ANNUAL REPORT 2017
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CONTENTS
President’s Report 02 CEO’s Report 08 Honorary Treasurer’s Report 12 Income and Expenditure 15 Independent Auditors Report 16 Statement of Financial Position 18 Council of the College of Anaesthetists of Ireland 2017 19 Education & Training Committee Report 20 Research Audit and Innovation Committee Report 25 Director of Postgraduate Training’s Report 26 Examinations’ Committee Report 29 CEPD-Congress Committee Report 36 Quality & Safety Advisory Committee Report 37 Professional Competence Scheme Committee Report 38 Credentials’ Committee Report 39 Information Technology and Communications’ Committee Report 40 Committee of Anaesthesia Trainees (CAT) Report 41 Joint Faculty of Intensive Care Medicine of Ireland Report 43 Faculty of Pain Medicine Report 45 Simulation Training (CAST) Report 46 Photographs from Recent Events 48 Education Calendar 2018 52
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PRESIDENT’S REPORT
Professor Kevin Carson, President
his year has been a tremen- e rst Diploma examination in anaes- e College awards Memberships and dous year in the life of the thesia in Ireland was developed as a con- Fellowships in anaesthesia, critical care College with many projects joint examination of both e Royal Col- and pain medicine as well as administer- and programmes maturing lege of Physicians of Ireland and e Royal ing a Master’s Programme and Leadership and coming to fruition. is College of Surgeons in Ireland held in 1942. Courses and Professionalism Programme. year has moved at, what seemed at times, a Perhaps a portent of the extended role of Currently we are in the process of prepar- Tfrenetic pace. anaesthesiologists who are recognised to- ing an application to become an a liate I am drawn to Seamus Heaney’s nal day as the perioperative physicians. College of the National University of Ire- poem completed ten days before he died, In 1946 the rst academic body of an- land, which will permit us to award our inspired by the painting ‘Banks of a Canal’ aesthetists was founded by the formation own degrees and diplomas. by the French artist Caillebotte: of the Section of Anaesthesia of the Royal Academy of Medicine in Ireland with Dr “So scholarship and art must be “Say ‘canal’ and there’s that nal vowel T PC Kilpatrick, anaesthetist and registrar Fragrant with personality Towing silence with it, slowing time of the RCPI as President and Prof Tommy And moral feeling. To a walking pace, a path, a whitewashed Gilmartin as Secretary. At that inaugural Distinction’s not an ego-trip.” gleam meeting, Sir Ivan Magill spoke on ‘Current (Seamus Heaney, Verses for a Of dwellings at the skyline. World stands topics in anaesthesia’. Fordham Commencement, 1982) still.” In 1959 the faculty of Anaesthetists of (Banks of a Canal, Seamus the Royal College of Surgeons in Ireland e College is completing our speciality Heaney, 2013) was founded. e rst or Foundation Dean document on ethics and professionalism was Professor Tommy Gilmartin. for the Medical Council to re ect the par- e imagery is captivating, powerful, e College of Anaesthetists of Ireland ticular contribution from anaesthesia, crit- almost sopori c. In a way, the poet chal- was founded as an independent college on ical care and pain medicine, covering such lenges us to slow down and re ect. is is Merrion Square in 1998, with the inaugu- topics as advocacy, consent, breaking bad the last year of my Presidency, my caretak- ration of Dr William Blunnie as the rst news and end of life issues. er-ship. is provides an opportunity to re- President of the College of Anaesthetists In 2008 the Faculty of Pain Medicine view highlights and memorable events that of Ireland. I have the honour of being the was founded. e College awards both took place during this year and during the seventh President. Diplomas and Fellowships in Pain Med- last three years; then we refocus and look is year marks the twentieth anniversa- icine. e Faculty has commenced the forward as we move on again. ry of the College’s foundation. process of accreditation of their training
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scheme with the Medical Council. e patronage has been especially noted Twelve per cent of approved hospital con- In 2009 the Joint Faculty of Intensive in our various overseas projects and en- sultant posts nationally are in anaesthesia. Care Medicine of Ireland was founded deavours. We are in the process of recording our short emanating from the Irish Conjoint Board An Honorary Fellowship is the highest but rich history, having commissioned a of Intensive Care medicine that had been award that the College can bestow and is re- book on the history of anaesthesia in Ire- examining trainees in the specialty since served for those who have made outstand- land and the College. 1996. ing contributions to anaesthesia, intensive Anaesthesia plays a pivotal role in the Historically the College of Anaesthetists care and pain medicine as well as acknowl- patient’s clinical journey. of Ireland was a constituent College of the edging academics and those in leadership e interaction of anaesthetists with pa- Joint Faculty along with the Royal College positions who act as role models, exemplars tients in the operating theatre being only of Physicians of Ireland and the Royal Col- and modern day heroes for our postgradu- one point of contact, albeit a highly eec- lege of Surgeons in Ireland. is re ects ate doctors in training, Members and Fel- tive one, as we mange some of the sickest the background specialities of trainees en- lows of the College. patients including those from the extremes tering the training programme. In order On September 23rd 1998 President of age, from 500 gram neonates to our to streamline the governance structures to Mary McAleese was awarded the rst Hon- most, fragile senior citizens with many co- facilitate IMC accreditation of the training orary Fellowship of the College. is senti- morbidities. Recognition of these patients’ programme in intensive care medicine, the nel event may be considered to be the rst pre-operative condition allows for their sta- Faculty has now become a faculty of the act of the independent College and thus, bilisation and optimisation. College of Anaesthetists of Ireland, while the date is considered to be the foundation Anaesthetists are involved in the man- still proudly acknowledging its parentage of the College. agement of patients during their clinical in and association with the other Colleges. On the 9th of April 2016 we had the journey from the time of consideration of It has been recommended by the review unique opportunity to acknowledge and surgery, to and a er their discharge home. team that the accreditation process will celebrate the achievements and outstand- We lay claim to being perioperative phy- soon conclude positively with the opening ing contributions that Professor William sicians. It is estimated that through our of the specialist register in intensive care Campbell, Nobel Laureate for physiology/ speciality and subspecialties that we are medicine before the current Medical Coun- medicine in 2015 had made to the eld of involved in the management of almost 70 cil demits in May of this year. medicine by awarding him an Honorary per cent of patients who pass through our In 2009 President Mary McAleese Fellowship of this College. hospitals. opened the refurbished building including His lifesaving discovery of Ivermectin – Whilst numbers do not re ect complex- the newly built Dr William Blunnie lecture a drug active against parasite roundworms ity, our most recent national audit from the theatre and the Clinical science education has changed the course of countless lives public sector hospitals enumerates that ap- centre in the mews site. across the globe. proximately: In May 2016 we were delighted, singu- e Honorary Conferring ceremony 168,000 General Anaesthetics larly honoured and appreciative to receive took place in Prof Campbell’s hometown of 53,000 Neuroaxial Blocks noti cation that we were to the rst train- North Andover just outside Boston – a not (Spinals/Epidurals) ing body to be granted Patronage by the unnoticed happy coincidence of geography 8,500 Regional Anaesthetics President of Ireland, Michael D Higgins, and anaesthesia. which we proudly but humbly acknowledge I am delighted to share with you that in In total, approximately 230,000 anaes- on our stationary. May this year our Patron and President of thetics were carried out in 2016. the State, Michael D. Higgins has agreed to Following on from the recent NAP5 From: be conferred with an Honorary Fellowship study into awareness, a further approxi- “Inishbo n on a Sunday morning, of our College in St Patrick’s Hall, Dublin mately 39% of anaesthetics will have been Sunlight, turfsmoke, seagulls, boatslip, Castle, in the same state apartments where administered in the private sector. d i e s e l …” he was inaugurated as President on 11 No- e physician’s healing hand on the Col- (Seeing ings, Seamus Heaney, vember 2011 and where then President lege Crest serves as a reminder that in Ire- 1991) Mary McAleese welcomed Queen Eliza- land all consultant anaesthetists are highly To: beth on 18th May 2011. We look forward to trained specialist physicians. Hidden in the thick of a tree is a bough this occasion with eager anticipation. On the other hand, this situation is not made of gold From the rst anaesthetic administered the norm in many countries around the And its leaves and pliable twigs are made in Dublin in 1847, a few weeks a er the rst world. According to the Lancet Commis- of it too.” anaesthetic was administered in Boston, on sion on Global Surgery 5 billion of the (Seamus Heaney, the Golden Bough, the 16th October 1846, the speciality has world’s population is without access to 1991) grown and developed. It has become one of safe and aordable surgical care and an- the largest departments in most hospitals. aesthesia. It is estimated that 143 billion
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additional surgical procedures are needed training programme with 40 trainees per His shoulders globed like a full sail strung in the low and middle-income countries year. It is likely that this number will need Between the sha s and the furrow. each year. e World Federation of Societ- to increase in line with workforce planning. e horse strained at his clicking tongue. ies of Anaesthesia (WFSA) has a mission to We are due to undergo reaccreditation of advance the profession ensuring that safe our SAT training programme by the Irish An expert. He would set the wing anaesthesia provision and training is led by Medical Council this year. And t the bright steel-pointed sock. anaesthesiologists. e College, with support from the e sod rolled over without breaking.” Accordingly, the WFSA de ne anaesthe- NDTP o ce has created 22 special interest (Seamus Heaney, Follower, 1996) siology as the medical science and practice year or fellowship posts, to allow further of anaesthesia. It includes subspecialty ar- subspecialisation in Ireland as we try to We have piloted four EPAs across a eas of practice such as perioperative med- retain, our highly trained doctors in this range of areas in the speciality. We are now icine, pain medicine, resuscitation, trauma country. evaluating the process before we invest fur- management and intensive care medicine. Most of the clinical education and train- ther in this methodology. e WFSA views the delivery of anaes- ing takes place in the hospital sites, inspect- Training is more than acquiring a palette thesia as a medical practice and an anaes- ed and approved for training by the College. of techniques and skills. Professionalism thesiologist as a quali ed physician who has We watch with interest how the Medical is a corner stone of a successful integrated completed a nationally recognised medical Council will roll out and report on its hospi- clinical practice. Anaesthetists are rec- training programme in anaesthesiology. tal inspection programme. ognised as natural multidisciplinary team In light of the WFSA, European and US e College is committed