationally and to four – the other offices being the University of RCPI is now working on a new project with the Abbey facilities available. enable us to continue to drive improvements in training. Limerick Hospitals Group office in Limerick, the South/ called ‘COVID-19: Coping and Caring’ which is exploring We are very grateful to all Trainees who participated in South West Hospital Group office in Cork and the Saolta the effect of COVID-19 on doctors’ wellbeing. A report summarising findings from the first three years the Training Post Evaluation to date. Hospital Group office in Galway. of the Training Post Evaluation was published in October Ensuring high standards on training sites 2019 and is available on our website. The report is Attracting the best graduates onto Online courses, online annual assessments, remote Building on the long-standing tradition of hospital based on 2,095 evaluations from doctors in Basic and our training programmes invigilated examinations and the Masterclass series has inspections, we are developing a formal accreditation Higher Specialist Training programmes in 86 training To raise awareness of the training opportunities we also brought RCPI closer to colleagues in so far as these process for training sites. To ensure a smooth transition sites across Ireland and the results may be viewed as offer and attract the best graduates onto our training services and supports brought to the individual. 24 5.1 25

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ePortfolio for Trainees A better experience for exam candidates The global COVID-19 Pandemic brought numerous A new and improved ePortfolio for Trainees in BST and From January to December 2019, 4,402 candidates challenges to the delivery of our examinations. All HST was launched in July 2019. RCPI is committed to took exams with RCPI covering specialities of General exams scheduled from March to June were postponed, continual improvement and will be reviewing the system Medicine, Paediatrics, Obstetrics & Gynaecology, Public due to social distancing restrictions as candidates were again in the later part of 2020. Health, Occupational Health and Psychiatry. While there unable to travel to one central examination centre. To was a fall- off in candidates on the previous year, there ensure the examination process could continue during Updated Training Curricula has been an 86% increase in candidates sitting our exams the pandemic in a safe and secure environment so that Following the Outcome Based Education (OBE) pilot year since 2013. doctors could continue with their training and career in BST Paediatrics we have reviewed Trainer and Trainee progression, remote invigilation was introduced for the feedback. In July 2019 we introduced an OBE curriculum majority of our written examinations. for BST General Internal Medicine and Histopathology and an OBE curriculum for HST Respiratory Medicine Since 2013, there Remote invigilation means that candidates are supervised will also be introduced shortly. Public Health Medicine has been an remotely by invigilators throughout the examination carried out a substantial review and this curriculum will and undergo numerous security checks prior to the be launched in 2021. In the next year we will be working exam. Candidates sit the same examination (structure, with each specialty to schedule outcome-based reviews format and length) online, in a quiet, secure place of for 2020-2022. their choosing, at home or at work. This method of exam delivery meant that candidates did not have to Supporting our Trainers travel to an exam centre and complied with all public 1,150 doctors have been approved as RCPI Trainers. 86% health guidelines. Doctors can apply to become RCPI Trainers once they are on the Specialist Division of the Register of the Medical This was a major change to the normal method of Council in their respective specialty and are working in delivery of RCPI examinations, and the support of all approved training sites in their specialty. RCPI provides increase in the number the examination boards involved is greatly appreciated. all new Trainers with a one-day training course for the of candidates sitting Essential Skills involved in this role. our examinations. As our clinical examinations take place in hospital settings and require close contact with real patients, 26 5.1 27

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Dr Cormac Kennedy, Chair of the RCPI Trainees' Committee

the delivering of these examinations is complex. We The new format of the Clinical exam took place in allows for a greater level of communication between Update from the RCPI Trainees’ Committee realise these are important examinations for our Trainees. Tallaght University Hospital in November 2019. The candidates, the patients and examiners, as face-to-face The Trainee’s committee in RCPI represents Trainees’ We are working closely with the clinical exam boards clinical examination focuses on the ability of the examining time has increased. A new international exam interests and works towards improving all aspects of and others to find a way of delivering them in safely in candidate to demonstrate proficiency in the areas of centre in Abu Dhabi was also established for the OSCE/ postgraduate training with RCPI. It has representatives line with public health guidance, while still maintaining history taking, communication, physical examination, Clinical exam. Due to current COVID-19 restrictions in on multiple RCPI committees, including on Council, all the standard and integrity of the examination process. problem solving and basic steps in the assessment and maternity hospitals, the O&G exam board are working on of whom are registered on our BST or HST programmes. management of the neonate, child or adolescent with developing a solution for the clinical component of this MRCPI in Paediatrics acute or chronic disease. examination as the safety of our patients and doctors In 2019/2020, a total of 23 Trainee reps were elected The recommendations of the Jenkins review have are our primary concern. to sites around Ireland. In conjunction with the opening now been fully implemented following the MRCPI The new clinical structure comprises of 6 x 12-minute of regional offices, this provides RCPI with a strong Paediatrics Clinical examination in November 2019. stations. Overall, the feedback from the candidates, Examination in Pathology national presence. The Part I question bank has been updated to ensure examiners and the extern examiner was positive. We are working with the Royal College of Pathologists in all questions reflect up to date medical practice and the UK and the Faculty of Pathology in Ireland to assist Trainees will be represented on the Board of the new are more appropriate to a candidate’s stage of training. The MRCPI Paediatrics Exam Board and the Associate the UK College with the delivery of their examinations for Institute of Medicine as well as on numerous committees No new topics have been added. Over the past year Dean, Dr Ciara McDonnell, are to be commended for Trainees based on the island of Ireland. This will enable within the Institute. Committee members have contributed the exam has undergone a standard setting process by their work in implementing the new format to the Part candidates to sit their exams in Ireland and continue with to many other committees and working groups throughout the board. II Written and Clinical exams. These changes will protect their training and career progression. We look forward to the year including the Recruitment and Retention working the integrity of this Membership examination and ensure cross-College collaboration and developing closer links group and RCPI’s Educational and Quality Committee. The first diet of the newly formatted Part II written that it remains relevant as a prestigious postgraduate between the Irish faculty and the UK College. examination took place in October 2019. The new qualification. A governance review of the Trainee Committee is exam format consists of one Single Best Answer paper, currently in progress under the leadership of the incoming replacing the essay paper, and one short answer question MRCPI in Obstetrics and Gynaecology chair, Dr Sean Armstrong. This will aim to further improve paper. Questions for the examination are coded by Work has continued on question development to ensure and balance the representation of Trainees throughout topic, area of knowledge, skill and age range so that the question bank is up to date for the MRCPI Obstetrics RCPI’s Faculties and Institutes. all papers will contain a fair, transparent cross-section and Gynaecology Part II Written exam. The clinical of the knowledge required of a Trainee at this stage of case of the OSCE is now fully observed. The clinical The Health and Wellbeing subgroup of the Trainee paediatric experience. case is currently 25 minutes in total by the beside and Committee has now become a standalone committee 28 5.1 29

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with its own Terms of Reference. The Chair of the project to support research for Trainees. Committee is elected with the other roles on the Trainee Committee and remains a member on the Trainee The COVID-19 pandemic resulted in a slightly delayed Committee. Dr Sean Casey was elected chair in 2019. and truncated election process for the Trainee Committee, Health and Wellbeing are establishing a course for BST which was completed at its AGM on July 23rd. An Trainees based on their very successful HST course. online ballot was held and most positions on the Trainee Committee were contested, with particularly strong For the first time this year, the National Education Day for interest in the BST and HST representative positions for Doctors in Training was organised as a standalone event medicine. Dr Sean Armstrong was elected as new chair outside of the St Luke’s symposium. The theme for this of the Committee. year’s Trainee day was “Lifestyle Medicine – Improving Patients' and Doctors' Health” and was run in tandem This is the first AGM which took place entirely virtually. It with the Trainees’ Committee awards on 6 September follows from the final meeting of the current committee in 2019. The Keynote Speaker was Dr Adam Kay, author April 2020 which was also entirely virtual. The committee of the best-selling book “This Is Going To Hurt”. The had previously enabled remote access to meetings due to day featured a selection of excellent presentation on the geographical spread of committee members and had the theme from Prof Brendan Kelly, Dr Ciara Kelly, Mr changed to an online election 3 years ago. The Committee Ian Power, Prof Michael Turner and Prof Niall Moyna. began using Zoom instead of Webex technology during the pandemic and this has been highly effective. Given the The Trainees’ Committee participated in the Medical variations in Trainees’ schedules and difficulty in attending Careers day organised by the Forum of Irish Postgraduate meetings at RCPI in person, it is envisaged that virtual Medical Training Bodies held on 5th October 2019 in meetings will be important for the committee in future. Dublin Castle. A focus on changes to training while maintaining required A number of other projects were in development this quality and standards due to COVID-19 will be a key year including a Social Inclusion Advocacy group and a component of the Committee’s work going forward. 30 5.1 31

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Recognising achievements –2019 - 2020 The Corrigan Medal We are keen to recognise the achievements of our Dr Zara Togher, BST General Internal Medicine for Trainees, Members and Fellows and those who contribute Cytomegalovirus Infection – Not So (H)armless to the history of medicine and patient advocacy. We are working to expand the number of awards that are offered Corrigan Medal - Best Poster Presentation by RCPI and its Faculties and Institutes. This year we Dr Kevin Kitt for 'I'm feeling fine Doctor..' - launched the Laura Brennan Advocacy Medal and the Pitfalls in the recognition and management Kate McGarry Prize. Awards winners for 2019 - 2020 of depression in older persons are listed here. William Stokes Award RCPI Trainees’ Committee Awards Dr Peter Barrett, SpR in Public Health Medicine for The Trainees’ Committee present three awards in RCPI; Increased risk of long-term renal disease in women who the Corrigan Medal, the David Mitchell Award, and the deliver preterm infants: a population-based cohort study William Stokes Award. The purpose of these awards is to recognise and reward excellence in a number of key William Stokes – Best Poster Presentation areas that form part of being a medical professional. Dr Dearbhla Kelly for Proteinuria as an Independent In October 2019, the Committee launched the new Dr Predictor of Stroke: Systematic Review and Meta-analysis Kate McGarry prize at St Luke’s Symposium in October 2019. The award will be given annually to the Trainee David Mitchell Award doctor (BST) who has submitted the best review of a Dr Taha Khalid, BST General Internal Medicine for medical journal article. Thyroid function testing in patients on immunotherapy at Sligo University Hospital (SUH)

David Mitchell – Best Poster Presentation Dr Donnchadh O'Sullivan for WhatsApp Doc? An audit of instant messaging usage and physician attitudes Dr Taha Khalid, Dr Diarmuid O’Shea, Prof Emer Shelley, Dr Dearbhla Kelly, Dr Kevin Kitt, Dr Terry McWade, CEO RCPI, Dr Heather Burns, Dr Sean Armstrong, Dr Zara Togher, Dr Cormac Kennedy, Dr Peter Barrett, Dr Donnchadh O’Sullivan 32 5.1 33

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MRCPI Examinations Faculty of Paediatrics Reuben Harvey Prize Canavan Medal - for best MRCPI General Kathleen Lynn Medal – Dr Patricia Scanlan The Reuben Harvey Prize is awarded by RCPI each year Medicine examination performance to the students who achieve the highest marks in their Dr David Fennell Faculty of Pathology class for final year examinations in Medicine, Surgery George Greene (Trainee) medal: Dr Naoimh O'Farrell and Obstetrics. Irish Clinical Academic Training (ICAT) Programme John D Kennedy Medal - Dr Susan Prendiville SpRs on RCPI HST programmes who were awarded ICAT Paule Cotter Medal - Prof Mary Therese Cafferkey Royal College of Surgeons of Ireland Fellowships in 2019/2020: Elysha Brennan Faculty of Public Health Medicine University College Dublin • Dr Andrea Bowe, Public Health Medicine Zachary Johnson Medal - Dr Treasa Kelleher Molly McGuckin • Dr Louise Rabbitt, Clinical Pharmacology and Dorothy Stopford Price Medal - Dr Peter Barrett Trinity College Dublin Therapeutics. Dorothy Stopford Price Best Poster Presentation – Dr Conor Browne • Dr Sarah Kelliher, Haematology Heather Burns National University of Ireland Galway • Dr Katie Ridge, Haematology Jessica Lowry Institute of Obstetricians and Gynaecologists University College Cork Fellowships for doctors in Higher Specialist Training Rory O’Connor Medal for best MRCPI Obstetrics John D. Kehoe Bresnihan Molly Fellowship - Dr Kieran Murray and Gynaecology examination performance, August/ University of Limerick Sanofi – Aventis Educational Grant - Dr Hannah Forde November 2019 – Dr Sarah Petch Christi Brady Pfizer Rheumatology Fellowship - Dr Rachel Flood Queens University Belfast Sean Boyle Memorial Medal (for delivering the annual Adam Wilson International Awards Sean Boyle Lecture March 2020) - Prof Richard Greene Best Case Report Contest at the McMaster International Review Course in Internal Medicine - Dr Sharon Cowley Clinch Medal for best abstract at JOGS Meeting 2019 (JOGS medal, sponsored by the Institute) - Dr Jill Faculty of Occupational Medicine Mitchell James Smiley Medal - Professor Tee Guidotti 34 5.2 35

ENHANCE 3,650 70 LIFE-LONG LEARNING AND PROFESSIONAL doctors attended RCPI CPD courses, conferences events conferences and DEVELOPMENT and or courses in events delivered in Dr Sinead Murphy, RCPI 2019/2020 RCPI 2019 /20 Director of Education

Throughout their professional lives, doctors must want to provide the best possible care for women, from constantly update their knowledge and expertise so adolescence to old age. It was developed in conjunction that they can provide world-class care to patients. with some of Ireland's leading Obstetricians and We continue to develop our range of lifelong learning Gynaecologists: and educational opportunities for doctors and other healthcare professionals. • Dr Michael O’Connell, Consultant Obstetrician Gynaecologist, Coombe Women’s and Infants 400 Professional development opportunities that University Hospital, Dublin doctors each week we delivered in 2019/2020 included: • Dr David Crosby, Chief Resident in Obstetrics and viewed the COVID 19 • Collaboratives to improve quality and patient Gynaecology, Cork University Maternity Hospital Webinars… safety • Quality Improvement in Action The course is focused on delivering the highest quality • Diploma in Medicine for the Older Person obstetrics and women's healthcare and covers: • Diploma in Primary Care Paediatrics with iheed • Certificate in Community Paediatrics • Antenatal and postnatal care • Certificate in Essential Leadership for New • The welfare of the foetus and neonate Consultants • Menstrual disorders • Clinical Update in Traffic Medicine • Family planning …one of which • Diploma in Obstetrics and Women’s Health • Hormone replacement therapy was watched by • Masterclass Series • Screening for gynaecological malignancy • COVID-19 Series • Three new conferences: Digital Health, Person- A total of 84 doctors registered for this online course Centred Care and Green Health during the past year. 1,200 Launch of New Diplomas in 2019 -2020 doctors The Diploma in Obstetrics and Women’s Health is Diploma in Medicine for the Older Person was launched in RCPI’s first online diploma. It is aimed at doctors who 2019 and focused on how to diagnose, treat and manage 36 5.2 37