to continu- leaders, moderators and good decision use of these terms, and the wider role of the ous professional development and lifelong makers. ese are skills we encourage and anaesthesiologist, the College is consider- learning for its Members, Fellows and foster in our trainees. ing the o cial introduction in Ireland of colleagues and has recently included com- Anaesthesia, Critical Care and Pain these terms replacing anaesthesia and an- pliance with PCS as a condition of “good Medicine can be challenging and demand- aesthetist with anaesthesiology and anaes- standing”. ing on a daily basis looking aer exacting thesiologist. e Australian and New Zea- e high delity, award winning, Sim- patients and their families; engaging with land College of Anaesthesia is undergoing ulation Department, one of the rst in the patients with life limiting conditions can be a similar process. country, continues to be one of the par- complex. Interestingly, most of the Fellows we have agons of the College. It plays an essential It is important that we provide a forum discussed this with seem to be in favour of role in clinical education and training at for our trainees and consultants to debrief the change, and we were encouraged when all levels and across all disciplines. We are and re ect on their experiences. Chief Herald did not see any con ict with justly proud of the developments of the However, the recent Dr Bawa Garba the name change and our granting of arms. multidisciplinary crisis management pro- ruling in the UK has raised concerns for Our next step is to ballot the Fellows. If this gramme taught here in the College. We’re trainees and trainers in this jurisdiction is accepted, then it will provide a massive just completing development of a second as doctors continue to work in some en- opportunity for rebranding of the speciality purpose built oor of the clinical sciences vironments that are challenging and less and the chance to let the wider public know building for ICU/ED/Ward scenarios and than ideal. To this end, the College Council that anaesthesiologists are indeed perioper- are grateful to the NDTP for funding our has organised a ‘hot topics’ session for our ative specialist physicians. new state of the art mannequins. We have trainees to explore the situation together Notwithstanding the physical plant of also introduced simulation into College and its implications with informed experts. our splendid headquarters building on examinations. We look forward to forming It is important that trainees develop Merrion Square, the College is actually a new partnerships to expand our reach in resilience to face legitimate challenges, vibrant body made up of Fellows, Members this high demand arena. as days can be long, patients and families and administrative sta with the Executive Workplace based assessments are a key are demanding. However, resilience must and Council at its heart. component of medical education and as- never stop us challenging and changing an e functions of the College can be sessment. e College is one of the rec- adverse or potentially toxic environment. grouped into three robust pillars that sup- ognised leaders in this eld globally along port and lend structure to the various activ- with Canada and New Zealand. e College Seamus Heaney advises, ities, the foundation. ese pillars are: is leading out on the development of En- trustable Professional Activities (EPAs) as a “Believe that further shore 1. Training, Education, Innovation and Re- means of assessing work based competen- Is reachable from here search cies as our trainees develop from novices to Believe in miracles 2. Examinations experts. And cures and healing wells. 3. Patient safety and standards. Call miracle self-healing We currently have a six year seamless “My father worked with a horse-plough,
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e utter, self-revealing of the pillars of our activity – the Exam- Patient Safety in Anaesthesia conference Double take of feeling” inations Department continues to ourish, attended by the incoming President of the ( e Cure at Troy, A Version of growing in the number of examinations WFSA. is meeting was a resounding suc- Sophocles’ Philoctetes, 1991) and the number of candidates being pro- cess and will become an annual event. cessed. We have moved to an online appli- We have provided a professional mentor cations system and are reviewing various IT e Quality and Safety Committee have training programme so the College will be systems to facilitate scoring and analysis. I established a National Safety Network with in a better position to support our trainees, am very happy to a rm our continued a named representative in each Depart- Fellows and consultant colleagues. collaboration with RCSI for psychometric ment of Anaesthesia in each hospital in the While we are an organisation committed analysis and validation of our examinations country. One function this will serve is a to patient safety, we passionately care about ensuring that they continue to meet highest forum to report unexpected events, equip- the physical safety of our trainees. Friday, international standards. is complements ment malfunction or drug alerts. ey are 16th of March, was ‘World Sleep Day’. e our in house medical educationalists who working with the NCPA, the Irish Stand- RCoA and AAGBI used this to highlight can provide an immediate analysis of ques- ing Committee and the AAGBI to achieve the dangers of fatigue for doctors working tions and performance at the examinations maximum compliance with anaesthesia long periods then driving home without centres. record keeping standards as well on-going any sleep. We too acknowledge, on occa- “Salus Dum Vigilamus” – safety while engagement with the HSE Quality Assur- sion this may happen in this jurisdiction, we watch. e by-line of our crest and ance and Verication Division in relation with potentially disastrous consequences. the apothegm of our practice. Safety and to Serious Reportable Events (SRE) (IE). e College supported the campaign em- standards is the third pillar of our College e College has contributed to the phasising the safety of “those who watch”. foundations. NCPA model of care for anaesthesia. e e words of Shakespeare’s Hamlet proposals included, especially the so-called is year the Post-Graduate Diploma come to mind: “2 plus 2” cover arrangement to improve course in anaesthesia/recovery for nurses the care of obstetric patients will have im- and midwives assisting anaesthetists con- “To die, to sleep plications on workforce planning for both tinued in College in partnership with our to sleep, perchance to dream trainee and consultant numbers, both of colleagues from the Faculty of Nursing in ay, there’s the rub, for in this sleep of which will need to increase. Trinity College and the NCPA. death We are represented on the UK’s Safe An- what dreams may come…” aesthesia Liaison Group (SALG). Research and innovation remains a A regular newsletter, safety warnings, foundation and catalyst for the continued It is our charge, our duty, to ensure the advisory notes and updates are placed in growth and development of our speciality. best outcomes so anaesthesia is a sleep of the safety section of our College website. dreams rather than the alternative. Launched in 2016, the College was the [Indent & Italic on quote; indent and Patient and personnel safety is every- rst training body internationally to sign up plain on annotation] one’s responsibility. Safety initiatives hone to the WSFA’s safety consortium Safe An- “Inspire me, then, didactic muse, and focus these ideals. Advances in moni- aesthesia for Everybody – Today (Safe-T), Beyond clichés and pompous views toring and equipment have in no small way promoting international standards for the Of art and science, contributed to this arena in both the oper- safe practice of anaesthesia worldwide. To be dulce et utile, ating room and in intensive care. But no As part of our on-going strategic plan we To speak sweetly and usefully matter how good the equipment, the anaes- have set up a College risk register to identi- About the world and th’ academy thetist or anaesthesiologist is the lynchpin, fy and mitigate risk and liability. And their alliance.” the ringmaster. One of the attributes of a vibrant, re- (Seamus Heaney, Verses for a Ford- sponsive contemporary body is change. ham Commencement, 1982) “Of all implements, the pitch fork, was is of itself can be challenging, but also the one presents new opportunities. is year, we is year the College has increased its at came near to an imagined perfec- have continued the restructuring of the funding for grants for Ireland based re- tion: administrative support team in the College search to €100,000 and I have negotiated When he tightened his raised hand and with the appointments of Mr Martin Mc- and approved by Council, an annual grant aimed with it, Cormack who joined us as CEO from the from the British Journal of Anaesthesia for It felt like a javelin, accurate and light. RCPI in August, Ms Margaret Jenkinson £50,000 with matched funding from the (Seamus Heaney, e Pitch Fork, as COO and Finance O cer, Dr Camil- College for Collaborative Research. 1991) lus Power as interim Director of Training In November we held the inaugural along with Ann Kilemade and Jennie Shiels e College examinations remain one
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in the Training Department and Mr Ben was delighted to see how the anaesthesia unites us in a unique branch of medicine Courtney in the Finance Department. To community was being introduced to Sea- that is still evolving. It is against this back- each we extend a warm welcome, assured mus’ work! ground that we are introducing our exam- that they will work with the Council and We have actively engaged with e Fo- inations into China. Already our Chinese Committees, trainees and Fellows as we rum of Irish Postgraduate Medical Training website and app are complete and the rst move forwards together in an open, robust Bodies as well as with the Medical Council exams will take place this year. partnership. during this year Our other agship programme overseas Whilst the demands of change can be Our partnerships and endeavours away is in Malaysia. In April 2016 we signed an exacting, they present us with the possi- from home, nurturing the positive facets of MOU with the College of Anaesthesiol- bility to assess where we are and our needs globalization, make Merrion Square a cate- ogists, Academy of Medicine of Malaysia going forward. gorical headquarters - the hub of our activ- to partner a Ministry of Health parallel, ities. Our overseas examination centres are competency based, specialist training pro- e poet confronts us to currently in Perdana and Penang in Malay- gramme to address the chronic, severe “walk on air against your better judge- sia, Oman, Bahrain, Jordan and Egypt. shortage of specialist trained anaesthetists ment” Following meetings in Hong Kong at in the country. e programme mirrors the (Seamus Heaney, e Gravel Walks, e World Federation of Societies of An- universities’ Master’s Programme in anaes- 1995) aesthesiologists meeting in 2016 and visits thesia. e parallel programme enshrines to the agship Peking University Hospital the CAI Membership and Fellowship ex- As part of our overarching appraisal, we College and Medical Centre – home of the ams into the curriculum. are in the process of a governance review of anthropological wonder, “Peking Man”, we We have inspected and accredited sev- the College as part of our College’s commit- o cially met the President and executives en hospitals in the both the Peninsula and ment to “good governance”. Many of our from the Chinese Society of Anaesthe- Eastern Malaysia for training. Articles of Association and Memoranda siologists in Guangzhou in August. is e College has undertaken a train the have their origins from the foundation of culminated in the signing of an MOU trainers and train the examiners courses the Faculty of Anaesthetists, RCSI in 1959 between CAI and the Chinese Society of as well as advising on curriculum devel- and the foundation of the College in 