ENHANCE LIFE-LONG LEARNING AND PROFESSIONAL

DEVELOPMENT Prof Anthony O’Regan Foundation Dean, Institute of Medicine

a wide range of conditions and clinical presentations Conferences: Digital Health, Green Masterclass Series Spotlight on the COVID-19 Webinar Series associated with older people. Modules cover mobility, Health, Person Centred Care The Masterclass series planned for 2019-2020 covered The COVID-19 Webinar series was part of the RCPI’s cognition, falls and bone health, community care, A Green Health Conference held in Nov 2019 a wide range of topics response to the global pandemic. One of our key goals neurological disorders, multi-morbidities and frailty, was designed to inform doctors, allied healthcare at the beginning of the pandemic was to ensure that psychiatry in old age, and advances in gerontology professionals and policy makers about the imminent • Familial Hypercholesterolaemia and Other we continue to support doctors in providing care for (including legal aspects). challenges for health, and to empower them to advocate Inherited Dyslipidaemias patients by delivering the clinical information they need. for behaviour and policy changes to improve the health • Intensive Care part 1 The course was developed by Programme Director Dr of the nation and our planet • Story Slam Prof Anthony O’Regan, Dean of the Institute of Medicine Joe Browne, Consultant Geriatrician, St James's Hospital, • Population Health was centrally involved in the COVID-19 webinar series. in conjunction with a steering committee who are leading A Digital Health Conference held in Dec 2019 provided a • Genomic Medicine experts in geriatric medicine. comprehensive overview of digital health in Ireland, and • Intensive Care part 2 the exciting new solutions in the pipeline. The day was • Doctors as Writers “Because of the rapidly changing The diploma explores the most critical issues facing devoted to understanding the role of digital medicine • Obesity nature of the situation, it was key geriatric medicine in Ireland addressing key areas such in the future of healthcare. that important and complex clinical as the expanding role of the multidisciplinary team, the 920 doctors attended the masterclass series in 2019- information could be communicated importance of expert communication and teamwork A Person Centred Care Conference was held in Jan 2020 2020. between clinicians across clinical sites and settings. and its key objective was to consider care as a way of quickly to those working on the thinking and doing things that sees the people using Dr Sinead Murphy Director of Education hosted the frontline. It was imperative for us in This course is targeted at physicians and general health and social services as equal partners in planning, webinar on “Resilience skills for dealing with Covid-19 the Institute of Medicine to take the practitioners who have an interest in the care of the older developing and monitoring care to make sure it meets and beyond” .This was to assist all frontline workers lead in this area and facilitate this person. In the past year, 31 participants took the Diploma. their needs. coping with stress and anxiety while working through the COVID-19 crisis. 186 doctors registered for this webinar. sharing of expertise in a way that was All three conferences were very well attended and easily accessible to doctors working in received excellent feedback. hospitals around the country.” Prof Anthony O’Regan 38 5.2 39

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DEVELOPMENT Dr Gaye Cunnane, Director of Health and Wellbeing

With the COVID-19 Series, RCPI created a new courses where quickly adapted to a virtual format for all HPV vaccination and adolescent cannabis use at our Promoting Health and Wellbeing among Doctors mechanism for delivering training and education. final year Trainees on BST and HST training programmes. Advanced Masterclass. We also learned more about the Professor Gaye Cunnane, Director of Health and “Doctors were able access these updates Content was moved to an online format with virtual great work done by Dr Kathleen Lynn and Madeleine Wellbeing delivered a large volume of talks and training sessions. Each virtual session had a maximum Ffrench-Mullen in founding St Ultan's Children's Hospital workshops to support the health and wellbeing of and experts from wherever they were based of 15 participants to allow for case study discussion. in 1919. doctors in the past year as well as approving health and at a time that suited them. The interest A combination of Zoom and Panopto were used to wellbeing policies and writing a number of articles on from doctors in both the live webinars and facilitate these educational courses. It was not possible A highlight was The Future of Medicine on Saturday the subject. Due to the current COVID-19 restrictions, the recordings shows the need for these to deliver simulation courses in the short term; however, 19 October where we heard from Paul Reid, Director online programmes in health and wellbeing were also educational updates during the pandemic. plans are underway to delivery these within public health General of the HSE, Dr Andrew Padmos, CEO of the developed and delivered. Prof Cunnane is actively It also shows that this new mechanism of guidelines in the coming year. Royal College of Physicians and Surgeons of Canada and involved in national initiatives such as the cross-training delivering medical education and its format Professor Jackie Taylor, President of the Royal College body collaboration and is currently analysing existing has been well received by doctors.” 2019 St Luke’s Symposium a celebration of medicine of Physicians and Surgeons Glasgow. data with the intention of publishing and carrying out St Luke's Symposium, our annual conference, took place research into the factors influencing wellness of our Terry McWade, RCPI CEO from 17 - 19 October and was fully booked this year. Continuing Professional Development Support Trainees and Trainers. On a weekly basis 400 doctors on average watched the Over the three days, over 700 attendees enjoyed a Scheme for Non-Consultant Hospital Doctors COVID-19 webinars and as many as 1,200 tuned in to wide variety of interesting, and often humorous, talks We offer a Continuing Professional Development Support Supporting Trainees in Difficulty the most attended webinar. The recordings were also and had the opportunity to catch up with old friends Scheme (CPD-SS) for Non-Consultant Hospital Doctors At the beginning of the year a number of training sites shared with the other postgraduate medical training and colleagues in a sociable atmosphere. We saw the who are not on a training programme. This scheme, visits were organised in order to promote our health and bodies and the universities to allow interns and final admission of 14 new Fellows and 6 honorary fellows, which is supported by the HSE, helps doctors fulfil their wellbeing services. Referral pathways were shared, and year medical students to view them. The recordings of presentation of the Reuben Harvey Prize, the inaugural St professional competence obligations by giving them free case studies discussed to illustrate the support available the webinars, which were viewed over 30,000 times, Luke’s Medal and the launch of our new award honouring access to courses in the areas of quality improvement, This resulted in an increase of referrals to the service, are available on the RCPI Digital Library –which can be the memory of Dr Kate McGarry FRCPI. patient safety and management and leadership skills. We predominantly self-referral at the early stages of training, accessed by logging in to www.rcpi.ie offer 46 courses and events free of charge to doctors which was very positive. However, from March 2019 We heard about the latest evidence and advice on on the CPD-SS, including all our Masterclasses and over onwards a sharp decline in referrals was observed. Mandatory Training in a Global Pandemic issues such as brief interventions, allergies, medical 35 online courses. A total of 435 doctors signed up to Referrals for issues around disabilities has increased as As a response to the COVID-19 pandemic, mandatory humanities, doctors treating doctors, gender neutral this scheme in 2019 -2020. well as adjustments required around maternity. 40 5.2 41

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YEAR OF REFERRAL REFERRAL CATEGORY Hospital Doctor Retention and Frequency Percent Frequency Percent Motivation (HDRM) Project 2016 2 3.4 Performance 8 13.8 The HDRM project is a HRB-funded research project led by Dr Niamh Humphries which focusses on the 2017 1 1.7 Career 7 12.1 emigration, retention and motivation of hospital doctors 2018 9 15.5 Health 25 43.1 in Ireland. 2019 25 43.1 Environment 10 17.2 2020 21 36.2 Family 4 6.9 Two new postdoctoral researchers, Dr John-Paul Byrne Total 58 100.0 Disability/Learning 4 6.9 and Dr Jennifer Creese were recruited to support the Difficulties work of this project. In the past year, a national survey of hospital doctors was undertaken with responses from Total 58 100.0 SOURCE OF REFERRAL 1,070 doctors. A publication from the survey focussed on work life balance was published in September 2020 in a Frequency Percent special edition of the European Journal of Public Health. This cartoon by Eoin Kelleher was commissioned to Assessment 1 1.7 illustrate the initial findings of the research project on Trainer 5 8.6 In response to COVID-19 and the impact it was having the impact of COVID-19 on Ireland’s hospital doctors. Associate Dean 1 1.7 on Ireland’s hospital doctors, virtual interviews were YEAR OF TRAINING Complaint 4 6.9 * TRAINING LEVEL CROSSTABULATION conducted with 48 hospital doctors in July 2020. The data is now being analysed with a view to informing Inspection 1 1.7 Year of Training BST HST policy and the ongoing response to COVID-19. Medical Training 2 3.4 First 20 8 NSD 12 20.7 Second 8 5 A paper entitled ‘Everything was just getting worse and PCS 1 1.7 Third 0 10 worse’: deteriorating job quality as a driver of doctor RPD 1 1.7 Fourth 0 3 emigration from Ireland’ was published in BMC Human Resources for Health in December 2019. Self 30 51.7 Fifth 0 1

Total 58 100.0 Total 28 27 In February 2020, the first in a series of policy dialogues 42 5.2 43

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was launched by RCPI President, Professor Mary Horgan line with national legislation, standards and guidance also not required to verify or audit doctors’ professional a broad range of activities to address the educational and the preliminary findings from the HDRM survey and international practice. competence records for the 2019 – 2020 year. needs of medical students, medical professionals and were presented to key policy makers. Two research road safety stakeholders in 2019/2020, including two briefs were developed for this event, one focussed on The feedback RCPI received at the end of this review The Medical Council also confirmed that for the 2020/21 Certificate courses and two undergraduate student workplace morale and the other on work life balance. was positive – HCI found that there is a good balance Scheme year, the following will apply: research projects. The research findings were also communicated through between the education that is provided by RCPI and the social media and at national meetings and international education that is approved by RCPI. The inclusion of a • The annual Clinical/Practice Audit requirement has The office engaged with medical professionals and conferences. learning needs survey in our Personal Development Plan been removed road safety stakeholders at a number of national and was highlighted as a good initiative. • Doctors are only required to record 25 CPD international conferences and events including the Helping doctors meet their Professional credits instead of the usual 50 credits. The other Transport Research Board Meeting in Washington DC, Competence requirements A working group was established to develop proposals 25 credits will be considered as met arising from CIECA, and the National Ploughing Championships. We administer 11 Professional Competence Schemes for the PCS Model and Framework. The working group increased learning by doctors during COVID-19 (PCS) on behalf of the Medical Council. The numbers consists of six nominees from the training bodies, the • Of the 25 credits that must be recorded, doctors The Office, which is led by Programme Director Professor enrolled on our professional competence schemes National Director of NDTP, HSE and some Medical are permitted to record these credits in any CPD Des O’Neill, continues to publish papers on topics related have been increasing each year since they were first Council nominees. RCPI’s CEO and Director of category and CPD requirements for each category to medical fitness to drive and had five peer-reviewed introduced in May 2011. Professional Competence will represent the RCPI’s six will not apply papers accepted during this academic year. training bodies on this working group. Participation in Medical Council Review Leading the growth of Traffic Medicine in Ireland of Professional Competence Schemes PCS and COVID-19 The National Office for Traffic Medicine continues to In the past year, we participated in an independent In response to COVID-19, the Medical Council confirmed develop a national framework for standards in Traffic review of Professional Competence Schemes, which was that it would not monitor compliance with maintenance Medicine on behalf of the Road Safety Authority. carried out by Health Care Informed (HCI) on behalf of of professional competence for the 2019/20 Scheme the Medical Council with a view to enhancing CPD for year. This meant that doctors were not required to make The office published the ninth edition of Ireland’s national doctors in Ireland. The aim of the review was to make a declaration about their maintenance of professional Medical Fitness to Drive Guidelines in July 2020 along recommendations on how the Professional Competence competence when retaining their registration with the with three new driver information leaflets for the RSA/ Framework Model and Scheme could be improved in Medical Council in 2020. Postgraduate Training Bodies are NDLS on Stroke, Vision and Pregnancy. It also delivered 44 5.3 45

PROMOTE LEADERSHIP 2,000 IN PATIENT CARE people trained in Quality Improvement

RCPI Quality Improvement Department is committed to Leadership and Quality in Healthcare programme supporting safer, higher quality and more cost-effective since 2011 healthcare. We offer world-class training in Quality • This year almost 50 healthcare professionals from Improvement methodology and advanced leadership hospital sites across Ireland completed our project- skills to healthcare workers across Ireland. based Quality Improvement in Action programme • 28 hospital based, multidisciplinary teams took part Healthcare workers are often the first to identify and in Quality Improvement Collaboratives aimed at 600 support practical solutions for making care safer and improving acute care for people living with COPD people graduate more efficient. We are leading providers in Quality and improving patient safety in paediatric and with the Diploma in Improvement (QI) training, with a growing range neonatal settings Leadership and Quality of educational programmes aimed at everyone in • New online Fundamentals of Quality Improvement in Healthcare healthcare, no matter their role or level of QI experience. module launched

The thousands of healthcare workers who have COVID-19 impact on delivery of Quality completed QI training with us since 2011 have seen Improvement programmes theory and methodology translate into tangible, As with all areas of the health service, RCPI was impacted measurable outcomes such as quicker access to care, by the COVID-19 pandemic in 2020. All in-person fewer adverse events, cost savings, reduced length of education programmes were initially suspended in stay and more prudent use of resources. March 2020, alongside nationwide restrictions, while our dedicated faculty teams developed and delivered Improving patient safety through training innovative, person-centred virtual programmes tailored in Quality Improvement methodology to each cohort of participants. • Over 2,000 people trained in QI through our collaboratives, Diplomas and Quality Improvement COVID-19 Quality and Safety video series courses Presented by quality improvement experts who work • Over 600 people have completed the Diploma in closely with RCPI, a series of bespoke videos were 46 5.3 47

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created and made available open-access to provide delivers significant achievements for the health service QI Scholars in Residence from Irish National Clinical Guidelines, this six-month support for maintaining quality and safety during the and patients. The Quality Improvement Scholarship in Residence collaborative programme supports participating teams COVID-19 pandemic. Programme for fourth-year and fifth-year Specialist through the process of implementing the Situation Over 90 individuals across 32 teams participated in Registrars and senior GP Trainees who are interested Awareness For Everyone (SAFE) improvement bundle The videos were designed to help those working on the three Diploma programmes offered this year. One in Quality Improvement, ran for the fourth time. The developed by the Royal College of Paediatrics and Child the frontline and anyone in healthcare with a suite of bespoke cohort was tailored to support 11 teams of one-academic year programme was developed by RCPI Health, UK. This bundle supports the enhancement resources and practical tools for dealing with quality and senior healthcare professionals and managers from and the International Society for Quality in Health Care of a safety culture through interventions such as a safety in a crisis/pandemic. Ireland’s Community Healthcare Organisations. (ISQua) to develop clinical leadership skills and quality Paediatric Early Warning System (PEWS), effective improvement knowledge. communication, and the huddle, as developed by Quality Improvement in Action Cincinnati Children’s Hospital. COVID-19 QI Series topics This programme ran through 2019-20 with two cohorts During the 12-month programme, the scholars receive • Quality and Safety at this time and almost 50 attendees from hospitals and clinical support to complete a QI project in their workplace. In the 2020-21 academic year, the SAFE programme • Systems thinking tools services all over Ireland. The second cohort was faced will be offered to adult medical teams. • Measurement for improvement with disruption due to the COVID-19 pandemic but The 2019-2020 Scholars in Residence were: • Using the Model for Improvement was adapted for virtual delivery with flexible web-based Daily team huddles improve communication and patient and PDSA cycles coaching support offered to all participants. • Dr Stephen Brennan safety in the neonatal unit at Galway University Hospital • Safety at the core - overview of patient safety • Dr Rachel Brodie • Psychological safety • Dr Cormac Kennedy “Based on our experience, the safety huddle • SItuation awareness “This was an amazing effort to continue • Dr Sinéad O'Donnell has empowered more staff, given all of us a • Person centred care learning about QI during unprecedented • Dr Adedayo Olawuni sense of community and enabled everyone times like COVID-19. Many of us to share relevant information. The safety Situation Awareness for Everyone Collaborative: observed positive or negative spins to huddle is now embedded in our daily routine; Diploma in Leadership and Quality in Making hospitals safer for children our projects during the pandemic which our SAFETY journey has only just started and Healthcare supporting frontline innovations The second Irish Situation Awareness for Everyone Every team undertaking the Diploma in Leadership and added a different and unique perspective (SAFE) Collaborative was delivered in 2019-2020 with it has been energised by the support of all Quality in Healthcare completes a project on improving to our learning.” 10 teams participating from frontline paediatric or members of staff” patient access, reducing waste or saving costs. Each team Participant from a Quality Improvement in Action course neonatal hospital settings. Building on recommendations Galway University Hospital SAFE Team 48 5.3 49

PROMOTE LEADERSHIP “The initial programme has been a great success in generating considerable IN PATIENT CARE engagement in the hospitals that have been involved in the collaborative.” Prof. Timothy McDonnell M.D. FRCPI FRCP Consultant Respiratory Physician St. Vincent’s University Hospital and St. Michael’s Hospital National Clinical Lead Respiratory Programme, HSE

COPD Collaborative: Improving clinical outcomes for for a reminder of the basic principles. These resources patients with Acute Exacerbation of COPD are available online to all. The COPD Collaborative ran from September 2018 to November 2019 as a joint initiative by the Clinical Fundamentals of QI Strategy and Programmes Division of the HSE, the This one-hour online module serves as a valuable National Clinical Programme for COPD and RCPI. introduction to quality improvement in healthcare and 18 frontline, consultant-led, respiratory specialist allows individual participants to understand their role teams representing 19 hospitals participated in the in Quality Improvement and develop their potential to collaborative. Clinical outcomes for patients presenting improve care. This module may be accessed by anyone with Acute Exacerbation of their Chronic Obstructive interested in learning about QI and has become part of Pulmonary Disease (AECOPD) were improved at a the required preparation for diploma and collaborative national level. programmes.