2008. Anaesthesiologists CSA/Chinese Medical opment. ese courses help underscore However, we now function and operate in Association to develop areas of cooper- the importance and consequences of high very di erent times with di erent expecta- ation and collaboration between the two stakes medical exams as well as the behind tions, regulation and accountability. organisations at an event hosted by His Ex- the scenes work that ensures reliability and e College is also in the process of con- cellency Ambassador O’Leary in the Irish validity of the College examinations. solidating its strategic plan for the next 3 Embassy in Beijing on the 7th of February is programme has been endorsed by years. is will provide stability and unity this year. is is particularly timely as the the Minister for Health and by the Director of vision as we move forwards, based on Chinese anaesthesia training is undergoing General who will o ciate at the forthcom- our three foundation pillars. revision with the formation of a College of ing hospital accreditation award ceremony. is year, we have had two very success- Anaesthetists and introduction of a nation- In Malaysia we are also exploring ways ful meetings of our newly formed Senior al curriculum. of extending our involvement with Penang Fellow’s Forum. We were delighted to wel- is was a very auspicious and special Medical College that is a joint venture of come the participants back to their College. day that marks a milestone in the relation- UCD and RCSI as it receives its enhanced We also plan to organise a Senate meeting ship between the CAI and the CSA and status of a branch Campus University. of the President and past Presidents of the CMA and thus with China itself. e sig- Our partnership with the Oman Medical College on an annual basis. nicance of the event can be contextualised Specialist Board (OMSB) continues. Last Another endorsement of our innova- perfectly against the backdrop of the Silk year ve fellows graduated from the two- tive and dynamic organisation is looking Road Economic Belt and the 21st Century year International Fellowship Programmes. outside and developing partnerships both Maritime Silk Road, the so called ‘Belt & Recently our Examinations Department at home and overseas. We look forward to Road’ initiatives rst launched by President held the membership OSCE in Oman. growing and developing our areas of co-op- Xi Jinping in 2013. In August a small group of us attended eration. As Liu an, one of the greatest authors of the rst National Society of Anaesthesiol- We were honoured to host a visit from the Han dynasty wrote, “a broad mind can ogy meeting in Malawi. In many ways this Marie Heaney in March to the College. She embrace diverse people”. is aspiration was a testament to the support, work and
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investment as well as the vision of previous tin Lecture ‘Who Needs Art” delivered by specialities as well as for the College as wit- Presidents of this College to help develop Prof Barbara Dawson, Director of Dublin nessed by the large numbers of young en- anaesthesia in Malawi against a backdrop City Gallery, e Hugh Lane. thusiastic doctors applying for our training of the second highest maternal mortality I think there are a number of enigmas as scheme and the demand for our trainees rate in the world by training both medical we look forward. Funding is limited. is who have completed our specialist training o cers and four Master of Medicine post year we have more patients, both elderly programme. graduate students. and children, on trolleys than ever before, I would like to extend my thanks to College support for such overseas proj- despite the promise of cash injections re- each of my colleagues on the Council and ects continues. is year, amongst others, cently. e exciting publication the Sáinte- administrative sta , especially Mr Martin we have sponsored two WFSA Fellowships care Report in May 2017 on the future of McCormack and Ms Margaret Jenkinson and pursue our engagement with CA- healthcare in Ireland has fallen behind in its for their unfailing help, support and wise NESCA (College of Anaesthetists of East, implementation programme. We are at risk counsel throughout the year. Southern and Central Africa). of ‘reform fatigue’ and yet ‘health inequali- I hope that in my time as President of the On a diametrically di erent point, we ty’ prevails. College of Anaesthetists of Ireland, a very continue our very fruitful participation in Recruitment across all specialties is special institution, that together we have the Tri-Nations (Anaesthesia) Common challenging, we are able to progress fewer been able to create Issues Group between ourselves, the Royal consultant posts and their take up is slow – College of Anaesthetists and the Australian more oen, not for nancial reasons but for “An oratorio… and New Zealand College of Anaesthetists. lifestyle choices and working conditions. Energy, balance, outbreak… is is an opportunity to meet quarterly Inability to employ suitably qualied At play for their own sake” and discuss issues a ecting anaesthesia at a nurses has resulted in closed operating (Seamus Heaney, In Time, 2013) global level – it is amazing to see how simi- rooms and ICU beds leading to longer lar issues are common to all three Colleges waiting lists which impact on patient care. As I conclude my nal annual report, I and the in uence we may bring to bear Not only do we have an aging popula- can a rm with condence that anaesthe- globally, for example on world-wide drug tion, but also an aging workforce in anaes- sia, intensive care and pain medicine are shortages. thesia and allied specialties. According to exciting, fullling career choices: the future With the building, transformation has the Medical Council “Medical Workforce is bright as we focus on our patients, train- not been limited to its personnel, but also Intelligence” Report 2016, over a quarter of ees and colleagues. e College is secure, remodelling of the building and relocation consultant anaesthetists are aged 55 years buttressed by its three robust foundation of some of the departments within the Col- and over. pillars and its Fellows as it goes forward. lege. In December, the newly renovated In other jurisdictions those over 55 years lecture theatre was reopened with a ribbon of age no longer take part in the on call rota. Professor Kevin Carson, cutting ceremony aer Dr William Blunnie As one advances in years it takes longer to President the rst President and whom the theatre is recover from interrupted sleep or nights named aer. without sleep. Perhaps considering a move e Training Department has been relo- to portfolio careers with reduced on-call cated to the 2nd oor of the clinical science may be the way forward so senior, experi- and training building. e stylish o ce enced consultant anaesthetists can remain space gives a sense of corporate identity to productive members of the perioperative the department. e Examinations Depart- team. is may be challenging for smaller ment has moved to the top oor of Merrion departments. Square, which will enhance security around Being released from clinical commit- the examinations. e Finance Department ments for College activities, for example, has also relocated to the top oor. In addi- for examinations, training events and exec- tion, we are completing development of a utive roles, is becoming more di cult and new oor for high delity simulation in the challenging as the workload and clinical training building. demands in the hospitals is compelling. e rst event in the renamed Dr Wil- Notwithstanding, I do think the future liam Blunnie lecture was the 2017 Gilmar- is buoyant for anaesthesia and its related
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CEO’S REPORT
Martin McCormack, e past year has been a time of change anaesthesia to trainees in year one of the provides systematic training to our train- CEO for the College but our core purpose re- SAT programme. is is a signi cant ees and continuing medical education mains the same – to protect lives and pro- change management programme and we and development to practitioners in an- mote the health of the patients we serve. It have created a repository of support ma- aesthesia through experiential learning is at the heart of everything we do, across terial in our online hub, enabled the use and directed self-re ection in a clinical all our pillars of activity and was a signif- of the feedback reports via mobile-app skills and simulation environment. is icant motivating factor when I decided to technology and developed an engage- year the College has signi cantly invest- join the College. ment strategy with our Tutors, Fellows ed in the upgrade and development of It was a great honour to be appointed and Trainees. It is great to see this project our high delity simulation training pro- as CEO this year, it is an opportunity that moving from a development to imple- gramme, opening up exciting new oppor- I relish. My immediate priorities are to mentation stage and we will continue to tunities for the future. protect, sustain and grow College activity review and measure progress. I am pleased to report that during my nationally and internationally. roughout 2017 the College inspect- rst year as Chief Executive, the College’s Abraham Flexner once said that ed and supported clinical site rotations in nances have remained strong. is has “Medical education is not just a program twenty-one sites across Ulster, Munster, enabled investment back into our core for building knowledge and skills in its re- Connaught and Leinster; and continued activities in Ireland and overseas. cipients, it is also an experience which cre- to develop our structured modules and As part of our strategic plan, College ates attitudes and expectations.” is year mandatory education courses and quali- Council have agreed to increase the we continued to develop and innovate our ty assure our membership and fellowship annual CAI research project grant to training programmes, examinations, con- examinations. €100,000, demonstrating commit- tinuous professional development, quality All this work is supported by our ment to research and innovation here and patient safety and research activity to College Council Fellows and we are in- in Ireland. Our Research, Audit and maintain our position as an international debted to the clinicians involved for their Innovation committee awarded this standard bearer for world-class practice of dedication and endeavours on behalf of year’s grant to two excellent applicants. anaesthesia, perioperative, intensive care the College and the specialty. We will Internationally, Council have also agreed and pain medicine. continue to impress upon government to fund World Federation of Societies Our core Specialist Anaesthesia the need to work with us to support cli- of Anaesthesiologists Fellowship pro- Training (SAT) programme contains nicians who devote time to College ac- grammes in Ghana and Cairo and to formative and summative assessments tivities. match collaborative research grant fund- aligned to a curriculum that assesses pa- Our CEPD Congress Committee con- ing of €50,000 with our o cial academic tient safety, integrity, teamwork, commu- tinues to develop education, training and journal partner BJA to support research nication and leadership as well as clinical continuing professional support for our in our specialties across Ireland and the skills, manual dexterity, pro ciency, prac- Fellows with a wide and varied portfolio UK. tice and re nement. of lectures, workshops, courses and an In September, we launched our outstanding annual congress and educa- International Strategy Entrustable Professional Activities (EPAs) tion calendar. e global burden of disease amena- in vascular access, managing pain in la- e College of Anaesthetists of Ireland ble to surgical intervention is substan- bour, paediatric anaesthesia, and general Simulation Training (CAST) programme tial and growing. Despite this, there are
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The Council has adopted a corporate governance framework for the eective governance of the College.