By the end of the programme, the following results had RCPI Improver’s Guide been achieved: This is a free, open access, online, easy to read beginner’s guide to the basic tools and concepts used in quality • Reduction in Length of Stay (6.75 days to 5.0 days) improvement in healthcare. It has been designed to • Increase in patient prescription review completed support improvers to develop their QI projects. before discharge (25 % to 75 %) • More patients supported by pre-discharge inhaler Research Collaborative for Quality technique training (55 % to 89.5 %) and Patient Safety • Reduced patient time to wait to see a respiratory The Research Collaborative in Quality and Patient Safety specialist (median 25 hours to 13 hours) (RCQPS) is a unique collaboration between the Health Research Board, the Quality Improvement Division of New resources for Quality Improvement the Health Service Executive and RCPI. Established in Healthcare teams participating in the SAFE Collaboration pictured in RCPI, No 6 Kildare Street This year we developed and published new resources for 2013, the Collaborative identifies the most pressing issues those interested in beginning their QI journey or looking affecting healthcare quality and patient safety in Ireland 50 5.3 51

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and put new processes and procedures in place for these programmes, the guidelines and data policies with participation still growing. The programme is patients and all health care related workers. There is a they produce are attracting international interest. The continuing to provide a safe space for learning and unique opportunity to learn from these adaptations and programmes are also members of the European Clinical continuous improvement. The working group is to improve the quality of approaches throughout and Audit Network (ECAN), established by the National Office reviewing the Programme’s QI Guidelines and will hold beyond this pandemic. for Clinical Audit (NOCA) and their Dutch counterparts, their annual conference later this year as an online event the Dutch Institute for Clinical Audit (DICA) which to give updates on the Programme to Radiologists and To date, €3.36 million has been awarded for RCQPS focuses on sharing learnings, collaboration on projects Diagnostic Radiographers. projects. and promotion of clinical audit as a vital component of quality improvement across healthcare systems. Gastrointestinal Endoscopy National Specialty Quality The National Gastrointestinal Endoscopy Quality Improvement Programmes Histopathology Improvement Programme has been successfully rolled The National Specialty Quality Improvement programmes The National Histopathology Quality Improvement out to all 37 public hospitals and to 10 private hospitals Patient representatives Paddy Grimes, Mary specialise in gathering quality improvement (QI) Programme celebrated its 10-year anniversary in 2019 providing endoscopy services. It is hoped that two O’Buachalla, Ann Murphy viewing posters displayed data in three diagnostic specialties: Histopathology, which was acknowledged at the Faculty of Pathology’s further private hospitals will be joining the programme by COPD Collaborative Teams Gastrointestinal Endoscopy and Radiology. The goal International Pathology Day on 22 November 2019. by the end of 2020. of these programmes, which are funded by the HSE Work was also completed on the programmes seventh and allocates funding for research into these issues, National Quality Improvement Team, is to optimise Annual National Data Report this year. The report was The programme published the fourth GI Endoscopy QI knowing they can help drive improvements in quality patient care through facilitating and supporting the compiled using national, anonymised data collected Annual National Data Report in November of 2019, and patient safety throughout the entire health system. use of evidence-based quality improvement in diagnosis from the National Quality Assurance and Improvement covering QI data from Q3 and Q4 of 2018. This report and reporting. The data gathered via these Programmes System (NQAIS) between January and December 2019. covering two quarters, will allow the programme to move In 2019, under the theme of Quality Improvement, two is also reported on locally and is aggregated in annual Twenty-nine Irish laboratories (including 22 public and 7 to a January to December reporting year going forward. projects led by Prof Kathleen Bennett and Prof George National Data Reports, which can be used to drive quality private) participated in the programme and contributed The launch of the report saw over 70 attendees take Shorten were awarded funding. In 2020, as a response improvement in hospitals. to this dataset. part in a conference in No.6 Kildare St. on the 12th of to the global COVID-19 pandemic, RCQPS launched a November. Among the speakers on the day was Prof funding opportunity supporting the National research Ireland is currently the only country in the world Radiology Rob Tollenaar, Chair of the Dutch Institute for Clinical response to COVID-19. The COVID-19 crisis has meant running national programmes such as these across The National Radiology Quality Improvement Audit, who delivered an insightful talk on “improving the health and social care systems have had to rapidly adapt public and private hospitals. Such is the success of Programme is currently running in 48 public hospitals, quality of care by measuring outcome”. 52 5.3 53

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Leading healthcare system design and innovation • Pathology Clinical Lead: Dr Mary Keogan service from Beaumont Hospital. The development of launched by Minister for Health Simon Harris TD on – The National Clinical Programmes • Paediatrics and Neonatology Clinical Leads: Dr a new model of care for MND enabled by Telehealth September 30th 2019. This Model of Care outlines how Over the past decade Ireland’s National Clinical Ellen Crushell, Prof John Murphy and Dr Nuala (TiM) – an integrated patient app and clinical platform, the care of People with Cystic Fibrosis (CF) should be Programmes have been a hugely successful initiative, Murphy which has been funded by the Health Research Board, organised and resourced now and in the future. One of bringing clinical leaders together to develop evidence- • Rare Diseases Clinical Lead: Prof Eileen Treacy has also been a key focus. the key recommendations of the Model is that people based models of care, care pathways and clinical • Renal Programme Clinical Lead: Prof George with Cystic Fibrosis must be cared for in a small number guidelines that have led to major improvements to Mellotte Improving quality and value and developing specialist of Designated Cystic Fibrosis Centres that are properly patient care. The programmes are a collaboration • Rehabilitation Medicine Clinical Lead: Dr Jacinta hospital care networks in common disease has been a staffed and resourced. This first Model of Care for CF in between the HSE and the Forum of Irish Postgraduate McElligott key workstream and in 2019 funding was secured via Ireland is the roadmap for CF care now and in the future. Medical Training Bodies. • Respiratory Clinical Lead: Dr Desmond Murphy the Sláintecare Integration Fund to support the care It will ensure that CF care and service improvements are • Rheumatology Clinical Lead: Prof David Kane pathway for Headache. This is a collaboration with evidence-based and cost-effective. RCPI-led National Clinical Programmes • Stroke Clinical Lead: Dr Ronán Collins the Irish Pharmacy Union, the Migraine Association of • Acute Medicine Clinical Leads: Prof Garry Ireland and Trinity College as well as 4 pilot Neurology As part of our response to COVID-19, the NCPCF Courtney and Dr Yvonne Smyth National Clinical Programmes are continuing to make centres in Tallaght, Galway, St James and Beaumont developed a national strategy for telehealth in CF. • Chronic Obstructive Pulmonary Disease Clinical a lasting impact on patient care. Examples of recent Hospitals. An all-island Deep Brain Stimulation Service This will see all adults and the majority of children Lead: Prof Tim McDonnell achievements and improvements are highlighted below. based in the Mater Hospital has been operational since with CF receive a wireless spirometer, Pulse Oximeter, • Cystic Fibrosis Clinical Lead: Prof Charles Gallagher early 2020 with a consultant post and multidisciplinary weighing scales and thermometer for use at virtual • Dermatology Clinical Lead: Prof Anne Marie Tobin National Clinical Programme for Neurology team offering pre and peri operative consultation and appointments. These virtual CF clinics will replace the • Diabetes Clinical Lead: Prof Sean Dinneen The National Clinical Programme for Neurology (NCPN) follow up post-surgery. This has been a long anticipated regular outpatient/day care clinics for most people with • Epilepsy Clinical Lead: Dr Ronan Kilbride continues to advocate for the realisation of the Model and welcomed development. A guidance document for CF during the COVID-19 period and will mirror as closely • Gastroenterology and Hepatology Clinical Lead: of Care for Neurology, which was launched in 2016. communicating expectations regarding the diagnosis of a as possible that of the current delivery model to minimise Prof Colm O’Morain Key priorities in 2019/20 have been the delivery of the Neurological condition has also been published by NCPN any stress and anxiety people with CF may feel about • Heart Clinical Lead: Prof Kenneth McDonald pathways of care for Motor Neurone Disease, Headache to support patients receiving a diagnosis of Neurological this new way of delivering care. • Neurology Clinical Lead: Prof Orla Hardiman and Multiple Sclerosis, as outlined in the Model of Care. condition for the first time. • Obesity Clinical Lead: Prof Donal O’Shea NCPN has supported the sustainability and development The NCPCF was also instrumental in driving the approval • Older People Clinical Lead: Dr Siobhán Kennelly of specialist rare disease networks in Neurology, thereby National Clinical Programme for Cystic Fibrosis of the HSE High Tech Hub as a national electronic • Palliative Care Clinical Lead: Dr Brian Creedon growing the Motor Neurone Disease (MND) National Cystic Fibrosis - A Model of Care for Ireland' was prescription transfer system. This eliminates wait times 54 5.3 55

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for people with CF to receive their prescriptions in the European Reference Networks (ERNs) were established The National Clinical Programme for Respiratory Disease dementia. Approximately 10,000 older people have post following a virtual appointment, who now have in 2017 by the European Commission. These networks (NCP Resp) launched an “End to End COPD Model of accessed Comprehensive Geriatric Assessment over the them instantly available in their pharmacy. are for healthcare professionals and patient organisations Care” in December 2019, describing a framework for the last three years. Additional capacity through advanced to share expertise, knowledge and resources about rare development of integrated respiratory services in Ireland practice models with Advance Nurse Practitioners for National Clinical Programme for Rare Diseases diseases across Europe. A total of 16 new applications and established two pilot sites in 2019/2020. Having older people are also beginning to show impact. There A ‘rare disease’ is a disease which affects no more than to join ERNs were submitted from Ireland in December completed an NCEC National Clinical Guideline for the has been an evolving change of attitude in terms of how 5 people in every 10,000. In Ireland, 300,000 people 2019. The National Clinical Programme for Rare Management of Acute Asthma in 2015, the programme healthcare workers see their role in managing long term are affected by rare diseases. In July 2019 the National Diseases, as well as the individual healthcare teams is currently developing a Model of Care for Asthma as conditions in older people. Clinical Programme for Rare Diseases published a Model who have applied, are eagerly awaiting the results of well as updating documents on COPD Outreach and of Care. This is a significant milestone for the rare the application process. Pulmonary Rehabilitation. Over the past few months, the programme has worked diseases community as the document sets out national extremely hard to tackle issues brought on by the recommendations for several areas including coding and National Clinical Programme for Respiratory Disease The NCP Respiratory has been a core provider of global COVID-19 pandemic, with specific risks for older registration of rare diseases, clinical care pathways and In Ireland it is estimated that 500,000 people are living leadership, direction and support to respiratory services people resident in nursing homes and at home. Several clinical research in rare diseases. with COPD yet only 200,000 are diagnosed. Ireland has across the country during COVID-19, supporting staff to interim measures and clinical guidance documents were the highest rate of hospital admissions with COPD of deliver patient care across many different settings. The developed to support local planning and management Now in its fifth year, the National Rare Diseases Office any country in the OECD (National Healthcare Quality programme will update existing guidelines as appropriate and published on the HSE Library Repository for Interim provides reliable information about rare diseases to Report System 2019). There were 15,127 inpatient and develop further guidance to support all health care Clinical Guidance and can be accessed at: https://hse. patients and their families, health care professionals, hospitalisations with a primary diagnosis of COPD in professionals to manage Respiratory patients in the era drsteevenslibrary.ie/Covid19V2/olderpersons. The researchers and policy makers. See www.raredisease.ie 2017 accounting for 3.9% of inpatient discharges (in of COVID-19. programme also supported and influenced information for further information. those over 35). for infection and prevention control measures, published National Clinical Programme for Older Persons on the Health Protection Surveillance Centre, which In Spring 2020, the National Rare Diseases Office Current estimates for asthma suggest that there are The National Clinical Programme for Older Persons can be accessed at https://www.hpsc.ie/a-z/respiratory/ commenced a new project to develop clinical care approximately 450,000 people with doctor-diagnosed continues to work to increase capacity within primary coronavirus/novelcoronavirus/ pathways for people living with rare diseases. This is a asthma in Ireland (approx. 1 in 10 of population), of and ambulatory care, as well as augmenting existing key recommendation within the National Rare Diseases whom approximately 240,000 are estimated to have capacity in acute hospitals to meet the needs of older Plan for Ireland. uncontrolled asthma. people. Fourteen integrated care teams nationally facilitate enhanced care delivery in frailty, falls and 56 5.4 57

BE A TRUSTED, AUTHORITATIVE VOICE ON PUBLIC HEALTH POLICY

RCPI and its Faculties and Institutes continue to play a challenges. We’ve ensured the professional medical voice leading role in influencing and informing public health has been captured in relevant national consultations policies through public affairs and advocacy activities. and we’ve engaged with media to promote the HPV We are regularly approached by policymakers and Vaccine and to support cervical check screening and the media when expertise and authority is needed to other cancer screening. inform legislation, health policies and public discourse. We are fortunate to have so many experienced In 2020, we launched our new podcast, The Expert View, Members and Fellows willing to contribute to media a series of interviews and discussions with experts from and engagement campaigns. within RCPI.

In the context of COVID-19, our Members and Fellows To ensure we focus our advocacy efforts on issues that have provided expert medical information in what may are important to our membership, in January, we sought be the most significant public health debate of our views on priorities for the next Minister for Health and time. Our President, Professor Mary Horgan, with her conducted a survey on Green Health in advance of an background as a specialist in infectious diseases, has October conference on this topic. We’ve also put in place played a leading role in this debate, as has our Dean of guidance to support Members in working with RCPI to the Faculty of Public Health, Prof Emer Shelley, Dean of highlight policy issues. the Faculty of Occupational Medicine, Dr Lynda Sisson and many others. Some of our key advocacy activities for the year are highlighted below. In 2019, our Faculty of Public Health and Faculty of Paediatrics have spoken up for children’s health and Providing an expert voice on COVID-19 wellbeing in the context of both homelessness and From the initial stages of the COVID-19 pandemic, the Direct Provision system. We also drew attention to spokespeople from RCPI have been prominent in doctor burnout and challenges in doctor retention with national media debate, providing clear, scientific our research projects and we convened a working group information to the public and to policy makers. A number to explore how RCPI might respond to some of these of RCPI Members are part of the National Public Health 58 5.4 59

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Emergency Team and Members of all of our Faculties and meeting the needs of children and their families, in terms We also announced a new award in 2019, to honour Supporting CervicalCheck and Institutes have worked tirelessly to inform the response of security, family autonomy, nutrition and access to the selfless approach and work of Laura Brennan, who, other cancer screening to this unprecedented health challenge. education and health services. The new Government following her diagnosis of terminal cervical cancer, We are committed to supporting lifesaving screening has pledged to abolish Direct Provision. dedicated her days to helping others by engaging with services, including the CervicalCheck programme. RCPI As an infectious diseases specialist, President Prof the public to build confidence in this vaccine. We were and its Faculties and Institutes have worked with various Mary Horgan has represented a professional medical On World Children’s Day, 20th November 2019, privileged to know Laura and help her communicate stakeholders, including the Department of Health and view in print, radio and television media throughout we published a position paper from the Faculty of her message. The Laura Brennan Advocacy Medal the HSE, to address issues and concerns that impact the pandemic. Prof Emer Shelley, Dean of the Faculty Paediatrics and Faculty of Public Health Medicine recognises patient and public advocacy for the health on the screening services. Many Fellows and Members of Public Health has also appeared in multiple media calling on the Government to urgently take action to of the population. from across the College, particularly the Institute interviews to present the Public Health perspective, address the serious harm to the health of thousands of Obstetricians and Gynaecologists, the Faculty of reassuring and informing the public in terms of the of children in Ireland experiencing homelessness necessity for, and effect of the public health measures and inadequate housing. The paper highlighted the introduced to minimise the impacts of the pandemic. unacceptable health risks and harm experienced by Prof Lynda Sisson, Dean of the Faculty of Occupational thousands of children affected by Ireland’s housing Medicine, has highlighted the impact of the pandemic crisis and which potentially can have long-term health on healthcare workers. Other specialties including implications for them into adulthood. Paediatrics, Obstetrics and Gynaecology and Pathology have also spoken publicly of the impacts of COVID-19 Both papers received extensive coverage in national on the provision of care within their specialties. and local media.