gross disparities in access to safe surgical nual evaluation of council and committee Committee of AAGBI and the National and anaesthesia care worldwide. As part e ectiveness, the development of annual Clinical Programme for Anaesthesia to of a properly functioning health system business plans and key measures of suc- communicate patient safety information all people should have access to safe, cess outcomes alongside a code of con- in a structured and systematic way. high-quality surgical and anaesthesia care duct for Council & Committee Members. with nancial protection when needed. e strategic planning process began Key Stakeholder Engagement We continue to collaborate with our stra- in October 2017 and will be published e theme of patient safety extends to our tegic partners to build on our international and launched in 2018, reecting the val- continued engagement with our regulator, commitments to help reach this goal. ues of the College, our strategic goals, the Medical Council. e College has re- From Johor Bahru at the tip of the the key areas of activity on which we will ected on the rst ve years of operation Malay Peninsula to Zhengzhou in East focus and it will de ne the criteria for of the Professional Competence Schemes Hanan province and from the Great Ri achieving success. e strategic plan will under contract with the Medical Council. Valley in Malawi to Muscat on the Persian endure over time and will guide the an- In October 2017, the Medical Council Gulf, the College is actively engaged in im- nual business planning process. together with the Forum of Postgraduate proving access to quality anaesthesia care College Council has established a cor- Medical Training Bodies hosted a and meeting the shortfall in skilled anaes- porate governance working-group, which Symposium to “Address the Challenge thetists in those countries through collab- regularly reviews developments in cor- of Compliance in the Maintenance of oration and consultation on examinations, porate governance and updates the cor- Professional Competence”. A number of training programme structure and con- porate governance framework and other key opportunities were broadly de ned tent, clinical skills workshops and interna- governance materials, as it deems neces- on how to facilitate and manage mainte- tional clinical fellowship programmes. sary and appropriate. nance of professional competence compli- ance, especially emphasising the need to Good Corporate Governance Quality and Patient Safety move away from considering profession- e College is committed to good cor- Given that patient safety is at the heart of al competence as a box ticking exercise porate governance, which strengthens everything we do, it was very satisfying and engage in more meaningful lifelong Council and management accountabil- to see the range and depth of research learning. e Medical Council have ex- ity and helps build public trust in the and thought provoking presentations at tended the PCS contract with the College College. e Council has adopted a cor- our Inaugural National Patient Safety in of Anaesthetists of Ireland for a further porate governance framework for the Anaesthesia Conference in November, three-year period. e ective governance of the College. e which we streamed live to Fellows, e College and JFICMI also engaged framework addresses matters such as the Trainees and Members across the globe. with the Medical Council and the Health commencement of a strategic planning is will now become an annual event in Service Executive to seek accreditation process, building on Council’s mission the College calendar. of the intensive care medicine higher and vision, the introduction of an an- I also commend the CAI Quality specialist-training programme. Having nual work programme and calendar for and Safety Advisory Committee for received support from the National Council, the introduction of a risk man- establishing a National Anaesthesia Doctors Training and Planning unit and agement system for the College, a review Safety Network. e QSA committee the Clinical Director of Acute Hospital of College committee structure and an- work closely with the Irish Standing services, we proceeded to make full sub-
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The College have collaborated with HSE National Clinical Programme for Anaesthesia (NCPA) in the development of a Model of Care for Anaesthesia and with the Critical Care Programme (CCP) supporting the implementation of a Model of Care for Adult Critical Care.
mission the Medical Council’s Education, supports, appraisal and assessment avail- Fellows and the broader development Training and Professional Development able to them. of the SAT training programme and the Committee in December 2017, which will e College had a signicant presence CAI Mentoring programme over her ten- be assessed and considered in 2018. at the national Medical Careers Day in ure. Dr Camillus Power was appointed as e Medical Council published its up- September in Dublin Castle, where over Interim Director of Training and Dr Brian dated Guide to Professional Conduct and 500 students had the opportunity to meet O’Brien took up his new role as Chair of Ethics (8th Edition) on (17th May 2016). specialist clinicians and sta from our the Training Committee. I look forward e College of Anaesthetists of Ireland College to learn more about SAT training, to working with them and I would also have dra ed an adjunct to that guide, to which remains the most competitive spe- like to thank Mr Fintan Foy, Mr Mark provide more sub-specialty level of de- cialty training programme nationally. Mc Donnell and Ms Maria Golden, who tail on professionalism in Anaesthesia, e College have collaborated with departed during the year, for the contri- Intensive Care and Pain Management and HSE National Clinical Programme for bution they made to the College. We wish will publish the document in 2018. e Anaesthesia (NCPA) in the development them well in their new endeavours. Medical Council of Ireland’s expectation of a Model of Care for Anaesthesia and I would like to acknowledge the contribu- is that the quality of the doctor’s compe- with the Critical Care Programme (CCP) tion of Council, Committee members, ex- tence, behaviours and relationships that supporting the implementation of a Model aminers, tutors and trainers for their com- underlie this professionalism is main- of Care for Adult Critical Care. mitment and support. Without you, we tained in the patient-doctor relationship. would not have a College. I would also like Alongside the Medical Council, we Our Heritage to thank the sta of the College for their continue to engage with the Forum of e CAI has approximately 130 Senior hard work and dedication in supporting Postgraduate Training Bodies and the HSE Fellows, who are retired from clinical the activities of the College. In particular, I National Doctors Training and Planning practice, who have demonstrated sus- recognise the support and contribution of unit on a variety of issues relating to train- tained achievements in anaesthesia, in- Ms Margaret Jenkinson, Chief Operations ing and the profession. In November 2017 tensive care or pain medicine and have Ocer. As Jean Paul Sartre once said, the College signed up to the Principles contributed to the science or practice of “commitment is an act, not a word” and Ms of Flexible Training in recognition of the anaesthesia and to development of the Jenkinson is a huge source of support in need to support more exible and di er- College. is year the College hosted an the day to day running of the College. entiated approaches during training that inaugural event especially for this group Finally, I would like to thank our take account of family, research or other of members under the chairmanship of President, Professor Kevin Carson for his constraints. Prof Dennis Moriarty and such was the leadership on Council during the time e President and I continue to advo- level of positive feedback that we will aim that we worked together. e President’s cate with the Forum and the HSE NDTP to host three Senior Fellows Forum events determination and an unrelenting com- for alignment of strategy in relation to per annum. mitment to excellence have enabled us to postgraduate training, to increase the level attain success and envision a bright future of funding in medical training, to devel- Acknowledgements for the College. op meaningful recruitment and retention e College is well served by a highly strategies and to support health and well- committed group of talented sta whose Martin McCormack, being of doctors. e College is commit- contribution is very much appreciated. CEO ted to working with the Medical Council In October Dr Cathy Armstrong retired and the HSE to develop a strategy to sup- from her position as Director of Training, port the increasing number of NCHDs not having given outstanding commitment in training and to review the educational to the College, our trainees, tutors and
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ed responsibility for the identi cation and assessment of risks and for report- HONORARY ing on same, as well as for reviewing the College’s risk management and internal control systems and making recom- mendations to Council. TREASURER’S I am delighted to be able to report on another year of solid progress for the College and on the healthy state REPORT of the College nances. e College continues to have no need for borrow- ings and is able to rely fully on operat- Dr Kevin Clarkson, Honorary Treasurer I am pleased to present our Financial ing surpluses. During 2017 we invested and Chair of the Finance & General Statements and my report for the nan- €900,000 with Merrion Capital. e Purpose Committee cial year ended 31st December 2017. College’s investment policy is to main- Our nancial strategy employs disci- tain a balance between income and plined nancial stewardship to ensure capital growth with medium risk and the long-term sustainability of our oper- an ethical stipulation that there should ations and the realisation of the growth be no direct investment in tobacco ambitions of the College. We place a related companies. e total return strong focus on generating a surplus for the year compares satisfactorily annually to ensure that our on-going with other types of investments of a commitments can be met. As a regis- similar risk pro le. ese investment tered charity, all surpluses are reinvested funds will assist the on-going nancial for the furtherance of training, educa- sustainability of the College, as well as tion and research. funding cutting edge research in the In 2017 the College undertook a elds of anaesthesia, pain medicine governance review that will contin- and perioperative medicine. ue into the early part of 2018. A key Grant ornton audited our accounts. recommendation from the review was We have received a clean, unquali- the necessity for a risk register. e ed audit opinion, which means that Finance Committee will be responsible the nancial statements present a true for assisting Council by taking delegat- and fair view of the nancial position
14.6% 7% 1.9% Income 2017 5.8% Annual subscriptions 14.6% (€525,435) 1.5% Educational meeting and courses 7% (€249,622) 50.4% 1.9% College fees 1.9% (€69,47 6) International education & training 5.8% (€210,000) 0.8% 0.7% Venue hire and event income 1.5% (€54,680) HSE income reimbursement 1.9% (€66,640) 15.4% Donations and sponsorship 0.8% (€26,948) Sundry income 0.7% (€25,904) Examinations 15.4% (€554,050) Grants: Structutal Funding Grants HSE 50.4% (€1,808,099)
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of the College and have been properly For 2018 we will focus on projects aimed at delivering a prepared in accordance with relevant legislation. No concerns or comments more sustainable organisation, with the College progressing were expressed. e Financial the move to an “Infrastructure as a service” hosted model in Statements of the College for the year ended 31st December 2017 are set out relation to its information technology strategy. on pages 12-18 of this annual report.