Speaking up for children’s health and wellbeing Supporting HPV Vaccine and the In a report published in December 2019, the Faculty of Laura Brennan Advocacy Medal Paediatrics called on the Government to abolish Direct Over the past year, we continued to highlight the Provision and place families in community-based, family- importance of vaccinations, with a focus on the HPV friendly housing and environments. The paper's lead vaccine. In August 2019, an opinion piece from the RCPI Kevin Brennan, Fergal Brennan, Dr Terry McWade, CEO RCPI, Bernie Brennan, Larry Brennan. The parents and siblings of author, Dr Niamh O'Brien, HST Paediatrics, outlined President on why boys need to be vaccinated for HPV the late HPV vaccine campaigner Laura Brennan visited RCPI in August 2019 ahead of the launch of our new award the Laura Brennan Advocacy Medal very clearly how Direct Provision is not adequately was published in the Irish Times. 60 5.4 61

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Pathology and the Faculty of Public Health Medicine, have around screening and to support healthcare professionals helped to restore confidence in the screening services by with open disclosure. joining committees, engaging with the media, and working collaboratively to implement recommendations. Empowering doctors to advocate for Green Health We know that doctors want to lead out on sustainable The RCPI President represents clinical issues and concerns healthcare. A survey, conducted with RCPI Members and on the CervicalCheck Steering Committee established Fellows ahead of an RCPI Green Health Symposium on by the Chief Medical officer, which also includes patient 6 November 2019, looked at the concerns of doctors advocates, and met separately with a delegation of in relation to climate change and the environment. patients affected by the CervicalCheck audit as part of The survey found that 95% of doctors want to take a the process proposed by Dr Gabriel Scally. leadership role in the area of sustainable healthcare and that 97% are worried about climate change and pollution. In December, we welcomed the findings by the Royal Dr Sadbh Lee from Irish Doctors for the Environment speaking at the Green Health Symposium on 6 November 2019 College of Obstetricians and Gynaecologists in the UK The one-day symposium was held in partnership that while some missed opportunities to prevent and with APC Microbiome Ireland and the Irish Heart diagnose cancer earlier in women were found, overall, Foundation and focused on challenges facing our health In 2020, RCPI joined the Climate and Health Alliance, Research is consistently highlighting the issues driving the Irish cervical screening programme is performing in Ireland stemming from climate change and increasing a new health sector climate alliance, committed to doctors to quit medicine or move abroad for better effectively. Some of our Members and Fellows spoke environmental pressures. Topics included antibiotics in advocating for government action on climate change working conditions. In 2019, we drew attention to to the media on behalf of the College and its Faculties the food chain, single use plastics in hospitals, healthier and its impact on public health. doctor burnout and challenges in doctor retention with and Institute during this challenging time for screening transport options, and air pollution. our research projects. Results from these projects were programmes, in particular Professor Donal Brennan and Recruitment and retention of medical talent published in the print and online media. Dr Ciarán Ó Riain. We also had support from Professor We’ve also shown our support for Irish Doctors for In December we circulated a survey to our Membership Jo Martin, President of the College of Pathologists in the Environment, an organization of doctors who aim to seek views as to what the top priorities should be A Policy Group established in RCPI to review issues London who wrote an opinion piece on this issue. to create awareness and implement action around for the next Minister for Health in Ireland. The overall in doctor recruitment and retention developed environment health and the impact it has on patients’ response was strikingly clear - the top priority for our draft recommendations in 2019/2020. These RCPI has also shown leadership in developing new health, meeting with them to discuss concerns and doctors is implementing measures to retain hospital recommendations will be reviewed in the context of educational materials and content to improve knowledge potential partnerships. doctors in the Irish health system. the new healthcare landscape resulting from COVID-19. 62 5.4 63 Disease hits BE A TRUSTED, most vulnerable, AUTHORITATIVE VOICE ON says expert Fronting-up PUBLIC HEALTH POLICY in a crisis

Consultations of Public Health (IPH) have entered a collaboration to Call to extend school year to make up RCPI responded to various consultations and requests increase the impact of research and advocacy in the for lost time for feedback in 2019/20 including a Department of area of tobacco use for both organisations. The Policy Keeping Physicians Transport Tourism and Sport Review of Sustainable Group, chaired by Dr Des Cox, published a pre-budget Mobility Policy (Active Travel) and a request from the submission in July 2019, recommending an increase in updated during Department of Health to provide feedback with regard excise duty on cigarettes. The group also called on the the pandemic to developing a national position on the reprocessing Government to fast-track legislative measures to prohibit and further use of single use medical devices. the sale of e-cigarettes to children and for funding for End Kids' research into these products. Direct Provision In June 2020, we made a submission to the COVID-19 Nursing Homes Expert Panel consultation survey, RCPI Professional Policy Group for GDPR Survivors need aftercare most of all the aim of which was to provide immediate real-time In 2019, we established an RCPI Professional Policy learnings and recommendations in light of the expected Group for GDPR, made up of clinicians representing ongoing impact of COVID-19 with regard to Nursing various specialties from the Institutes and Faculties Homes over the next 12-18 months. within RCPI, and legal advisors. The Policy Group issued its first set of guidelines in March 2019 and published The Expert View- new podcast updated guidelines in December 2019. Expert: Ireland has In 2020, we launched our new podcast, The Expert View, Call for outdoor areas in bars a series of interviews and discussions with experts from done really well in Facilitating policy development to become non-smoking across RCPI. In May and June 2020, topics covered RCPI has long been a well-respected voice in public health controlling Covid-19: included a COVID-19 Q&A, outdoor smoking, testing debates. Our Members and Fellows lead initiatives and capacity for COVID-19, contact tracing, COVID-19 and discussions that influence government policies, legislation women’s health, the return to sport and the impact of and shape public debate. In 2020, we put in place guidance COVID-19 on vulnerable children. to support Trainees, Members and Fellows in working with RCPI to highlight policy issues. Collaboration on Tobacco - Institute of Public Health Direct Provision 'causes children life-long harm' From 2020, the Policy Group on Tobacco and the Institute 64 5.5 65

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We are very proud to have an international network around the world to promote the value of MRCPI and of over 12,000 doctors: more than half of our the high standard of doctors who achieve Membership Licentiates, Members and Fellows practice in over 80 of RCPI. This is something we will continue to do in the countries worldwide. We value our relationships with year ahead. sister Colleges in the United Kingdom, United States, Canada, Australasia, Malaysia, Singapore, Hong Kong During his first year in RCPI, our new CEO, Dr Terry and South Africa. In the last year, we also started to McWade, travelled extensively, meeting Members in build a connection with the newly established Macau India, Malaysia, UAE, Kuwait, Bahrain and Saudi Arabia Academy of Medicine. and is committed to continuing that engagement.

Achieving the highest standards requires us to show The International Medical Graduate leadership in the international provision of education, Training Initiative training and global health strategies. We continue to Our International Medical Graduate Training Initiative, build strong relationships at government and institution now in its sixth year of operation, continues to provide levels in Canada, Malaysia, India, Zambia, the Kingdom a route for sponsored doctors to experience structured of Saudi Arabia, Oman, Kuwait, Bahrain and the United postgraduate medical training in the Irish public health Arab Emirates. service. Under this initiative, suitably qualified medical Trainees from the Gulf Cooperation Council (Kingdom of We continue to increase our global presence and remain Saudi Arabia, Kuwait, the United Arab Emirates, Bahrain focused on connecting with our Members from around and Oman) undertake a fixed period of training in clinical the world. In 2019 we hosted the International Medical services in Ireland. Education Leaders Forum and held a meeting with our Members and Fellows in the Gulf region. We hope RCPI offers two streams of training under this Initiative: to have more meetings like this in the future to hear Fellowship and Residency. Trainees accepted onto these how we can support our Members in their professional programmes are fully sponsored by their governments development. In addition, we regularly meet with for the duration of their training. Ministries and health authorities and medical bodies 66 5.5 67

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Where our international Trainees are from: This was the first official graduation ceremony for our programme allows doctors who are enrolled with the two years of training in Ireland in several specialties. international training programmes to take place outside College of Physicians and Surgeons in Pakistan and the This year 47 doctors completed their medical training in • Oman 13% of Dublin. This ceremony was to honour the achievement Sudan Medical Specialisation Board (SMSB) to complete Ireland in July 2020 and returned to their home country. • Saudi Arabia 47% of 37 graduates of the International Clinical Fellowship • Kuwait 13% Programme across 18 specialties. Currently there are 117 doctors • United Arab Emirates 18% from Pakistan and Sudan enrolled • Bahrain 9% Spotlight on the International on this programme for 2019/2020 Residency Training Programme across all medical and surgical To date, 73 Trainees have graduated from the International Our International Residency Training Programme is specialties. 60 Trainees commenced Medical Graduate Training Initiative and have returned now a three-year residency programme offered in year one in July and 57 commenced home to embed their newly acquired knowledge and skills Ireland to international doctors. This programme is year two of the programme. in the health services of their home countries. currently offered in Internal Medicine and Paediatrics. There are currently eight doctors training in Ireland on Impact of COVID-19 Spotlight on the International Clinical the Residency Programme in Internal Medicine and COVID-19 presented challenges Fellowship Programme Paediatrics and recruitment for the 2021 intake will regarding recruitment, provision of The International Clinical Fellowship Programme offers commence in September. educational programme offerings structured, curriculum-based specialist training at a and visa applications this year. All senior level for doctors who wish to pursue higher Supporting postgraduate training for recruitment and course delivery training. Fellowship programmes are now available in doctors from Sudan and Pakistan was facilitated online, and 26 specialty areas and this year we have 39 Trainees We continue to work with the College of Physicians and quarantine protocols were followed on this programme in Ireland. Our Special Interest Surgeons Pakistan, the Sudan Medical Specialisation for doctors entering the country. Fellowship Programme provides access to training at Board (SMSB), the HSE and the Forum of Irish Candidates did face difficulties a subspecialty level. Postgraduate Medical Training Bodies (the administration accessing the Occupational English of the Forum of Irish Postgraduate Medical Training Test (OET) and the International On 6 October 2019, graduates of our International Bodies is provided by agreement through the RCPI English Language Testing System Clinical Fellowship Programmes from five countries Executive) on the Postgraduate Scholarship Programme We were delighted to host the 2019 International Medical Education Leaders (IELTS) examinations. Forum (IMELF) in No.6 Kildare Street on 17 October 2019. attended a special graduation ceremony in Oman. in Ireland for doctors from Pakistan and Sudan. This 68 5.5 69

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This year, two shipments of decommissioned medical The EQUALS Initiative continues to support the new equipment were sent from hospitals in Ireland to Zambia College of Medicine and Surgery (ZACOMS). Lusaka, Zambia. The equipment was tested by the The new College has worked with RCPI to develop a EQUALS Initiative’s leading clinical engineers before tailored Train the Trainer course which was delivered it was distributed to hospitals and health clinics, such as to the ZACOMS Faculty in Autumn 2019. the Memorial Sr Lucy O’Brien Health Post. This Health Post is based in the rural Chibombo District, serving a The EQUALS Initiative has also developed Engineering community that previously had to travel long distances Workshops for Clinical Engineers working throughout to access primary healthcare. Zambia. Karl Bergin (Head of Engineering, The Coombe Women and Infants University Hospital) delivered the first workshop in Lusaka in November 2019.

President of the Royal College of Physicians of Ireland, Prof Mary Horgan, travelled to Dubai to host a special meeting of In the coming year, we plan to ship two 40-foot Members and Fellows based in the Gulf Region in October 2019. containers to Zambia containing important medical supplies and equipment including Incubators, Educational programmes for the overseas market The Equals Initiative: working to improve health in low Laboratory Equipment and Ultrasound Machines. These Opportunities to offer educational programmes income countries. will be distributed across Zambia to centres in need in internationally are growing. Our collaboration with The EQUALS Initiative's is a collaboration between RCPI conjunction with the Ministry for Health. Irish online medical education group, iheed, has yielded and Ireland’s Health Service Executive that works to: considerable success in the last year. Our inaugural The EQUALS Initiative is funded largely by RCPI and programme under the partnership was a six-month • Source and donate good quality equipment from through donations. If you are interested in getting blended learning programme leading to an RCPI Diploma Irish hospitals to hospitals in Zambia involved, please contact [email protected] or call 01 in Paediatrics. 73 doctors completed the first intake of • Build healthcare services in Zambia 863 9700.

this Diploma in Paediatrics in 2019 and 151 doctors • Support the training of biomedical engineers Seamus O’Grady, Ireland’s Ambassador to Zambia and were recruited to commence a programme starting in • Develop postgraduate medical training in low representatives from The Memorial Dr Lucy O’Brien autumn 2020. Our aim is to pursue other opportunities income countries Health Post, which benefited from equipment and training as part of the EQUALS initiative in this area in the coming year. 70 5.5.1 71

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OUR FOLLOWING ON SOCIAL MEDIA

TWITTER 14K >4m Our social media followers on Twitter views of our Tweets JULY 2019 TO JUNE 2020 presence helps us to reach thousands FACEBOOK >12.9K >2.9m across the world followers on FACEBOOK views of our Facebook posts JULY 2019 TO JUNE 2020

LiNKEDIN >5.3K followers on LinkedIN INSTAGRAM YOUtube > 52.5K We joined Instagram in July 2019 views of our videos on Youtube Find us at instagram.com/RCPI_doctors 72 5.5.1 73 We have an international BUILD OUR network of over GLOBAL PRESENCE 12,000 THE GLOBAL RCPI COMMUNITY doctors TOP TWENTY Where our members and fellows are based Locations where our Trainees, Members and Fellows are based:

Ireland 6,294

United Kingdom 1,456 147 Saudi Arabia 565 Malaysia 469

Doctors were admitted as United States Of America 342 fellows of rcpi in 2019/20, India 276 133 of those were admitted in absentia throughout 2020 Pakistan 270

United Arab Emirates 244

Northern Ireland 219

Canada 171

Australia 168

6 Oman 150

Honorary fellows admitted Hong Kong 102 to RCPI in 2019/20 Scotland 75

Wales 60

Singapore 44

Kuwait 42 428 Sudan 40 New Zealand 38 Doctors were conferred Bahrain 36 with MRCPI in 2019/20 74 6.0 75

MEMBERSHIP AND FELLOWSHIP OF YOUR COLLEGE

Our Members and Fellows are the lifeblood of the Becoming a Fellow of RCPI Royal College of Physicians of Ireland. Our collective Fellowship is the highest and most prestigious category voice and combined expertise create strength to help of membership within the Royal College of Physicians of deliver the very best in medical education and help Ireland. As a Fellow of RCPI you will be joining a group to positively influence public health policy. To date, of over 3,000 consultants from around the world who more than 12,000 doctors worldwide are proud to have made substantial contributions to their specialty. be part of RCPI. You will become part of RCPI’s long and illustrious history of exceptional physicians that stretches all the way back Becoming a Collegiate Member of RCPI to 1654. As a Fellow you will have the chance to lead, Membership of RCPI is a significant milestone on the change and influence in your field of medicine, both path to becoming a specialist, as you are inducted into in Ireland and internationally. Your example, skills and a prestigious group of world class physicians. Once you expertise will light the way for doctors of the future. have become a Member you are invited to become a Collegiate Member by paying an annual subscription. This Fellowship gives you a voice amongst peers to shape gives you access to exclusive benefits including free CPD the future of Irish medicine. You can attend our Annual events such as our Members and Fellows Conference Stated Meeting, vote in Elections, influence healthcare – our Annual Conference, St Luke’s Symposium, free policies as part of our Committees and policy groups and access to selected medical journals, and membership participate in the nomination process of a candidate for of our affinity scheme which offers discounts on a wide Seanad Éireann. range of products, hotels and services and access to our Heritage Centre. In addition to those associated with Membership, there are further benefits to be enjoyed as part of your “Being a member of RCPI has given me Fellowship which are worth in excess of €1,200 per year. a sense of belonging within the medical These include access to the BMJ, The Lancet and the New England Journal of Medicine as well as an invitation community in my postgraduate career.” to our Annual Stated Meeting, invitations to exclusive Dr Bernadette Brady, MRCPI events at our Heritage Centre, discounts and much more. 76 6.0 77

MEMBERSHIP AND “I consider Fellowship of the Royal College of Physicians of Ireland to be an FELLOWSHIP OF internationally recognised honour and professional achievement.” YOUR COLLEGE Dr Catriona Ryan, FRCPI

Are you ready to become a Fellow? In 2019/20 we admitted 6 Honorary Fellows: l’Association d’Hospitalisation Canassurance (Blue the Faculty of Medicine, Memorial University of To become a Fellow, you must: Cross), Secretary of the Board of the Directors of Newfoundland, Canada. A former member of the Admitted during the 2019 St Luke’s Lallemand Inc and President of Vocalex Inc. National Advisory Committee on Immunization, 1. Hold Membership of the Royal College of Physicians Symposium FRCPI ceremony Dr Bowmer chaired many advisory committees in of Ireland (or equivalent) for at least four years • Dr Ian Bowmer, Executive Director of the Medical Newfoundland and testified along with provincial 2. Have held a consultant post for at least a year • Professor James Donovan Best, Dean at the Council of Canada and president-elect of the Royal government at the Kreaver Commission. He was 3. Have your application supported by two Fellows Lee Kong Chian School of Medicine in Singapore, College of Physicians and Surgeons of Canada. a member of the NL provincial commission that in good standing distinguished clinician and researcher. Professor An internist, infectious disease specialist and HIV studied physician abuse of patients, the committee Best served as Chairman of the Research Committee researcher and care provider, he is the former on advanced directives and chaired the NL For more information visit our website or contact of the Australian National Health and Medical Dean of Medicine and Professor Emeritus at Commission studying provincial preparedness post [email protected] Research Council 2006-2012 and is currently a SARS. He also chaired the CFPC-Health Canada member of numerous research boards in Singapore. Expert Committee to develop a Guide on the Honorary Fellows admitted in 2019/2020 He has played a leadership role in his career in Treatment of HIV in Adults and Adolescents and Admission to Honorary Fellowship is the highest RCPI endocrinology through his work in diabetes and is recognised as a leader in HIV care and research. can bestow. Introduced in the early 1700s, Honorary metabolism, leading to the discovery of the GLUT Dr Bowmer is the recipient of several honours, Fellowship is only awarded to world leaders in medical 12 glucose transporter and through his studies on including Canada’s 125th Confederation Medal. science, the arts and philanthropy, or those who have cardiovascular risk in the diabetic population. made an exceptional contribution to society. Unlike • Professor Jackie Taylor, President of the Royal Fellows and Members, Honorary Fellows are not • Dr Françoise Chagnon, Past President of the Royal College of Physicians and Surgeons of Glasgow. necessarily medically qualified. Previous recipients College of Physicians and Surgeons of Canada. She has a major interest in training and education of Honorary Fellowship include former Presidents, She is a former member of the Canadian Medical of healthcare professionals and a sub-specialty Eamon DeValera, Erskine Childers, Patrick Hillery, Mary Association’s Committee on Health Policy and interest in heart failure. She is an Honorary Robinson, Mary McAleese and Michael D. Higgins. Economics and currently holds appointments at Senior Clinical Lecturer and was awarded an Other recipients include poet and Nobel Laureate, the the McGill University Health Centre, St Mary’s Honorary Professorship of University of Glasgow late Seamus Heaney, former US Ambassador to Ireland, Hospital Center, the Institut Universitaire de in 2018. She is immediate past Chair of the Jean Kennedy Smith, the RT Hon John Hume and Sir Geriatrie de Montreal and is a consultant at the British Geriatrics Society Cardiovascular Section. Bob Geldof. Axio Health Group. Dr Chagnon is director of Professor Taylor’s other main professional 78 6.0 79

MEMBERSHIP AND FELLOWSHIP OF YOUR COLLEGE

roles have been as Vice President Medical and scientific institutions to the history of medicine, Honorary Secretary of the Royal College of particularly with respect to Ireland. Professor Jones Physicians and Surgeons of Glasgow and she has pioneered the study of history of medicine in became President in December 2018. Ireland which has included work on tuberculosis, medical emigration, medical education, family • Professor Mark Lane, President of the Royal planning and the impact of the Troubles on medical Australasian College of Physicians Within the professionals. Professor Jones was the co-director College he has held various roles including with Dr Catherine Cox of the Centre for the History Chair of the Specialist Advisory Committee for of Medicine in Ireland (CHOMI), jointly based in Gastroenterology in New Zealand, Chair of the Ulster University and University College Dublin. Specialties Board and more recently Chair of the Prof Jones and Dr Cox received a substantial New Zealand Adult Medicine Division Committee. Wellcome Trust grant to establish CHOMI. His subspecialty interests include inflammatory bowel disease, coeliac disease, colon cancer screening and therapeutic endoscopy. Other roles held previously include Secretary and President of the New Zealand Society of Gastroenterology. He has been a patron of the Coeliac Society of New Zealand and on the board of Crohns and Colitis New Zealand.

• Professor Greta Jones, Emeritus Professor of History at Ulster University and co-founder of the Centre for the History of Medicine in Ireland (CHOMI). Professor Jones’ expertise and publications range from work on the nineteenth century history of ideas, the history of Darwinism, 80 7.1 81

Faculty Report

Dr Lynda Sisson Dean, Faculty of Occupational Medicine

The Faculty of Occupational Medicine is the national Some of last year’s highlights for the Faculty • Professor Tee Guidotti travelled to Dublin in professional training body for occupational medicine in November 2019 to deliver the Faculty’s annual Ireland and strives for the highest possible standards • Occupational Medicine physicians were heavily Smiley Memorial Lecture. He was also conferred in health at work. involved in the response to the COVID-19 with Honorary Fellowship of the Faculty of pandemic. Dean of the Faculty, Dr Lynda Sisson, Occupational Medicine at the event, which The Faculty is proud to meet the strict standards contributed a piece to the Irish Times on the role of incorporated the Faculty’s annual dinner, AGM and required to deliver postgraduate specialist training in Occupational Medicine physicians in looking after admission ceremony. occupational medicine and offers a four-year Higher frontline healthcare workers during the pandemic. Specialist Training Programme for doctors who wish to • In line with an RCPI-wide review of governance, specialise in Occupational Medicine. • While the annual spring conference had to be the Faculty convened a temporary group to review cancelled along with so many other events, the its own governance and Standing Orders, chaired The specialty is an increasingly important and relevant Faculty organized a webinar in conjunction with by current Board member and former Dean, Dr one because of the changing modern world of work and public health in June entitled ‘SARS–CoV-2: Tom O’Connell. At the time of writing the group are the Faculty continues to advocate for its advancement Experiences and Perspectives from Occupational planning to present a draft governance document and for the continuing development and expansion of Health and Public Health.’ for approval at the September meeting of the its accredited training programme. Faculty Board. All changes to Standing Orders have • The Faculty adapted to the challenges of COVID-19 to be approved at the Faculty’s AGM. by moving a number of its other activities online, such as its end-of-year assessments for Trainees • Dr Tom Gaffney, Occupational Health Physician and its Board meetings from March onwards. The with the RCSI Hospital Group and a Member of move to online interactions offers an opportunity the Faculty was co-author on a paper published for increased engagement in Faculty activities by in the journal ‘Diabetes Care’ in June. The paper those who for reasons of location or because of was entitled ‘An Evaluation of the Safety of Pilots clinical and other commitments might hitherto With Insulin-Treated Diabetes in Europe Flying have found it a challenge to make time for travel to Commercial and Non-commercial Aircraft.’ physical meetings. 82 7.2 83

Faculty Report

Professor Louise Burke Dean of the Faculty of Pathology

The Faculty of Pathology works to ensure the highest • Expert Advisory Group (EAG) been submitted to the HSE and Department of Health. podcast series – The Expert View – available on Spotify. standards in laboratory medicine in Ireland. • COVID-19 Mortality National Co-Ordination Group Dr Mary Keogan contributed to an Irish Times piece • National Transfusion Advisory Group (NTAG) Webinars by Dr Muiris Huston, and Dr Clive Kilgallen, Chair of The Faculty is accredited by the Medical Council Faculty Fellows contributed to RCPI’s weekly webinars the Histopathology Working Group was interviewed by of Ireland and is proud to meet the strict standards National Clinical Programme in Pathology aimed at providing clinicians with up-to-date information the Irish Times on autopsy guidelines developed during required to deliver postgraduate specialist training in five The Dean is working closely with Dr Mary Keogan, about the virus and patient care during the pandemic. COVID 19. Pathology specialties. It offers a two-year Basic Specialist Clinical Lead of the National Clinical Programme in The Faculty also organised its own dedicated webinar. Training Programme (BST) in Histopathology, the first Pathology, on COVID-19 testing including hosting Contributors included: Moving Faculty activities online step to becoming a histopathologist in Ireland. It also and contributing to regular meetings with Hospital The Faculty adapted to the challenges of COVID-19 by offers six Higher Specialist Training (HST) programmes laboratories regarding testing for SARS-CO-V2, meetings • Consultant Immunologist and Clinical Lead for the moving activities online, including Board and committee in Pathology: Chemical Pathology, Clinical Microbiology, with Hospital Group Nominees and meetings with INAB Pathology National Clinical Programme Prof Mary meetings from March onwards, and meetings of its Haematology, Histopathology, Neuropathology and on remote assessments. Keogan ‘Vintage Pathologists Group’ of retired pathologists. Immunology. The Faculty works with the National • Dr Una Ni Riain, Consultant Microbiologist, NUIG Online meetings offer an opportunity for increased Clinical Programme for Pathology and the National Medical Leaders Forum • Consultant Histopathologist and Chair of the engagement in Faculty activities by those who might Histopathology Quality Improvement Programme to The Dean of the Faculty participated in the Medical Faculty’s Histopathology Working Group, Dr Clive hitherto have found it a challenge to attend physical set standards for pathology services in Ireland. Leaders Forum, convened in response to the COVID-19 Kilgallen meetings, and also played a huge role in ensuring the pandemic. The Forum brought together post graduate • Dr Cillian De Gascun, Consultant Virologist, continued activities of the Faculty. Contribution to the national healthcare training bodies, leaders in the clinical community, HSE Director of the NVRL and Chair of the Coronavirus response to COVID-19 and the Department of Health to discuss a wide-range Expert Advisory Group Impact on training programmes COVID-19 has created exceptional changes for of topics including the impact of COVID-19 on Training • Professor William Gallagher, Chair, HSE Laboratory The Faculty’s Education and Training committee under laboratory practice training and education. The specialty and Education. R&D Product Solutions Group; Director, UCD its Chair Dr Maeve Doyle (the Faculty’s Director of of Pathology plays an important role in dealing with the Conway Institute Training and Education) continues to work with RCPI pandemic in our country and the Faculty is extremely Irish Medical Council • Faculty Dean Prof Louise Burke in addressing the challenges and impacts of COVID-19 proud of this contribution to the national effort. Fellows On behalf of the Faculty, the Dean participated in on our training programmes. Members of the Faculty of of the Faculty are present on many key committees a consultative forum with the Irish Medical Council Public engagement Pathology (including the Dean and Director of Education dealing with the pandemic, including: regarding re-introduction of non-COVID care in an Webinar talks by Dr Cillian De Gascun and Dr Mary and Training) and staff from RCPI met regularly with optimal manner. Recommendations from the forum have Keogan were developed into a podcast for RCPI’s new members of the RCPath (UK) examinations committee 84 7.2 85

FACULTY OF PATHOLOGY

in 2020 and with the Irish Medical Council. sessions and an excellent poster session. Speakers event celebrated important recent developments a survey of mortuary/autopsy facilities in Ireland to Prof Jo Martin, President of the Royal College in Pathology. The Dean, Prof Louise Burke outlined inform a report detailing the Faculty of Pathology’s Plans are being put in place to facilitate Irish Trainees to of Pathologists, UK and Prof Truls Leegard were the roles of a pathologist in diagnosis, treatment recommendations for future delivery of Post- take their exams in Ireland instead of the UK. The Faculty conferred with Honorary Fellowship of the Faculty and patient outcomes. The 10th anniversary of the Mortem Examination Services in Ireland, with continues to collaborate closely with the RCPath UK on at an admission ceremony which included, for the Faculty’s National Histopathology QI programme particular emphasis on the Coronial Service. exams and other initiatives. first time at the symposium, the admission of its was marked, and patient representative Mr Peter latest Associate (Trainee) Members. The AGM was Clarke discussed the importance of the programme • Governance The Faculty also underwent an accreditation process also held during the symposium. from the patient's perspective. A new guideline, A Governance Review Working Group, chaired with the Irish Medical Council earlier this year. ‘Communication of Critical Results into the by Prof Rob Landers, has been created to review • Pathology Trainee Day – September 2019 Community’ was launched and there were talks on the existing governance structures within the Additional Higher Specialist Training The now annual Pathology Trainee Day, free for superbugs and antibiotics resistance, GDPR, and Faculty of Pathology and make recommendations Post in Clinical Microbiology Trainees on RCPI schemes in all pathology sub- HPV screening. for improvements. In line with this review two The Faculty welcomes the recent expansion of RCPI’s specialties, took place in September 2019. The standing committees have also been formed - specialist training programmes and in particular the theme was ‘The Future of Research and Screening’. • Screening FPath Scientific Meetings Committee and FPath additional Higher Specialist Training Post in Clinical There were talks on ‘Implications of GDPR for In May, the Histopathology Working Group Credentials Committee. Microbiology. Clinical Microbiology plays a crucial role Biobanking, Research & Laboratory Medicine’ Chair and member of the Faculty Board, Dr Clive in pandemic response and this post creates an additional by Prof Michael Farrell from RCSI, and a panel Kilgallen recently organised a remote meeting on • Prof Dermot O’Brien Hourihane opportunity for access to high quality training within the discussion on ‘The Future of Screening Services in screening services for all Faculty Fellows involved The Faulty extends its sincere condolences to the Irish healthcare service. Ireland’. Stephanie Whelan from RCPI’s research in screening services, including discussion on family of Professor Dermot Hourihane (1933- department discussed making an application to the recent Supreme Court Judgement delivered 2020.) With his passing, pathology in Ireland has Some of the past year’s other highlights include: a research ethics committee and Dr Sean Hynes in March 2020. Dr Dave Nuttall PhD presented lost a great teacher, trainer, mentor, colleague and offered advice on pursuing a research career in recent changes to the CervicalCheck screening friend. As well as being a leading academic and • Annual symposium pathology. programme and invited participation to some of its diagnostic pathologist and a force for change in The Faculty of Pathology’s 38th annual symposium committees and groups. Irish pathology, Prof Hourihane was a founding took place on 6th and 7th February 2020. Topics • International Pathology Day – November 2019 Fellow of the Faculty of Pathology and was its included Fungal Infections, Forensic and Digital The Faculty marked International Pathology Day • Survey of mortuary /autopsy facilities second Dean (1984-87.) Pathology and GDPR. It also included breakout with an event at No. 6 Kildare St in November. The The Histopathology Working Group is conducting 86 7.3 87