Income & Expenditure Account activities – a 9.6% increase on the 2016 In summary, in 2017 there is a contin- gure. e College’s nancial results for an “Infrastructure as a service” host- uance of the sound nancial perfor- the year were in line with expectations. ed model in relation to its information mance and position of the College. Total technology strategy. income of the College for the nancial Statement of Financial Position Finally, I gratefully acknowledge the year ended 31st December 2017 was e statement of nancial position support of the loyal and hardworking €3,590,854 which represents a 7.5% as at 31st December 2017 details the members of the Finance committee for increase on the total income for 2016. assets and liabilities of the College and their contributions and on-going nan- e majority of income continues to I am delighted to report that the net cial stewardship, thereby ensuring the be earned from those activities that are assets now total €8,778,285. is is an on-going success of the College. I would core to the College’s strategy. increase of 4.4% on the 2016 net assets. also like to express my sincere gratitude HSE funding remains our largest Debtors at 31st December 2017 were to the sta in the Finance o ce, Ms single source of income, accounting for €756,923. e majority of this balance Margaret Jenkinson our Finance O cer 52% of total income. While income for relates to HSE invoices. Creditors at 31st and her team - Mr Ben Courtney who Annual Subscriptions has fallen slight- December 2017 were €664,366. joined the department in January 2018 ly in 2017 it should be noted that 2016 In 2017 the College continued to and Ms Natalie Brennan. We look was an exceptional year for subscrip- focus on investing in new and exist- forward to another exciting year ahead. tion income. Furthermore, we have had ing technology to improve services to signi cant uptake from our UK Fellows Fellows and trainees. For 2018 we will Dr Kevin Clarkson, in relation to our reduced subscription focus on projects aimed at delivering Honorary Treasurer and Chair of the for dual membership. Total expendi- a more sustainable organisation, with Finance & General Purpose Committee ture for the year was €3,224,268 which the College progressing the move to represents an increase of 7.2% on 2016 expenditure. Overall, a strong surplus of €370,784 was generated on ordinary 0.1% 0.4% 0.9%
14.3%
4.6% Expenditure 3% 2017
Educational material, meetings & courses 14.3% (€461,192) Examinations 4.6% (€147,234) Research sponsorship and tutors 3% (€96,277) 9.9% 41.8% Governance 9.9% (€319,182) Depreciation 5.8% (€186,767) HSE Discretionary expenditure 2.1% (€66,640) Venue hire and event expenditure 0.3% (€10,103) 5.8% O ice & IT 16.9% (€547,623) Wages, salaries, related charges training 41.8% (€1,351,092) 16.9% 2.1% Bank Charges 0.9% (€29,099) General 0.1% (€4,562) International charitable activities 0.4% (€12,814) 0.3%
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Income & Total expenditure for the year was €3,224,268 which represents an Expenditure 2016- 2016 increase of 7% on 2016 expenditure. Overall, a strong operational 2017 2017 surplus of €370,784 was generated on ordinary activities – a 10% increase on the 2016 figure.
3,800,000 3,590,854
3,340,363 3,224,268
3,008,218
2,850,000
1,900,000
950,000
0 Income Expenditure
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INCOME AND EXPENDITURE DRAFT INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED DECEMBER
INCOME 2017 2016 Annual subscriptions 525,435 567,123 International education and training 210,000 175,000 College fees 69,476 77,887 Educational meetings and courses 249,622 214,493 Examinations 554,050 560,861 HSE Structural Funding 1,808,099 1,545,094 HSE Income Reimbursement 66,640 79,513 Donations and Sponsorship 26,948 39,405 Venue hire and event income 54,680 63,841 Sundry income 25,904 17,146 3,590,854 3,340,363
EXPENDITURE Wages, salaries, related charges, sta training and recruitment 1,351,092 1,141,903 Educational material, meetings and courses 461,192 283,509 Examinations 147,234 203,237 Oice and IT 547,623 548,088 Governance 319,182 379,788 Research sponsorships and tutors 96,277 106,443 International charitable activities 12,814 9,255 Depreciation 186,767 194,175 Financial 29,099 24,121 Venue catering and advertising costs 10,103 29,770 General costs 4,562 8,416 HSE discretionary expenditure 66,640 79,513 Fair value movement of investments (8,317) - 3,224,268 3,008,218
OPERATING SURPLUS 366,586 332,145 Interest receivable and similar income 4,198 6,281 Interest payable and similar charges - - Surplus on ordinary activities before exceptional items 370,784 338,426
On behalf of the Board of Directors Prof Kevin Carson Dr Kevin Clarkson
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AUDITOR’S REPORT
Independent Auditors’ Report to the Members of College of in relation to which the ISAs (Ireland) require us to report to Anaesthetists of Ireland CLG you where: • the directors’ use of the going concern basis of account- Opinion ing in the preparation of the nancial statements is not We have audited the nancial statements of College of appropriate; or Anaesthetists of Ireland CLG, which comprise the Statement • the directors have not disclosed in the nancial state- of Comprehensive Income, the Statement of Financial Position, ments any identi ed material uncertainties that may the Statement of Cash Flows, the Statement of Changes in cast signi cant doubt about the Company’s ability to Equity for the nancial year ended 31 December 2017, and the continue to adopt the going concern basis of account- related notes to the nancial statements. ing for a period of at least twelve months from the date e nancial reporting framework that has been applied in when the nancial statements are authorised for issue. their preparation of the nancial statements is Irish law and accounting standards issued by the Financial Reporting Council Other Information and promulgated by the Institute of Chartered Accountants in Other information comprises information included in the Ireland including FRS 102 ‘ e Financial Reporting Standard Annual Report, other than the nancial statements and our applicable in the UK and Republic of Ireland’. (Generally auditor’s report thereon. e directors are responsible for the Accepted Accounting Practice in Ireland). other information. Our opinion on the nancial statements In our opinion, College of Anaesthetists of Ireland CLG’s does not cover the information and, except to the extent other- nancial statements: wise explicitly stated in our report, we do not express any form • give a true and fair view in accordance with Generally of assurance conclusion thereon. Accepted Accounting Practice in Ireland of the assets, In connection with our audit of the nancial statements, our liabilities and nancial position of the Company as at responsibility is to read the other information and, in doing so, 31 December 2017 and of its nancial performance and consider whether the other information is materially inconsis- cash ows for the nancial year then ended; and tent with the nancial statements or our knowledge obtained • have been properly prepared in accordance with the in the audit, or otherwise appears to be materially misstated. requirements of the Companies Act 2014 and the If we identify such material inconsistencies in the nancial Companies (Accounting) Act 2017. statements, we are required to determine whether there is a material misstatement in the nancial statements or a mate- Basis for Opinion rial misstatement of the other information. If, based on the We conducted our audit in accordance with International work we have performed, we conclude that there is a materi- Standards on Auditing (Ireland) (ISAs (Ireland)) and applica- al misstatement of this other information, we are required to ble law. Our responsibilities under those standards are further report that fact. described in the ‘responsibilities of the auditor for the audit of We have nothing to report in this regard. the nancial statements’ section of our report. We are indepen- dent of the Company in accordance with the ethical require- Matters on which we are required to report by the ments that are relevant to our audit of nancial statements in Companies Act 2014 and the Companies (Account- Ireland, namely the Irish Auditing and Accounting Supervisory ing) Act 2017 Authority (IAASA) Ethical Standard concerning the integrity, • We have obtained all the information and explanations objectivity and independence of the auditor, and the ethical which we consider necessary for the purposes of our pronouncements established by Chartered Accountants Ireland, audit. applied as determined to be appropriate in the circumstances • In our opinion the accounting records of the Company for the entity. We have ful lled our other ethical responsibili- were su cient to permit the nancial statements to be ties in accordance with these requirements. We believe that the readily and properly audited. audit evidence we have obtained is su cient and appropriate to • e nancial statements are in agreement with the provide a basis for our opinion. accounting records. • In our opinion the information given in the Directors’ Conclusions Relating to Going Concern Report is consistent with the nancial statements. We have nothing to report in respect of the following matters Based solely on the work undertaken in the course
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of our audit, in our opinion, the Directors’ Report perform audit procedures responsive to those risks, and obtain has been prepared in accordance with the require- audit evidence that is su cient and appropriate to provide ments of the Companies Act 2014 and the Companies a basis for our opinion. e risk of not detecting a material (Accounting) Act 2017. misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, Matters on which we are required to report by intentional omissions, misrepresentations, or the override of exception internal control. • Based on our knowledge and understanding of the Obtain an understanding of internal control relevant to the Company and its environment obtained in the course audit in order to design audit procedures that are appropriate of the audit, we have not identi ed material misstate- in the circumstances, but not for the purpose of expressing an ments in the Directors’ Report. opinion of the eectiveness of the Company’s internal control. • Under the Companies Act 2014 and Companies Evaluate the appropriateness of accounting policies used (Accounting) Act 2017, we are required to report to and the reasonableness of accounting estimates and related you if, in our opinion, the disclosures of directors’ disclosures made by management. remuneration and transactions speci ed by sections Conclude on the appropriateness of management’s use of 305 to 312 of the Acts have not been made. We have the going concern basis of accounting and, based on the audit no exceptions to report arising from this responsibility. evidence obtained, whether a material uncertainty exists relat- ed to events or conditions that may cast signi cant doubt on Responsibilities of the management and those the Company’s ability to continue as a going concern. If they charged with governance for the financial conclude that a material uncertainty exists, they are required statements to draw attention in the auditor’s report to the related disclo- As explained more fully in the directors’ responsibilities sures in the nancial statements or, if such disclosures are inad- statement, management is responsible