Faculty Report

Dr Ellen Crushell Dean of the Faculty of Paediatrics

The Faculty of Paediatrics is the national professional This year’s highlights: on the Rights of the Child, this Faculty and the and Inadequate Housing on Children’s Health”. It and training body for Paediatrics in Ireland, working to It has been an eventful year. The emergence of COVID-19 Faculty of Public Health Medicine published a joint was primarily concerned with Article 27 - children ensure the highest standards in child health. has changed how we work, how we live, how we teach, position paper on “The Impact of Homelessness and young people's right to live in a way that how we train. The flexibility of our doctors in adapting to The Faculty is accredited by the Medical Council of the new situation has been tremendous and innovation Ireland to train General Paediatricians, Neonatologists has been seen everywhere. In RCPI, remote invigilation and Paediatric Cardiologists. The Faculty offers a two- and webinars have become standard. year Basic Specialist Training programme in General Paediatrics, and Higher Specialist Training programmes Some of the Faculty’s highlights from before in General Paediatrics, Paediatric Cardiology and and after the arrival of the pandemic. Neonatology. A range of one-year subspecialist post- • The October 2019 Autumn Conference included CSCST fellowships are also offered, as well as a general the awarding of the Faculty's 2nd Dr Kathleen Lynn paediatric training programme for paediatric Trainees Medal to paediatric oncologist Dr Patricia Scanlan; from Pakistan (CPSP) and Sudan (SMSB). and the Ralph Counahan Lecture was delivered by Prof Flaura Winston, paediatrician, doctorally- On completion of HST, doctors have the appropriate trained engineer, and lead on child injury prevention clinical expertise to be appointed as consultants, research studies. Prof Winston was admitted into managing their patients’ healthcare needs without Honorary Fellowship of the Faculty, alongside Prof supervision. Paediatricians working in general hospitals in Emily Logan, first Chief Commissioner of the Irish Ireland mainly practice General Paediatrics, dealing with Human Rights and Equality Commission. This day the prevention, diagnosis and management of a wide also included the Faculty’s Annual General Meeting range of diseases. Paediatricians in tertiary children’s and concluded with a wonderful dinner at No. 6, hospitals (e.g. Our Lady’s Children’s Hospital Crumlin) where attendees were treated to the musical talents tend to have a specific subspecialty interest, such as of some of our Fellows. Paediatric Immunology or Paediatric Metabolic Medicine. • To coincide with World Children’s Day 2019 Prof Karina Butler, Dr Patricia Scanlan, Dr Judith Meehan, Dr Ellen Crushell, Prof Flaura Winston at the Faculty Autumn Conference. and the 30th anniversary of the UN Convention 88 7.3 7.4 89

Faculty Report FACULTY OF PAEDIATRICS

Professor Emer Shelley Dean of the Faculty of Public Health Medicine

helps them achieve their full potential. This paper • Paediatric talks were included in the RCPI Established in 1976, the Faculty of Public Health Trainees, Members and Fellows were involved in the received significant media attention and has led COVID-19 webinars with Prof Eleanor Molloy and Medicine is accredited by the Medical Council to provide Health Service Executive (HSE) modules. The Faculty’s to high level meetings in the HSE to address the Prof Karina Butler. Higher Specialist Training and for the Professional Work Packages aimed to support implementation of the difficulties experienced by these families. Competence Scheme for continuing education. The new model, with a planned delivery date of June 2020: • COVID-19 related guidance documents were Faculty consists of Fellows, Members and Diplomate • In June 2020 we published an “Interim Guidance developed by the paediatric diabetes clinical Members and is governed by a Board chaired by the 1 Content of training - Curriculum Review, led by on Medically Vulnerable Children” for families, programme, and the paediatric and neonatology Dean, Professor Emer Shelley. National Specialty Director, Dr Mairin Boland, doctors and other healthcare professionals. It clinical programme. These are available to all on Dr consistent with the RCPI transition to outcome- arose out of concern across many specialties that Steevens’ library website. Since the emergence of SARs-CoV-2 early in 2020 and the based education and assessment some children with severe underlying conditions subsequent COVID-19 pandemic, public health physicians may be unnecessarily cocooned during the have taken a lead role in the national and regional 2 Settings for Training, led by Dr Suzanne Cotter, pandemic with possible negative consequences response, and in liaising with international colleagues in aiming to expand opportunities in Ireland and on education, quality of life and wellbeing of the World Health Organization and the European Centre internationally themselves and their families. for Disease Control. In addition to prevention and control of infectious diseases and environmental threats to 3 Education and Training for Trainees, Members and • The Faculty contributed to and approved a health, doctors in this specialty use information systems Fellows, led by Dr Ian Quintyne, to scope needs for document in June 2020: “A National Clinical and available evidence to inform health policy, promote training, especially in management and leadership Review of the impact of COVID-19 Restrictions healthier lifestyles and reduce health inequities, and to on children and guidance on reopening of schools plan and evaluate healthcare services. 4 Career advice and coaching for Trainees, led by and the normalisation of paediatric healthcare Dr Alan Smith, to review needs and resources for services” which was approved by Dr Colm Henry Highlights from the past year training advisors and coaches CCO and presented to NPHET. An updated version Following the publication of the Crowe Horwath was submitted in August. It strongly advocated for Review of the Role, Training and Career Structures of 5 Dual Accreditation, led by Professor Elizabeth reopening of schools and full reinstatement of child Public Health Physicians, the Department of Health Keane, to review opportunities and feasibility of health and mental health services in community established an Implementation Oversight Group (IOG) dual training of public health and other specialties and hospitals. in March 2019 to design a restructured public health service. The Faculty is represented by the Dean and many 90 7.4 91

FACULTY OF PUBLIC HEALTH MEDICINE

In addition to supporting reform and quality improvement • The Review of the Faculty’s Membership • Based on a review of the literature and • Dr Breda Smyth was awarded funding for a of the public health service, these reviews will facilitate examination (MFPHMI) resulted in revision of substantial consultation with stakeholders, and post-CSCST ASPIRE Fellowship in Health Service improvements in specialist training and continuing the format of the Part II, reducing the written in association with the Faculty of Paediatrics, Improvement & Quality Improvement. Dr education. component from three to two public health the Faculty position paper on ‘The impact of Geraldine McDarby was also awarded funding reports (Parts IIA and IIB) and replacing the Part Homelessness and Inadequate Housing on the for a post-CSCST ASPIRE Fellowship and on In January 2020 the Department of Health tasked II General Oral with an Oral Examination of Health of Children’ was published in November completion of training, will commence hers in the the HSE with refining the design of the service and Professional Competence (Part III). 2019. Follow up involved media interviews and Autumn of 2020. developing a workforce plan. However, this work was meetings with the HSE. interrupted due to the focus on COVID-19. • Guest speakers at the Faculty’s Winter Scientific • During her second year in training, Dr Andrea Meeting in December 2019 included Dr Elzbieta • The Seniors Special Interest Group organised a Bowe was awarded an ICAT Scholarship with Other highlights this year Drazkiewicz Grodzicka who spoke about ‘trust journal club and a conference reviewing topical funding to undertake a PhD while completing an and conspiracy theories as they relate to issues in RCPI, the Faculty, health protection and extended training programme. • Seven Specialist Registrars (SpRs) successfully vaccination and vaccine hesitancy’ and Dr Lynda the health services. completed specialist training and seven started in Sisson, who provided an update and guidance first year, resulting in a total of 34 doctors on the on improving our health. Margaret O'Neill and • At the National Education Day for Doctors in Public Health Medicine Higher Specialist Training her colleagues Aoife Ryan and Sharon Kennelly Training Dr Peter Barrett won the William Stokes programme. presented on a timely topic: ‘Malnutrition in an Award for his study “Increased risk of long-term Obesogenic Environment’. renal disease in women who deliver preterm • The Faculty received a draft report on infants: a population-based cohort study”. He also Reaccreditation by the Medical Council which • The AGM on the 3 December 2019 was followed won the Dorothy Stopford Price Medal for his proposes to re-accredit the HST Programme with by a CPD event with speakers Dr Fenton Howell presentation on “A national measles outbreak in minimal conditions. Due in September 2020, (tobacco control), Prof Joe Barry (reducing alcohol Ireland linked to a single imported case”. likely recommendations are consistent with the related harm) and Dr Declan Bedford (minimising The 2019 Trainee Award Winners, including the Dean, Prof Emer Shelley, who presented the Dorothy Stopford Faculty’s views on opportunities for ongoing trauma due to road traffic injuries). These Price Medal to Dr Peter Barrett (who also received the improvement of training. colleagues distilled wisdom from their many years William Stokes Award) and the award for the best poster competition to Dr Heather Burns. of sustained advocacy on these topics. 92 7.4 7.5 93

Faculty Report FACULTY OF PUBLIC HEALTH MEDICINE

Professor Anthony O’Regan Foundation Dean, Institute of Medicine

• Neurology Response to COVID-19 online in July. The Part I was rescheduled to early In an historic event for RCPI, on 23 January 2020, the • Three certificates of Satisfactory Completion of September. The existing format of the General Oral new professional and training body, the Institute of • Palliative Medicine Specialist Training were brought forward by two will be retained in October, with the new format Medicine was launched. • Pharmaceutical Medicine to three months to enable the doctors to take on Part III postponed to Autumn 2021. senior roles in the health service. The Institute of Medicine represents the largest spectrum • Rehabilitation Medicine • The final Curriculum Review workshops were of medical specialties in Ireland, with over 1,000 trainees • Respiratory Medicine • Some SpRs were redeployed from specialist training cancelled. Implementation of the new curriculum and consultant trainers in 18 specialties. sites to contribute to the pandemic response. Online was postponed to July 2021 • Rheumatology support sessions were organised to identify any The 18 specialties represented are: issues arising from changes to training plans and the • The Summer Scientific Meeting was cancelled as The Institute oversees matters relating to the medical training environment. was the admission ceremony, with the hope of • Cardiology specialties that were previously governed by the Irish rescheduling for Autumn 2020. Committee on Higher Medical Training (ICHMT), with • Clinical Pharmacology and Therapeutics • Many activities were moved online, including annual the ICHMT now fully subsumed into the Institute of evaluations of training at the end of June in advance • Faculty affiliates availed of opportunities to join the • Clinical Genetics Medicine. The Institute has a wider remit than the of July rotations. Despite many challenges, SpRs CCPI clinical COVID-19 webinars. In addition, a joint ICHMT, representing medicine as a speciality in addition • Dermatology acknowledged the extensive opportunities for webinar was held on 25 June with the Faculty of to the training-related aspects which were previously learning provided by their involvement in the public Occupational Medicine including Prof Mary Codd • Endocrinology and Diabetes Mellitus the responsibility of the ICHMT. health response to the pandemic. who spoke about “Lessons from Contact Tracing”; • Gastroenterology Dr Abigail Collins on “The health protection role in The Institute will support professional affairs related • In collaboration with course leaders, the RCPI residential care facilities”; Dr Ina Kelly on “Protecting • General Internal Medicine to clinical medicine and will forge close working Education Department is planning new formats Ireland's meat factory workforce; the public health relationships with specialist professional societies, • Genitourinary Medicine to deliver Mandatory Courses during training, for perspective” and Dr Derval Igoe who summarised hospitals and other healthcare sites, the HSE, universities, example providing material online followed by the findings of “The Study to investigate COVID-19 • Geriatric Medicine other postgraduate medical training bodies, and the workshops and tutorials infection in people living in Ireland (SCOPI)”. • Infectious Diseases Medical Council. The Institute of Medicine will also act as an authoritative source of advice within RCPI in • The Part II MFPHMI (Oral on Public Health • Medical Oncology connection with General Medicine. Reports) was rescheduled from April to deliver it • Nephrology 94 7.5 95

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Professor Anthony O’Regan was appointed as Three committees have been established within the Irish Committee on Higher Medical Training doctors in general medicine, including the development Foundation Dean in November 2018 and Dr Ed McKone Institute: Until establishment of the Institute of Medicine, The Irish and delivery of Professional Competence Schemes in was appointed as Director of Education and Training in Committee on Higher Medical Training (ICHMT) was the accordance with the standards specified by the Medical December 2018. The board is comprised of: • Education and training committee national training body for General Medicine in Ireland. It Council. The ICHMT also reviewed applications to the • BST committee was established in 1971 and developed policies relating Specialist Division of the Medical Council’s Register • Dean • HST committee to postgraduate specialist training in General Internal of Medical Practitioners in accordance with standards • Director of Education and Training Medicine and its associated sub-specialties in Ireland, specified by the Medical Council. • Two Council-nominated Fellows In 2020, two meetings of the board took place. Both implementing and reviewing the delivery of training • Two independent Fellows were held virtually because of the COVID-19 pandemic. programmes in these specialities, including recruitment, The last meeting of the ICHMT was held in November • One trainee representative A first AGM and meeting of the Institute with a selection selection, assessment, examination, remediation and 2019 and the remit of the ICHMT now is part of the new • Two lay members of prominent speakers was scheduled to take place in certification. The ICHMT approved new Trainers, posts, Institute of Medicine. RCPI is immensely grateful to all • President of RCPI as ex-officio member June, but this was cancelled due to COVID-19. departments and hospitals for training in each specialty. who contributed to the ICHMT since its establishment. • Dean of Exams It also ensured maintenance of professional standards for • Up to three co-opted members, as agreed by the Clinical Updates on COVID-19 board members The Institute established the very successful webinar series, Clinical Updates on COVID-19. These took place Most board positions have been filled. The two every Wednesday and the live webinar was accessible independent fellows were appointed via a process to all Trainees, Members and Fellows of RCPI, while whereby expressions of interest were sought from recordings, hosted on RCPIs website, are made available Fellows who were not current post holders of any role to other doctors. A wide range of speakers from Medicine within the Institute of Medicine or RCPI. There were 26 and other specialties presented up to date clinical applicants, and two board members were subsequently information via Zoom and other webinar technologies appointed. The two lay members are awaiting approval, which have proved hugely useful to a wide audience. as is the position of Dean of Exams.

The last meeting of the ICHMT 96 7.6 97

Faculty Report

Dr Cliona Murphy Chair of the Institute of Obstetricians and Gynaecologists

The Institute of Obstetricians and Gynaecologists Mutilation. We published guidance on maternity continues to guide doctors in the provision of medical and services in the context of COVID-19 and Dr Jennifer surgical care for women throughout their lives. Combined Donnelly was a speaker at a COVID-19 masterclass. training in both obstetrics and gynaecology is crucial because of the overlap between these specialties. • In September 2019 our Annual Study Day included a session on applied drama techniques The Institute has 247 Members and Associate Members used in medical training for pregnancy-related who are experienced Consultant Obstetricians/ bereavement care - a collaborative project Gynaecologists and leading experts in their field. with the Abbey Theatre. We also had the Sean Established in 1968, the Institute is accredited by the Boyle Lecture delivered by Prof Richard Greene, Medical Council of Ireland to deliver postgraduate Director of the National Perinatal Epidemiology specialist training in Obstetrics and Gynaecology. It Centre and Professor of Clinical Obstetrics, UCC offers a three-year Basic Specialist Training programme, plus a talk by Adam Kay, world-renowned author which is the first step to becoming an Obstetrician/ of multi-award-winning bestseller 'This is Going Gynaecologist in Ireland and a five-year Higher Specialist to Hurt'. This was followed by the Institute’s AGM Training programme. and an admission ceremony.

Highlights from last year include: • In November 2019 the fifth Irish Congress of Obstetrics, Gynaecology and Perinatal Medicine • Advocacy: We published updated guidelines on took place in Galway. This national conference Termination of Pregnancy in August 2019. We provided a unique opportunity to hear from experts made a submission to the Dept of Health on representing a wide range of organisations involved access to free contraception. We presented to in Obstetrics, Gynaecology and Perinatal Medicine. the women’s health task force in the Dept of Health emphasising the gaps in service and the • The theme of the fifth Congress was controversies gynaecological needs for women. We published in Obstetrics and Gynaecology. We were joined by IOG Spring Conference: Dr Cliona Murphy, IOG chair with Ellie Kisyombe, Dr Sindy Joyce and Prof Clíona Ní Cheallaigh a guideline on management of Female Genital the Irish Perinatal Society, Continence Foundation 98 7.6 99

INSTITUTE OF OBSTETRICIANS & GYNAECOLOGISTS

Ireland, the Irish Gynaecological Endoscopy • Growth: Recruitment and retention of doctors Society, the Irish Fertility Society, the Irish Society remains a top priority for the Institute and in June of Gynaecological Oncology and the Junior 2020 we established additional training posts to Obstetrics and Gynaecology Society. The event allow more opportunities for doctors to advance also included the Annual Clinical Reports meeting. their medical careers while remaining within the The external reviewer was Prof Andrew Shennan. Irish health service. We awarded 8 CSCST, and 1 post-CSCST, and we admitted 17 specialists into • In March 2020, to mark International Women's Membership of the Institute. Furthermore, as part Day, we hosted a Spring Conference for all of an ongoing governance review, we appointed Dr healthcare professionals with a special session Suzanne O’Sullivan into the new role of Director of focused on women’s health in marginalised Training and Ms Caoimhe Daly, Barrister, as a lay communities, such as those living in direct member on the Institute’s Executive Council. provision, traveller women, and homeless women.

• The Institute was proud to support a campaign aimed at challenging stereotypes, fighting bias, broadening perceptions, improving situations and celebrating women's achievements.

• Speakers included Ellie Kisyombe, an asylum seeker from Malawi who ran as a local election candidate in 2019, Dr Sindy Joyce, an Irish Traveller and human rights activist who is the first Irish Traveller to obtain a doctorate from an Irish university, and Dr Cliona Ní Cheallaigh, who spoke about health inequalities in the homeless community. 100 8.0 101

CELEBRATING OUR HISTORY AND HERITAGE

Prof Brendan Kelly Dun’s Librarian

We are the proud guardians of historical archives, books, collections has been transformed. He led the application portraits, medical instruments and curiosities dating to the Wellcome Trust in 2009 for funding to catalogue back over 500 years. the archives for the first time. This funding opened the collections to a much wider research community, Our Heritage Centre in No.6 Kildare Street is a fully generating more interest in them and resulting in the accredited museum specialising in the history of formation of the Heritage Centre. healthcare in Ireland. Established in 2010 under the guidance of Harriet Wheelock, Keeper of Collections, Prof Brendan Kelly took up the post of Dun’s Librarian the Heritage Centre has grown to become one of the in June. Prof Kelly is Professor of Psychiatry at Trinity best-known medical history collections in Ireland. College Dublin and Consultant Psychiatrist at Tallaght Hospital, Dublin. As well as his medical qualifications, Retirement of Dr Paul Darragh as Dun’s Librarian Prof Kelly holds a PhD in the history of medicine and This year saw the retirement of Dr Paul Darragh as Dun’s has published extensively on the history of psychiatry. Librarian after more than 13 years of dedicated service. During Dr Darragh’s tenure the care of our historic Highlights of the year In October we hosted a fully booked event in the Corrigan Hall celebrating 140 years of the Dublin Hospital Rugby Cup, Ireland’s oldest rugby cup competition, and a day of talks to mark the centenary of the founding of St Ultan’s Hospital.

During the year we have received several donations to the collections, including the archive of Dr Neil John Blayney (1874-1919) presented by his grandson Dr Neil Brennan and the archive of Dr John Kirker (1922-2011),

Dr Paul Darragh donated by his son Dr Stephen Kirker. The strength of Dr Morgan Crowe opening the event marking the 140 years of the Dublin Hospital Rugby Cup our collections rests on such generous donations. 102 103

Our new online archive and museum catalogue was archive. This call is still open, and submissions are launched this year. The upgraded and improved most welcome. catalogue will help increase awareness of the collections. In addition, we are now able to share digital images of Developing our collections items with the catalogue record, opening the collections We are always looking to expand our collections in order to researchers who cannot visit in person. to tell the full story of the development of medicine in Ireland - and not just from doctors’ points of view. If Impact of COVID-19 you have items relating to medicine, nursing, hospitals, The closure of the Heritage Centre to researchers pharmacies or the patient experience dating back 30 and the public from mid-March has impacted on our years or more we want to hear from you. visitor numbers, which are down by about a fifth on previous years. Limited reopening to researchers will If you’re thinking of donating items, contact Harriet commence later in the year. Wheelock, Keeper of Collections at harrietwheelock@ rcpi.ie or +353 (0)1 6698 817. Although in-person visits have decreased, we have seen a sustainable increase in online engagement through our social media channels and the website. Engagement rates trebled during the period between April and July compared to previous months. During this period we ran a joint initiative with MindReading – Pause for a Poem, launched three new online exhibitions and made our back catalogue of webcasts available online.

In recognition of the impact of COVID-19 on the profession we launched a call for those working in healthcare to submit their experiences to a pandemic

Celebrating 140 years of the Dublin Hospital Rugby Cup 104 9.0 105 GOVERNANCE

9.1 Registration and Constitution The EY review included a series of recommendations to Following approval by Council later that year, a 9.3 Trustees and Council The Royal College of Physicians of Ireland is a registered reform governance including: Governance Implementation Programme commenced to At present the Trustees of RCPI are the President, charity in the Republic of Ireland (CHY 1897), with a oversee delivery of significant changes to our governance Registrar and Treasurer: Charities Regulatory Authority Number 20002718. • Establishment of an Executive Board, reporting structures. The programme is due to be fully completed to Council. Membership to include Officers1, all by the end of 2020 and most of the recommendations • Professor Mary Horgan (President) Our mission is to train, educate and continuously develop Faculty and Institute Deans, our Chief Executive have already been implemented. • Dr Diarmuid O’Shea (Registrar) doctors for current and future world health needs. Our Officer, our Chief Financial Officer and a Senior • Professor Donal Reddan (Treasurer) vision is to lead excellence and quality in medical practice Independent Director The report also recommended additional reforms which Following a review of the composition and remit of through world-class training, education and healthcare • Review of committees across RCPI including are currently underway including: Council, the trustees for the coming year will now include improvements in Ireland and internationally. establishment of a Governance and Nominations all members of Council. Committee (reporting to Council) and committees • review of the governance within each of the RCPI is governed under the 1692 Charter and subsequent of the Executive Board including the Finance, Audit Faculties and Institutes Under devolved authority from the Body Corporate, amendments – most recently the 1979 Royal College and Risk Committee and Remuneration Committee • review of the roles and appointment processes for Council is the senior governing body of the Royal College of Physicians of Ireland (Charter and Letters Patent • Review of the membership composition and clinician-led roles of Physicians of Ireland. Amendment) Act. role of Council including removal of the Senior/ • and to explore equity of Memberships and Junior Fellow designation, reducing the number of Fellowships Council’s role is to ensure the legal and ethical integrity Underpinning the Charter, RCPI established a set of by- Council members and ensuring elected members of RCPI. It defines the values, mission, vision, goals, laws which specify in more detail, how RCPI is governed representatives of the Faculties and Institutes In addition to the recommendations of the EY report, objectives and strategic directions of RCPI, and approves under Council. • Establishment of the Institute of Medicine the Charities Regulator has launched a new Code of general policies. Council also ensures the accountability including appointment of a Dean, Board and a well- Governance and all registered charities in Ireland are of the Royal College of Physicians of Ireland by monitoring 9.2 Governance reforms structured governance model for Medicine required to be fully compliant with the Code in 2020. and supporting the implementation of policies, directives In order to ensure that the governance structure and We have undergone a review of our compliance against and general functions. It fulfils this accountability and processes were in line with best practice and the each of the standards and implemented new policies monitoring through various means including the receipt requirements of Charity legislation, RCPI appointed EY and procedures (including Conflict of Interest and and review of reports from the Executive Board, Faculty in 2017 to conduct a governance review. Communications policies) to ensure alignment with Boards, standing committees and the CEO. the code.

1  Officers are the President, Vice-President, Registrar and Treasurer 106 9.0 107

Council GOVERNANCE Name Role/s Council members and meeting attendance1 attendance 2019/20 Professor Mary Horgan FRCPI President and Chair 5/5 Vice-President and Censor Professor Richard Costello, FRCPI 2/5 Director of Research Dr Diarmuid O’Shea FRCPI Registrar 5/5 Professor Donal Reddan FRCPI Treasurer 4/5 Professor Michael Keane FRCPI Senior Fellow 4/5 Professor Des O’Neill, FRCPI Senior Fellow 5/5 Dr Blanaid Hayes FRCPI FFOM Senior Fellow 1/52 Council has the ultimate responsibility for the actions, Other highlights from Council last year were: Senior Fellow Professor Anthony O’Regan, FRCPI 5/5 decisions and policies of the Royal College of Physicians Foundation Dean, Institute of Medicine Senior Fellow of Ireland. • Approval of the new governance framework for Professor Hilary Hoey, FRCPI FFPAED 4/5 Director of Professional Competence the Institute of Medicine – including the Standing Dr Emer Kelly FRCPI Junior Fellow 5/5 During the period 1st July 2019 – 30th June 2020, Orders, terms of reference and role descriptions Dr Declan Byrne FRCPI Junior Fellow 4/5 Council met five times, in September, December, • Approved changes in the By-Laws in relation to Dr Ronan Collins FRCPI Junior Fellow 4/5 February, April and June. Council member voting and quorum Professor Francis Finucane FRCPI Junior Fellow 5/5 • Key discussion items included recruitment, training Junior Fellow Professor Cathy McHugh FRCPI 4/5 At each meeting, Council received updates via the and retention of doctors in the Irish health system, Censor CEO’s report, approved nominations to Fellowship as Membership, career progression and access to Dr Áine Carroll FRCPI Junior Fellow 5/5 well as updates on finances from the CFO. There were training Dr Lynda Sisson FFOM Dean, Faculty of Occupational Medicine 4/5 also regular updates on the Risk Register and progress • Approval of Council election process for Dr Ellen Crushell FRCPI, FFPAED Dean, Faculty of Paediatrics 5/5 updates on key strategic projects. 2019/2020 Professor Louise Burke, FRCPI Dean, Faculty of Pathology 4/5 • Approval of RCPI Conflicts of Interest policy Professor Emer Shelley FPHM, FRCPI Dean, Faculty of Public Health Medicine 4/5 • Approval of the budget for the 2020/2021 Dr Cliona Murphy, FRCPI Chair, Institute of Obstetricians and Gynaecologists 5/5 financial year Mr Feargal O’Rourke Lay Member 3/5 Ms Karyn Harty Lay Member 4/5 Censor Professor Colm Bergin, FRCPI 4/5 Director of Training Site Accreditation Professor Mary Higgins FRCPI Censor (joined Oct 2019) 4/4 Professor Frank Murray FRCPI Past-President 2/5 Professor John Crowe FRCPI Past-President 4/5 Dr Sinead Murphy FFPAED Director of Education 4/5 Professor Conor O’Keane FRCPI, FFPATH Director of Quality and Clinical Care 4/5 Dr Una Fallon FFPHMI Chair, Research Ethics Committee 0/5 Dr Cormac Kennedy MRCPI Trainees Committee Chair 3/5 Dr Sean Armstrong MRCPI Trainees Committee Vice-Chair (joined Oct 2019) 1/4 1 Numbers reflect meetings attended versus meetings invited to Dr John Barragry FRCPI Medical Council – RCPI representative 4/5 2 Absence due to illness Dr Paul Darragh FRCPI, FFPHMI Dun’s Librarian (retired June 2020) 1/4 108 9.0 109 GOVERNANCE

9.4 Executive Board Paediatrics and Obstetrics & Gynaecology. Executive Board members and As delegated by Council, the Executive Board oversees • Agreed reformatting of meetings from in person to meeting attendance 2019/20 the operation and management of RCPI. The Executive virtual Board focuses primarily on oversight of operational • Agreed a campaign to increase public engagement management and reports to the Council. through recruitment of members of the public to Name Role/s Executive attendance participate as members on various RCPI, Faculty Prof Mary Horgan President and Chair 13/14 Membership of the Executive Board includes the RCPI and Institute Boards and Committees. Officers, CEO, CFO, Deans of the Faculties and Institutes • Discussion of a wide range of matters such as Prof Richard Costello Vice-President 6/14 and a Senior Independent Director. The Executive Board recruitment and retention of doctors in the Irish Dr Diarmuid O’Shea Registrar 13/14 normally meet up to nine times per annum, but due to Health system, the RCPI international medical the COVID-19 pandemic they met more frequently in graduate training programmes - current position Prof Donal Reddan Treasurer 13/14 2020. and proposals for the next 3 years, changes to the process for training site accreditation, changes Prof Anthony O’Regan Foundation Dean, Institute of Medicine 10/14 The Executive Board met nine times from March – June proposed for training post evaluation process, Prof Louise Burke Dean, Faculty of Pathology 13/14 in response to urgent matters relating to the COVID-19 the doctors training outcomes research study, pandemic. In total they met 14 times during the period Membership, career progression and access to Dr Lynda Sisson Dean, Faculty of Occupational Medicine 9/14 July 2019 – June 2020. training. Dr Ellen Crushell Dean, Faculty of Paediatrics 13/14 • Approval of Terms of Reference - Trainee Health Some of the key discussions and decisions from the and Wellbeing Committee and updated Terms of Dr Cliona Murphy Chair, Institute of Obstetricians and Gynaecologists 10/14 Executive Board last year Reference for the Executive Board and the Library Prof Emer Shelley Dean, Faculty of Public Health Medicine 14/14 and Heritage Committee. • During the COVID-19 pandemic there was ongoing • Approval of policies - RCPI Conference and Major Mr Kieran Crowley Senior Independent Director 14/14 monitoring and review of RCPI’s overall response Events Policy and RCPI Travel and Expenses Policy. Dr Terry McWade Chief Executive Officer 14/14 and plans on matters including agreement to move • Approval of changes to Dun’s Librarian role. to remote invigilation for examinations, allowing Ms Sheila Gallagher Chief Financial Officer 14/14 them to restart on the 25 June 2020. • Expansion of the BST programmes in Medicine, 110 9.0 111 GOVERNANCE