for the preparation equate, to modify their opinion. eir conclusions are based of the nancial statements which give a true and fair view in on the audit evidence obtained up to the date of the auditor’s accordance with Generally Accepted Accounting Practice in report. However, future events or conditions may cause the Ireland, including FRS102, and for such internal control as Company to cease to continue as a going concern. they determine necessary to enable the preparation of nancial Evaluate the overall presentation, structure and content of statements that are free from material misstatement, whether the nancial statements, including the disclosures, and wheth- due to fraud or error. er the nancial statements represent the underlying transac- In preparing the nancial statements, management is tions and events in a manner that achieves a true and fair view. responsible for assessing the Company’s ability to continue as e Auditor shall communicate with those charged with a going concern, disclosing, as applicable, matters related to governance regarding, among other matters, the planned going concern and using the going concern basis of account- scope and timing of the audit and signi cant audit ndings, ing unless the management either intends to liquidate the including any signi cant de ciencies in internal control that Company or to cease operations, or has no realistic alternative may be identi ed during the audit. but to do so. [SH1] e purpose of our audit work and to whom we owe ose charged with governance are responsible for oversee- our responsibilities ing the Company’s nancial reporting process. is report is made solely to the Company’s members, as [SH1] Responsibilities of the auditor for the audit of the a body, in accordance with section 391 of the Companies Act nancial statements 2014. Our audit work has been undertaken so that we might e auditor’s objectives are to obtain reasonable assurance state to the Company’s members those matters we are required about whether the nancial statements as a whole are free from to state to them in an auditor’s report and for no other purpose. material misstatement, whether due to fraud or error, and to To the fullest extent permitted by law, we do not accept or issue an auditor’s report that includes our opinion. Reasonable assume responsibility to anyone other than the Company and assurance is a high level of assurance, but is not a guarantee the Company’s members as a body, for our audit work, for this that an audit conducted in accordance with ISAs (Ireland) report, or for the opinions we have formed. will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are consid- Colin Feely, FCA ered material if, individually or in the aggregate, they could for and on behalf of reasonably be expected to in uence the economic decisions of Grant ornton users taken on the basis of these nancial statements. Chartered Accountants As part of an audit in accordance with ISAs (Ireland), the Registered Auditors auditor will exercise professional judgment and maintain Dublin 8 professional scepticism throughout the audit. ey will also: Identify and assess the risks of material misstatement of the nancial statements, whether due to fraud or error, design and
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STATEMENT OF FINANCIAL POSTITION
31 DECEMBER 2017
2017 2016 FIXED ASSETS Tangible Assets 4,443,196 4,517,432 Investments 908,317 - 5,351,513 4,517,432
CURRENT ASSETS Debtors 756,923 550,657 Cash at bank and in hand 3,334,215 4,299,342 4,091,138 4,849,999
CREDITORS Amounts falling due within one year (664,366) (959,930)
NET CURRENT ASSETS 3,426,772 3,890,069
TOTAL ASSETS LESS CURRENT LIABILITIES 8,778,285 8,407,501
CAPITAL AND RESERVES
Retained Surplus 8,778,285 8,407,501
MEMBERS FUNDS 8,778,285 8,407,501
On behalf of the Board of Directors Prof Kevin Carson Dr Kevin Clarkson
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Council of the College of Anaesthetists of Ireland 2017
BACK ROW LEFT TO RIGHT: Ms Margaret Jenkinson; Prof David Honan; Ms Anne Maher; Dr Brian O’Brien; Prof Gerry Fitzpatrick; Dr Calathur Nanda Kumar; Dr Ehtesham Khan; Prof George Ghaly; Dr Padraig Sheeran; Dr John O’Dea; Dr Miriam Langdon
FRONT ROW LEFT TO RIGHT: Mr Martin McCormack; Dr Rory Page; Dr Kevin Clarkson (Honorary Treasurer); Prof Kevin Carson (President); Dr Anne Hennessy (Vice President); Dr Brian Kinirons (Honorary Secretary); Dr Camillus Power; Dr Jeanne Moriarty
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TRAINING AND EDUCATION COMMITTEE REPORT
Dr Brian O’Brien, Chair e committee met four times over cess were changed in summer of 2017, ty of operating environments. Moving of the Training and Education Committee the year and dealt with a broad vari- and most involved found the new for- the SIY option to year 4/5 is a way to ety of issues pertaining to the overall mat better. Further modi cations are encourage this. Reorganising this ow- running of the scheme, and an equal presently under consideration, but are chart – which covers a six-year pro- range of matters pertaining to indi- likely to be relatively minor. We aim gramme for 40 people – or 240 years vidual trainees. e major topics we to commence a formal process of data of working life – has been a Herculean have spent time on include the SAT collection on the learning process and task for college sta ! Ann Kilemade recruitment process, the roll out of progression of the 2018 intake, which and Dr Camillus Power have been ma- EPAs (Entrustable Professional Activ- may lead to the publication of a re- jor contributors to this process. ities) as a smartphone-assisted form of search. Ultimately this should provide e rollout of EPA’s in the second clinical teaching, and a sweeping e ort an evidence-base for the on-going evo- half of 2017 was a major change in the to reform the allocation of trainees on lution of the programme. training programme, the full e ects the SAT matrix so as to maximise the e matrix of training posts is a of which are not as yet apparent. e quality of training, the transparency complex chart, covering the six-year trial period for the project began in and the fairness of the system. Ideally programme of 40 doctors. Each se- October, and full implementation for we wish to minimise the disruption of quence needs to include paediatric SAT 1/2 trainees begins in July 2018. personal lives, while providing a pre- experience, obstetric care and a broad In essence, this process will put clin- dictable supply of high calibre doctors range of other specialties. We try to ical and theatre-based teaching on a to our training hospitals. Frequently schedule each trainee to work in only formal, quanti able basis. It begins a these objectives are di cult to recon- two geographical locations, one of process of evolution away from time- cile, and the necessary trade-o s and which is necessarily Dublin. Requests based apprenticeships toward observed compromises make up the substance to swap, and the existence of Special demonstrations of procedural and oth- of much of our discussions. Interest Years (SIYs), disrupt the pat- er competencies in the hospital setting. SAT recruitment is in a very positive tern, and inevitably have knock-on Acquisition of each de ned skill is state, with more than two applicants e ects. ese are important options documented up to a point where one for every training post. We recruited however, and justify themselves as they is deemed fully competent, and can 40 newcomers to the programme at improve trainees’ levels of satisfaction thereaer be “entrusted” with that task. interviews in January, they being se- and their experience of the programme It remains an ambitious venture. lected from over 60 shortlisted. e generally. Nonetheless, we are trying to Training days for tutors and instruc- interviews are intended to be objec- improve adherence to the prescribed tion videos were provided aer a two- tive, with structured questions, and programme, and to establish mecha- year project to choose and de ne the points awarded for speci c achieve- nisms and guidelines for posts being skills and competencies, develop the ments on one’s CV. e time a orded swapped, and we may look to move relevant app, and begin to troubleshoot to us by consultants to conduct these the SIYs to an earlier point in train- it. It is now on the App Store and up- interviews is greatly appreciated; in- ing. Many appear to agree that the last take has been strong, with useful and deed it underpins the credibility of the year is best conducted as an undi er- positive feedback to trainees and to the programme from its earliest stages. entiated, high-level anaesthesia post in College continuing. More information We thank them for their input. e which one is expected to function close on this is available from the CAI web- application form and interview pro- to consultant level, in a broad diversi- site, and elsewhere. Although the term
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is perhaps overused, this is a genuine challenging. Some relate to work, Suice to say that as a full year passes paradigm shi in clinical teaching. At but many do not. We try to be of this stage it’s limited to four clinical in- assistance, and to mitigate problems for our 240 or so doctors in training, terventions but the project will expand as best we can. We are frequently clearly this can be seen to encompass to cover many more. It has required frustrated that we cannot do more, signi cant planning and investment however, and unfortunately this is three human lifetimes of experiences. of resources at Council level. e EPA unlikely to change despite any ef- concept will be a major component of forts we make. e CAT group con- Diiculties arise, and in some cases the SAT programme as experienced by tributes signi cantly in many ways they are very complex and challenging. trainees in the future. to the committee, not least in help- e terms of reference of the com- ing individuals to bring problems to Some relate to work, but many do mittee were also reviewed during the our attention. eir valuable contri- not. We try to be of assistance, and to year. In certain respects, this type of bution is crucial to the committee, appraisal needs to be done regularly – and we are very thankful for it. mitigate problems as best we can. items referred to become obsolete, and sometimes new scenarios arise that Dr Brian O’Brien, warrant speci c rules to be added. e Chair of the Training and Education current dra appears more re ective of Committee current training realities, and we will endeavour to maintain that standard. A major contribution made by tutors in our 25 training hospitals must be ac- knowledged. e names of all tutors are listed at the end of this report. is year saw Dr Patricija Ecimovic complete her term as lead tutor, and we wish to thank her as well as all other tutors for their work, and wish Dr Ecimovic the best in the future. With regard to the problems that are raised by individual trainees, it may be wiser to avoid giving examples or listing scenarios. Suce to say that as a full year passes for our 240 or so doc- tors in training, clearly this can be seen to encompass three human lifetimes of experiences. Diculties arise, and in some cases they are very complex and
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During the year, additional Tutors were appointed with specific responsibility for the implementation of EPAs for the SAT 1 trainees. All our Tutors have played a significant role in the past year and are deserving of our grat- itude. A current list of Tutors nationally is provided below.
Tutors
Dr Eleanor O’Leary Adelaide, Meath, National Children’s Hospital Dr Katrina O’Sullivan Adelaide, Meath, National Children’s Hospital Dr Karthikeyan Srinivasan Adelaide, Meath, National Children’s Hospital Dr Karen Tan Adelaide, Meath, National Children’s Hospital Dr Grace Donnelly Beaumont Hospital Dr David Moore Beaumont Hospital Dr Criona Walshe Beaumont Hospital Dr Norah O’Leary Cappagh National Orthopaedic Hospital Dr Enda Shanahan Cappagh National Orthopaedic Hospital Dr Christopher Holmes Children’s University Hospital, Temple St Dr Kay O’Brien Children’s University Hospital, Temple St Dr Micheál Looney Connolly Hospital Dr Shane McGeary Connolly Hospital Dr Sabrina Hoesni Coombe Women’s Hospital Dr John Chandler Cork University Hospital Dr Parvaiz Hafeez Cork University Hospital Dr Padraig Mahon Cork University Hospital Dr Louise Moran Letterkenny General Hospital Dr Kathryn Byrne Mater Misericordiae University Hospital Dr Catherine Deegan Mater Misericordiae University Hospital Dr Margaret Doherty Mater Misericordiae University Hospital Dr Jennifer Hastings Mater Misericordiae University Hospital Dr Katie Padfield Mater Misericordiae University Hospital Dr Ciara Canavan Mayo General Hospital Dr Jeremiah Dowling Mercy University Hospital Dr Mohammad Faheem Midland Regional Hospital Mullingar Dr Kevin McKeating National Maternity Hospital, Holles St Dr Paula Connolly Our Lady of Lourdes Hospital, Drogheda Dr Jubil Thomas Our Lady of Lourdes Hospital, Drogheda Dr Suzanne Cronly Our Lady’s Children’s Hospital Crumlin Dr Suzanne Crowe Our Lady’s Children’s Hospital Crumlin Dr Patrick Thornton Rotunda Hospital Dr Denise Rohan Royal Victoria Eye and Ear Hospital
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Dr Emer O’Mahony Imho Sligo General Hospital Dr Omar Tujjar Sligo General Hospital Dr Michael O’Sullivan South Infirmary Victoria University Hospital Dr Carl Fagan St James’s Hospital Dr Niall Hughes St James’s Hospital Dr Thomas Ryan St James’s Hospital Dr Thomas Schnittger St James’s Hospital Dr Dara Breslin St Vincent’s University Hospital Dr Niamh Conlon St Vincent’s University Hospital Dr Donal Ryan St Vincent’s University Hospital Dr Abigail Walsh St Vincent’s University Hospital Dr Joseph Costello University College Hospital, Galway Dr Leo Kevin University College Hospital, Galway Dr Jennifer McElwain University College Hospital, Galway Dr Catherine Motherway University Hospital Limerick Dr John O’Dea University Hospital Limerick Dr Owen O’Sullivan University Hospital Limerick Dr James Shannon University Hospital Limerick Dr Patricija Ecimovic Waterford Regional Hospital Dr Vida Hamilton Waterford Regional Hospital Dr Colette Murphy Waterford Regional Hospital Dr Muhammad Shahid Wexford General Hospital
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Certi cate of Specialist Training 2017
Fahd Aamir Jul-17 Hafiza Misran Jan-18 Hani Abdalla Jul-17 Darren Mullane Jul-17 Dalia Abdelrahman Jul-17 Shrijit Nair Jul-17 Colin Black Jul-17 Sinead O’Keee Jan-18 Thomas Drew Jul-17 Shanmuga Ramaswamy Jul-17 Sheila Duggan Jul-17 Jassim Rauf Jul-17 Éimhín Dunne Jul-17 Kazim Raza Jul-17 John Fitzgerald Jul-17 Jonathan Royds Jul-17 Tagarisa Foto Jul-17 Lindi Snyman Jul-17 James Freeman Jul-17 Orsolya Solymos Jan-18 Deborah Galvin Jul-17 Farrukh Suhail Jul-17 David Greaney Jul-17 Nuala Treanor Jul-17 Sheeba Hakak Jul-17 Bill Walsh Jul-17 Francesca Holt Jul-17 Vandan Ward Jul-17 Mark Johnson Jul-17 Richard Katz Jan-18 Joseph Keaveney Jul-17 Azza Kibeida Jul-17 Aoife Lavelle Jul-17 Katarina Lenartova Jul-17 Aidan Magee Jul-17 Sinead McCarthy Jul-17
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CAO Annual Report_2018_V13.indd 24 22/05/2018 08:30 25 RESEARCH AUDIT AND INNOVATION COMMITTEE
RESEARCH AUDIT AND INNOVATION COMMITTEE
Dr Jeanne Moriarty, e committee met in February, May, September and November 2017. Chair of the Research Audit and Innovation College Research Grant 2017 Committee ere were seven applicants for the College Research Grant which was awarded to Dr Fennessy and Professor McCaul (€25,000) for their project, “Creation and vali- dation of anatomically correct cricothyroidotomy models for training by 3D print- ing” and Drs Royds and McCrory (€50,000) “Identi cation and classi cation of the peptide and cellular constituents of CSF in patients with chronic neuropathic pain”. e submissions were of excellent calibre. e College Research Grant was increased to €100,000 for 2018. In addition, the College is collaborating with the British Journal of Anaesthesia in a joint research grant of £100,000.
SATARN CAT has established a trainee research and audit network, which was endorsed by the committee. e committee continues to support applications from trainees and Fellows who wish to undertake surveys and clinical audit. Training will be required in relation to the new data protection regulations.
Dr Jeanne Moriarty, Chair of the Research Audit and Innovation Committee
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DIRECTOR OF POSTGRADUATE TRAINING REPORT
Dr Camillus Power, Interim In October 2017 Dr Cathy Armstrong re- Training and Education role passed review of the operation of the Training Director of tired as Director of Postgraduate Train- to Dr Brian O’Brien and I wish him Department, including an in-depth Postgraduate ing and as a result, I vacated my Chair of well in this important role on behalf of review of Rotations to ensure greater Training Training Role to take up the position of Council. fairness and transparency, Training Interim Director of Postgraduate Training A number of changes had taken Regulations and general Policies and for six-eight months. I’d like to take the op- place in the Training Department with Procedures. In addition, the EPA Proj- portunity to acknowledge the ne work and the appointment of a new Training ect had reached an important mile- dedication of Cathy on behalf of the train- O cer and new sta . In that context, stone, whereby it was time for a tran- ees, trainers and the College. e Chair of it seemed appropriate to undertake a sition from theory into practice. is
We also wish to acknowledge the sad untimely passing of Dr Mark Owens, who was an excellent trainee and a very talented and dedicated doctor. Dr Owens was a member of the CAT Committee and as a tribute to his remarkable dedication, we are delighted to include the picture above to acknowledge his very fine work on behalf of the next generation of trainees.
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KEY ACHIEVEMENTS
EPA DEVELOPMENT • Launch of EPA project in our hospitals • EPA tutor study days and training for SAT 1s • Development, launch and upgrade of the App and a Digital Resources Hub for online resources • Transition to hospital – going live with four EPA’s and four feedback reports • Irish Health Care award commendation • Grant funding awarded by the HSE
ROTATIONS TRAINING DEPARTMENT • Completed full review of the rotations template and revised template developed. • Scope included review of 240 trainee allocations The current composition of the Training Department and roles are outlined below: across six-years in 25 hospitals. NAME ROLE • Greater transparency with revised template published Dr Camillus Power Interim Director of Training on College website Dr Eilis Condon Deputy Director of Training • Reviewed SIY and Post CST Fellowships with a view Ann Kilemade Training Oicer to centralising the appointment of the SIY posts – Jennie Shiels Training Manager pilot under way Lauren Donohoe EPA Administrator RECRUITMENT Sinead Byrne Simulation, PCS and • Revised applications process with ability to apply International Programme through an on-line application system Rebeca Williams Secretariat and Training Administration • Appointments completed with 40 new trainees Mary Barrett Secretariat and Training Administration starting July • Autumn and spring SLA reviews with NDTP
INTERNATIONAL TRAINEE PROGRAMME • Completion of programme for 2 CPSP trainees with five further trainees mid programme resulted in placing four core EPAs and enthusiasm within the new Training • Initiation of the Sudan programme with first trainee four feedback reports at the disposal of Department. due to start in July 2018 trainees and tutors in all our training I wish to acknowledge the sterling OVERSEAS FELLOWSHIP INITIATIVE hospitals. is included a decision to work of our new Training O cer and • Completion of the first group of trainees from Oman launch the App, a Digital Resources Training Manager who have had to hit in July 2017 Hub and the training of 25 EPA tutors. the ground running on a very steep • Annual Trainee Reviews All of this was to allow practical experi- learning curve, with excellent sup- • Completed for 2017 and underway for 2018 ence of this project to inform Council’s port from a largely new team, many decision (in April 2018) on how best of whom had to take on new respon- MEDICAL CAREERS DAY to develop competency based medical sibilities to support the wide range • Attended day co-ordinated by the Forum of Post- education for our training programme of interconnecting College activities, graduate Training Bodies going forward. ranging from recruitment, allocation • Information and simulation experience provided We present the work of the Train- of trainees, simulation to Faculty and ing Department in the format of a committee support so that the trainee ADMINISTRATIVE SUPPORT table, opposite, to better illustrate the receives the best possible chance to • Continued administrative support to Joint Faculty work achieved to date and the scope progress through their training and of Intensive Care Medicine of Ireland, Faculty of of activities managed by the Training achieve their CSCST. It is also import- Pain Medicine, Intensive Care Society of Ireland, Department. Hopefully, this captures ant to acknowledge the input of CAT to Committee of Anaesthetic Trainees (CAT) and the the sense of change, dynamism and the work of the Training Department, Training and Education, Credentials, Quality & Safety, Research & Academic Committees.
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EEPA Annual Report EPA Annual Report in particular in light of the signi cant change over the last 12 months. Review January - December 2017 Review January - December 2017 We also capture the live nature of the current EPA work in the set of infographics presented le and take this opportu- Live EPA Elements Launched in September 2017 EPA Pro ect Engagement nity to thank all the consultants and trainees who have en-
gaged in the process this far. In particular, we want to thank the following consultants who worked in the co-design of the EPAs with both Dr Josephine Boland and Dr Eilis Condon: Dr Kay O’Brien, Dr Patricija Ecimovic, Dr Rebecca Fanning, Dr David Moore, Dr Kathryn Byrne, Dr Criona Walshe, Dr Ron Charles and Dr Karthikeyan Srinivasan A particular thanks to Ms Lauren Donohoe for her ex-
EPA Pro ect EngagementLevel of EPA Participation cellent administrative support and to both Lauren and Ms 100%* Awards/Funding Máirín Murray of Digital Doddle, for their innovative com- munication strategy, a sample of which is included in the
HSE rant Irish Healthcare A ardHub Acces infographics piece le . I wish to acknowledge the dedicated and untiring work undertaken by Dr Josephine Boland in bringing together all the strands in developing EPAs over the * Percentage of Trainees last three years into one document that will function as a key Engagement. resource for all involved in Competency Based Medical Edu- Grants and Awards in 2017 Grants and Awards in 2017 cation in the College.