9.5 Boards and Committees (Council Lay Member) with the President, Registrar strategy and financial planning of training and During the last financial year, FinARC met four times and The Boards and Committees reporting directly to Council and Treasurer as Members. New members will be professional affairs related to the Faculty or the activities of the Committee included the following: are: appointed following results of the 2020 Council Institute, on behalf of its membership. Each Board is elections. chaired by the Dean or Chair of the Faculty/Institute — Discussion of business plans and ongoing • Executive Board (see section 9.4) and Boards are composed of elected Members, review of financial performance including cost • Credentials Committee Fellows, Ex-Officio members and Co-Opted management plans. • Governance and Nominations Committee The Credentials Committee is responsible for members. Last year saw the establishment of the — Ongoing review of risk registers. The Governance and Nominations Committee was reviewing applications for Fellowship of the Institute of Medicine and the inaugural meeting of — Completed an external audit tender process. established in 2020 following recommendations Royal College of Physicians of Ireland and making the Board was held in June 2020. — Review of annual financial statements. of the independent governance review to assist recommendations to Council for nominations to — Meetings with external auditors including review the Council of RCPI in fulfilling its obligations and FRCPI and Honorary Fellowship. During 19/20 See section 6 for reports from the Deans of the of the audit plan and the results of the external oversight responsibility for: the Credentials Committee met 5 times and Faculties and Institutes. audit process. approved 196 applications for Fellowship. Please — corporate governance practices, principles, see 6.0 Membership and Fellowship for further The following committees report to the Executive Board: Finance, Audit and Risk Committee Members guidelines and related policies; information. (19/20): — nomination of candidates for appointment to • Finance, Audit and Risk Committee • Mr Joseph O'Shea (Chair) specific roles under the remit of this committee; Credentials Committee Members (19/20) The Finance, Audit and Risk Committee (FinARC) • Mr Paul Moore — composition and evaluation of the Council and • Prof Mary Horgan (chair) is responsible for independently reviewing • Dr John Barragry Council committees • Dr Diarmuid O'Shea financial statements and the effectiveness of • Dr Maeve Skelly • Prof Hilary Hoey RCPI’s internal controls. FinARC ensures that the • Prof John Crowe The Committee held its inaugural meeting in July 2020 • Dr Conor McCarthy interests of RCPI are fully protected in relation to • Mr Jamie Olden and reviewed recommendations for appointment • Dr Geoff Chadwick its business and ensure the adequacy and accuracy of lay members to RCPI Boards and Committees • Dr Cathy McHugh of financial reporting and internal control and the • Remuneration Committee as well as review of the duties of the Registrar and management of Corporate Risk. This committee The Remuneration Committee functions to Treasurer roles. Due to incoming changes to Council • Boards of the six Faculties and Institutes acts independently of management and no powers ensure that staff are provided with appropriate membership, the Committee functioned under an The role of the Boards of each of the Faculties and or responsibilities are transferred to it nor does it compensation to encourage enhanced performance interim membership chaired by Mr Feargal O’Rourke Institutes of RCPI is to oversee the governance, sit in any approval chain. 112 9.0 113 GOVERNANCE

in a fair and responsible manner and are rewarded • Education and Quality Committee Education and Quality Committee Members • Library and Heritage Committee for their contribution to the success of RCPI. The Education and Quality Committee was (19/20): The Library and Heritage Committee oversees the established in 2019 (replacing the previous • Dr Sinead Murphy (Chair) management and development of the Heritage The committee reviews and makes recommendations Education and Professional Development Director of Education Centre and RCPI’s historic collections. to the Executive Board in relation to the broad pay Committee) to strategically plan, prioritise and • Prof Hilary Hoey and benefits policies. quality‐assure educational programmes for Director of Professional Competence During the last financial year, this committee met 3 professional development and to oversee the • Dr Tom O’Connell times. Details of the committee’s activities can be RCPI aims to reward its staff equitably and Professional Competence Schemes. Faculty of Occupational Medicine found in the report of the Heritage Centre in section 7. consistently, in accordance with their value to RCPI • Dr Ellen Crushell and in a manner that incentivises high performance A new approval process for professional development Faculty of Paediatrics Library and Heritage Committee Members and the achievement of RCPI’s strategy. programmes was introduced last year. All new • Dr Maeve Doyle (19/20): developments must complete an application submitted Faculty of Pathology • Dr Paul Darragh (Dun’s Librarian & Chair until During FY 19/20, the Committee met to consider to the Education Committee for consideration. This • Dr Gerardine Sayers June 2020) a pay policy framework for future pay increments new process helps to ensure governance around Faculty of Public Health Medicine • Prof Brendan Kelly (Dun’s Librarian & Chair from for Programme Coordinators. The pay policy was prioritising programmes and that they are aligned with • Dr Sam Thomas June 2020) introduced in February 2020 and provides a clear RCPI’s strategic direction, mission, and values. During Institute of Obstetricians & Gynaecologists • Prof Colm Bergin (Censor) process for potential pay progression for Programme the last financial year, the committee met six times • Prof Anthony O’Regan • Prof Richard Costello (Censor) Coordinators during their employment with RCPI. and there were six applications for new programmes Institute of Medicine • Dr Catherine Cox (Co-opted) which included conferences, short one day courses, • Dr Ed McKone • Mr Brian Crowley (Co-opted) RCPI’s remuneration philosophy is to ensure that Certificates and Diplomas. Institute of Medicine • Prof Mary Daly (Co-opted) RCPI remains competitive in attracting the calibre • Dr Ann O’Shaughnessy • Ms Joanna Finegan (Co-opted) of staff required to implement RCPI’s strategy The committee also reviewed reports and evaluation Head of Professional Affairs • Dr Anne Freeman (Fellow) on completed programmes, Professional Competence • Dr Sarah Cullivan • Prof Joseph Harbison (Fellow) Remuneration Committee Members (19/20): Scheme reports and CPD event approvals. Trainee Representative • Prof Mary Higgins (Censor) • Prof Donal Reddan (Chair) • Ms Yvette Fitzgerald • Prof Mary Horgan (President) • Dr Diarmuid O’Shea QA Officer • Dr Karl Kavanagh (Trainee Representative) • Prof Francis Finucane • Prof Michael Keane (Fellow) • Mr Eamon Drea (External HR Consultant) 114 9.0 115 GOVERNANCE

• Dr Leanne McCormick (Co-opted) TRUSTEES AND OTHER INFORMATION • Sandra Nicholson, Human Resources Manager CHARITY REGISTRATION • Dr Brendan McDonnell (Trainee Representative) • Michael Hughes, Manager, Digital Technologies CHY Number: 1897 • Prof Cathy McHugh (Censor) Trustees of RCPI Office Charities Regulatory Authority Number: 20002718 • Dr Lisa McLoughlin (Fellow) Prof Mary Horgan (President) • Prof Eoghan Mooney (Fellow) Dr Diarmuid O’Shea PRINCIPAL OFFICE • Prof John F Murphy (Fellow) Prof Donal Reddan Frederick House • Dr Diarmuid O’Shea (Registrar) 19 South Frederick Street, Dublin 2 • Prof David Powell (Apothecaries’ Hall) CHIEF EXECUTIVE OFFICER • Prof Donal Reddan (Treasurer) Dr Terry McWade PRINCIPAL BANKERS Ulster Bank COUNCIL 130 Lower Baggot Street, Dublin 2 See table of Council members under section 9.3 AUDITORS EXECUTIVE BOARD BDO See table of Executive Board members under section 9.4 Beaux Lane House Mercer Street Lower SENIOR MANAGEMENT TEAM St Peter’s, Dublin 2 • Dr Terry McWade, Chief Executive Officer • Sheila Gallagher, Chief Financial Officer SOLICITORS • Dr Ann O'Shaughnessy, Head of Education, Innovation Arthur Cox and Research Ten Earlsfort Terrace, Dublin 2 • John Magner, Head of International Affairs Ronan Daly Jermyn • Leah O'Toole, Head of Postgraduate Training and The Exchange, George’s Dock Education (until April 2020) IFSC, Dublin 1 • Colm Small, Interim Head of Postgraduate Training and Education (as of May 2020) • Siobhán Creaton, Head of Public Affairs and Advocacy 116 10.0 117 FINANCIAL REPORTS

About the College of Exceptis Technologies, where he led the sale of this Strategic Plan cost reduction as a result of Covid 19, primarily in travel, Since its foundation in 1654 The Royal College of business to Trintech Group in 2000. Prior to establishing The College is at the end of its current 5 year strategic event costs and provider costs. Physicians of Ireland (RCPI), with its Faculties and Valitacell, Terry was deputy CEO of the Royal College of plan and work is underway to determine the College Institute, provide postgraduate medical training and Surgeons in Ireland (2001-2013). priorities for the future and the new way of delivering professional development opportunities to doctors post graduate training. This process will involve the Results for the financial year working in 25 specialties. Collectively, we are the Membership events Institutes and Faculties and will respond to Member 2020 2019 largest provider of postgraduate medical training in 3,650 doctors attended RCPI conferences events and or and trainee needs. A significant amount of research was € € Ireland. Our mission is to ensure that patients receive courses in 2019/2020. Some key events that took place undertaken during the year with an external provider, Total comprehensive loss (306,132) (669,949) the best possible care. We do this by training and were our annual conference St Luke’s Symposium which Trueology, to determine the needs of our Fellows, assessing doctors and providing accredited education took place over three days during the month of October members and trainees. A full provision was provided in this years financial and professional development programmes. We also and was attended by 372 doctors. Also, during October statements for dilapidation costs on our two leased quality-assure standards in specialist medical practice we held a meeting for our Members and Fellows based Financial Performance buildings. This amounted to €431k. Had this provision and promote good health through our policy and public in the Gulf Region in Dubai. We continued to hold our The Executive are satisfied with The College’s overall not been made the College would have a total outreach initiatives. RCPI is recognised as a leading, Masterclass Series which cover a wide range of clinical trading and financial performance during the year. After comprehensive profit of €125k trusted and authoritative voice in the professional and topics. There were eight of these events in 2019-2020 the appointment of the new Chief Executive Officer, public debate on matters of health. and they were free for Members and Fellows in good management’s priority was to evaluate the College’s Principal risks and uncertainties standing. 920 doctors attended the masterclass series in variable costs to deliver savings and a more focussed The Business risks centres on the recent challenges New Chief Executive 2019-2020. As part of the RCPI’s response to the global spending approach which delivered a reforecasted posed by the Covid 19 pandemic, mainly the In August 2019, Dr. Terry McWade was appointed Chief pandemic, we held weekly webinars for our Members budget at half year of €700,000 before interest, continuation of written and clinical exams and the Executive of RCPI. He joined the College from Valitacell, a and Fellows on COVID 19. One of our key goals at the depreciation and investments. This has lead to an restricted or delayed travel of overseas medical biotechnology company, where he was CEO. Dr. McWade, beginning of the pandemic was to ensure that we continue improvement in the College’s financial performance year trainees. There is a need for new ways of delivering who qualified as a medical doctor at Trinity College Dublin, to support doctors in providing care for patients by on year. Due to the Covid 19 pandemic there were delays our courses and diplomas through digital channels has led a number of technology and medical innovations. delivering the clinical information they need. On average in exams and courses which had a significant impact and ensuring that the training experience and content He previously worked in the pharmaceutical industry at 400 doctors each week viewed the COVID 19 Webinars on revenue. However, a remote invigilation solution maintains our professional standards. Servier Laboratories, as Managing Director of Servier – one of these webinars was viewed by 1,200 doctors. which was in discovery process within the College was Denmark. He led the healthcare consulting practice of the Over 30,000 doctors have viewed the recordings of the escalated and enabled the College to deliver exams by Boston Consulting Group in London and is former CEO webinars in the RCPI Digital Library. June 2020 and recover revenue. There were significant 118 10.0 119 FINANCIAL REPORTS

Political Contributions the College are fully protected in relation to its business Auditors There were no political contributions made during the and ensure the adequacy and accuracy of financial Following a tender process the College appoointed BDO financial year (2019-€NIL). reporting and internal control and the management as new auditors for the financial year ending 30 June of Corporate Risk. This committee acts independently 2020. Subsidiary Undertakings of management and no powers or responsibilities are Details of subsidiary undertakings are set out in Note transferred to it nor does it sit in any approval chain. Signed on behalf of Executive Board: 23 to the financial statements. Disclosure of Information to Auditors Going Concern In the case of each person who are executives at the The Executive, after making enquiries, and having regard time of the executives’ report and financial statements ………………………………………………………………………………… to the College’s financial position, operating performance are approved: Professor Mary Horgan and available finance have a reasonable expectation that President the College has adequate financial resources to continue a) So far as the Executive is aware, there is no relevant operating, without significant curtailment in activities, audit information of which the College’s auditors are for the foreseeable future. unaware; and ………………………………………………………………………………… Professor Donal Reddan Accounting Records b) Each Executive has taken all steps that ought to have Treasurer The College employs appropriately qualified accounting been taken by the Executive in order to make himself/ personnel and maintains a computerised accounting herself aware of any relevant audit infromation and system to comply with the requirements of of the to establish that the College’s auditors are aware of Date: 9th October 2020 Companies Act 2014. that information.

Finance, Audit and Risk Committee (FinARC) Post Balance Sheet Events The Finance, Audit and Risk Committee (FinARC) is Other than the ongoing impact of Covid 19 there are no responsible for independently reviewing financial significant events since the financial year end. statements and the effectiveness of the College’s internal controls. FinARC ensures that the interests of 120 10.0 121 FINANCIAL REPORTS

EXECUTIVE BOARD’S RESPONSIBILITIES STATEMENT FOR THE FINANCIAL YEAR ENDED 30 JUNE 2020

The executives are required to prepare group and effect and the reasons for any material departure On behalf of the Executive Board: college financial statements for each financial year. The from those standards; and executives have elected to prepare the group and college • prepare the financial statements on the going financial statements in accordance with the Financial concern basis unless it is inappropriate to presume Reporting Standard 102 ‘The Financial Reporting that the group will continue in business. Standard applicable in the UK and Republic of Ireland’ (“relevant financial reporting framework”). The executives are responsible for ensuring that the ………………………………………………………………………………… group keeps or causes to be kept adequate accounting Professor Mary Horgan The executives must not approve the group and college records which correctly explain and record the President financial statements unless they are satisfied that they transactions of the group and college, enable at any give a true and fair view of the assets, liabilities and time the assets, liabilities, financial position and profit financial position of the group as at the financial year or loss of the group to be determined with reasonable ………………………………………………………………………………… end date, of the profit or loss for that financial year. accuracy, and enable the financial statements to be Professor Donal Reddan audited. They are also responsible for safeguarding the Treasurer In preparing those financial statements the executives assets of the group and hence for taking reasonable are responsible for: steps for the prevention and detection of fraud and other irregularities. Date: 9th October 2020 • selecting suitable accounting policies and applying them consistently; • making judgements and estimates that are reasonable and prudent; • state whether the financial statements have been prepared in accordance with applicable accounting standards, identify those standards, and note the 122 10.0 123 FINANCIAL REPORTS

CONSOLIDATED STATEMENT OF INCOME AND RETAINED EARNINGS FOR THE FINANCIAL YEAR ENDED 30 JUNE 2020

Notes 2020 2019 € € All activities relate to continuing operations. Turnover 4 16,961,971 18,668,136 The financial statements were approved and Expenses (17,207,498) (19,455,779) authorised for issue by the Executive Board on Operating Loss (245,526) (787,643) 9th October 2020 and signed on its behalf by: Interest receivable and similar income 5 91,246 83,374 Interest payable and similar expenses 7 (100,148) (84,857)

Loss before tax (254,428) (789,126) Tax on loss - - ………………………………………………………………………………… Professor Mary Horgan Loss after tax (254,428) (789,126) President

Other Comprehensive Income Net (Loss)/Profit on Investments 11 (51,703) 119,177 ………………………………………………………………………………… Professor Donal Reddan Total comprehensive loss for the financial year (306,132) (669,949) Treasurer Retained Earnings at 1 July 6,841,250 7,511,199 Date: 9th October 2020 Profit/(Loss) for the financial year (306,132) (669,949)

Retained Earnings at 30 June 6,535,118 6,841,250 124 10.0 125 FINANCIAL REPORTS

CONSOLIDATED STATEMENT OF FINANCIAL POSITION FOR THE FINANCIAL YEAR ENDED 30 JUNE 2020

Notes 2020 2019 The financial statements were approved and € € € € authorised for issue by the Executive Board on and signed on its behalf by: Fixed assets Tangible assets 10 12,617,569 13,027,415 Financial investments 11 8,069,110 8,098,855 20,686,679 21,126,270 ………………………………………………………………………………… Current assets Professor Mary Horgan Debtors 12 1,976,879 1,923,834 President Cash at bank and in hand 13 1,488,168 1,309,211 3,465,047 3,233,045 ………………………………………………………………………………… Creditors: Amounts falling due within one year 14 (6,924,150) (6,896,575) Professor Donal Reddan Net current liabilities (3,459,103) (3,663,530) Treasurer Total assets less current liabilities 17,227,576 17,462,740 Creditors: Amounts falling due 16 (5,515,993) (5,875,993) Date: 9th October 2020 after more than one year Provisions for liabilities 17 (430,968) — NET ASSETS 11,280,615 11,586,747 Capital and Reserves Revaluation reserve 20 4,745,487 4,745,487 Profit and loss account 20 6,535,128 6,841,260 11,280,615 11,586,747 126 127 Royal College of Physicians of Ireland, Frederick House, 19 South Frederick Street, Dublin 2, Ireland Phone: +353 1 863 9700 Fax: +353 1 672 4707

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