Dr Camillus Power, Interim Director of Postgraduate Training
Training and Engagement
EPA Tutors Training Days EPA Trainee Induction Survey
Tools and Resources
Feedback Reports App
This Month's Progress
Spotlight on the CAI Hub
:
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EXAMINATIONS’ COMMITTEE REPORT
Dr Anne Hennessy, Vice-President CAI, Chair of Examinations Committee
2017 was once again a busy year in the Examinations O ce with an ex- MCQ Total Candidates Number Successful Pass Rate % panding overseas portfolio in addition January 74 39 52.7% to our examination commitments in Dublin. e committee met formally June 77 32 42% 4 times during 2017 - January, April, September 79 50 63.3% September and December. In addition, committee members and examiners undertook a huge amount of work in their own time – writing questions, Number of Candidates in Attendance Number of Successful Candidates correcting scripts, generating reports Location January June September January June September and developing protocols. Dublin 23 42 28 10 18 19 Malaysia 35 20 36 20 11 23 Membership Examinations Oman 10 5 7 5 2 5 Chair Dr D. McCoy Jordan 0 0 1 0 0 0 Egypt 3 4 0 1 1 0 Lead Examiners Bahrain 3 6 7 3 0 3 MCQ Dr L. Kevin SBA Dr M. Mugawar; Dr G. Morrison OSCE Dr P. Connolly SOE Dr D. Honan (Physiology); OSCE/SOE MCAI Overseas – Dr C. Murphy ere were two sittings of the Oman and Malaysia (Pharmacology) OSCE/SOE part of the examina- In February a delegation from the tion in Dublin. Seventy-seven College comprising three examiners, MCQ of a total of 122 candidates tak- the President and the Examinations ere were 3 sittings of the MCQ com- ing this part of the examination Manager travelled to Muscat, Oman to ponent of the examination during the were successful. ere was no examine the OSCE and SOE compo- year. is part of the examination tests exchange examiner at the spring nents of the MCAI. We were joined by candidates’ knowledge in Physiology, examination. Dr Chris Leng was a number of local examiners. Eighteen Pharmacology and Clinical Measure- the Exchange Examiner from the candidates were examined of whom ment. ere are 3 x 60 minute MTF Royal College of Anaesthetists at nine were successful. An Examiner papers and an SBA paper. e exam- the autumn sitting. Training Day was held prior to the start ination ran concurrently in 6 centres in Dublin, Malaysia, Oman, Jordan, Egypt and Bahrain. A total of 230 can- SOE / OSCE Total Candidates Number Successful Pass Rate % didates sat the MCQ paper in 2017 of Spring 62 34 55% whom 121 were successful. Autumn 60 43 72%
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of the examination. e feedback Spring Total Candidates Number Successful from local examiners was excellent. Dublin 58 29 In November a team of examiners travelled to Perdana University, Kua- Malaysia 6 1 la Lumpur, Malaysia. Six of 22 candi- Bahrain 27 9 dates were successful. Dr D. McCoy and Dr C. Burlacu also ran a very successful Train the Trainers day. Spring Total Candidates Number Successful Pass Rate % February MCQ/SAQ 91 39 43% Fellowship Examination April SOE 54 37 68.5% Chairs Dr M. Gri n; Dr G. Iohom
Lead Examiners Answer Question (10 SAQs) paper. Medal Winners Fi y-eight candidates were success- MCQ Dr M. Gri n MCAI Dr C. Lyons; ful. Sixty-four candidates were exam- SBA Dr F. Conway; Dr S. Murphy ined in the SOEs, 44 were successful. Dr G. Morrison FCAI Dr P. Fennessy; ere was no exchange examiner. SAQ Dr A. Hayes Dr N. Barnwell SOE I Dr R. Whitty FJFICMI No winner SOE II Dr M. Scully Fellowship of the Joint Faculty of FFPMCAI No winner Clinical SOE Dr G. Iohom, Intensive Care Medicine 2017 Dr M. Gri n Eight of ten candidates were New Developments successful. e committee was delighted to wel- come two new members during the Spring examination: Diploma in Pain Management year – Prof R. Arnett from RCSI who A total of 91 candidates sat the - 2017 has agreed to act as an advisor on qual- nal fellowship written examination Seven of 13 candidates were ity assurance matters and Dr G. Mor- paper in February. is was held in successful. rison who, with a diploma in medical Dublin, Malaysia and Bahrain. It education, provides advice and assis- comprised of a 90-minute MTF pa- Fellowship of the tance on question writing and makes a per (40 questions, 200 responses), a Faculty of Pain Medicine CAI 2017 signi cant contribution to the analysis 60-minute Single Best Answer (SBA) ree of four candidates were of each component of the MCAI and paper (20 questions) and a 3-hour successful. FCAI as they are taken by candidates. Short Answer Question (SAQ) pa- per. irty-nine candidates were successful. Of the 54 candidates who presented for the SOEs in Dublin, 37 were successful. ere was no ex- change examiner at the spring itera- Autumn Total Candidates Number Successful tion of the nal examination. Dublin 73 43 Malaysia 6 3 Autumn / winter examination: Bahrain 27 12 A total of 106 candidates sat the - nal fellowship written examination paper in September. is also com- prised of a 90-minute MTF paper (40 Autumn Total Candidates Number Successful Pass Rate % questions, 200 responses), a 60-min- September MCQ/SAQ 106 58 54.7% ute Single Best Answer (SBA) paper December SOE 64 44 69% (20 questions) and a 3-hour Short
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Work is ongoing, as part of the over- the 2017 Examiner Training Day in all College strategy, to improve our IT the College, which was very well re- systems in order to enhance the deliv- ceived by the examiners. Drs. McCoy, ery of our examinations. Gri n and Hennessy spoke about the Some changes to the examination structure of the MCAI and FCAI ex- question style and marking are planned aminations and there were talks from for 2018. In the Fellowship Examina- Prof. R. Arnett, Dr H. McKeague and tion Short Answer Question (SAQ) Dr G. Morrison on the principles of paper, each question will be broken assessment, question writing and stan- down into three or four components dard setting. and each component will be scored rather than giving an overall mark for Thanks each question. e marks allowed for e workload for both examiners and each component will be detailed on the the examinations o ce is increasing examination paper and it is hoped that as we continue to develop our inter- this will assist candidates with their national pro le and improve our stan- time management. Over the course of dard setting procedures and general 2018 Multiple True False (MTF) ques- examination processes. tions will be phased out. ere will be a I would like to extend my thanks to concurrent increase in Single Best An- the Vice Chair of the Committee Dr swer questions. Brian O’Brien, the chairs of each exam- In the Membership Examination the ination and to all examiners for their number of MTF questions will remain hard work, loyalty and commitment to at 90. e number of SBAs will increase the examination process. I would also over the course of the year to 50. like to thank the lead examiners and New equipment was successfully pi- standard setting panel members for all loted for the Critical Incident and Sim- the extra work they undertake. ulator stations for the Spring OSCE. I wish to acknowledge all members is has now become an integral part of the Examinations Committee and of the OSCE and is used in all iterations to thank them for their advice and sup- of the MCAI OSCE examination. port throughout the year. Towards the end of 2017 it was Finally I would like to thank the Ex- agreed that College trainees with 12 aminations Department Team – Mark months prior experience in Irish Train- O’Rourke, Ann-Marie Harte and Eoin ing Hospitals can apply to sit Fellow- Lumsden led by Ms Ruth Flaherty. ship Examination in year three. e smooth running and success of In 2018 the College will be looking each College examination is hugely at further expansion of the overseas ex- dependent on the hard work, forward aminations to include China. planning and dedication and support of Ruth and her team and I am very Examiner Recruitment and grateful to them all. Education We have been fortunate in that we have Dr Anne Hennessy continued to recruit new examiners Vice-President CAI throughout the year. All new examin- Chair, Examinations Committee ers are required to observe each exam- ination and undergo examiner training prior to commencing formally as a College examiner. In September, 30 examiners attended
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Successful Candidates MCAI 2017
Mohamed Abdelghany Patrick Conway Muhammad Hassan Ameerah Abdul Razak Danielle Courtney Noelle Healy Aasia Afzal Barbara Cusack Rachel Henke De Bastidas Rayeesul Ahamed Rachael Cusack Alan Horan Wael Alhalabi Ahmed Dagez Samahir Hussein Abeer Ali Ali Ismaeal Xenia David Mohamed Issam Eldin Ali Karam Alkhateeb Alison Deasy Chiun Chen Jee Dhari Alrashed Ayman Edarous John Jiju Abdul Rasheed Ambalathveettil Abdou Eid Gerard Kavanagh Pattath Eihab Elshabrawy Damian Kerrigan Muhammad Athar Mary Finnan Mahendar Kumar Mehr Ali Awan Kate Fitzpatrick Daniel Lehane Ross Bowe Mirela Fratita Meng Huey Lim Padraig Calpin Muhammad Ghafoor Rory Linehan Una Casey Conor Gormley Craig Lyons Subhash Chander Patrick Griin Tai Jiun Ma Nisha chaudhary Jamal Hafeez Cathal Mac Donncha Kean Seng Cheah Amad Hania Claire MacSweeney Robyn Concannon Colleen Harnett Eveline Matthews
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Mohammad Fardeen Maudarbaccus Varsha Rajesh Rai Margaret McLoughlin Antony Ratnasingham András Mikor Kiran Reddy Waqas Idrees Minhas Rana Shoaib Sadiq Arig Mohamed Amina Sajid Ahmed Abdelmuty Mohamed Ali Reza Sayeed Mahmud Amr Mohammed Chenal Shah Nur Hafizah Mohd Noor Zaeem Siddique Chuang Shin Mok Kashif Siddique Stephen Murphy Richard Skelly Husam MUSA Caroline Smyth Fu Yew NG Corina Gabriela Soare Dermot Nolan Komella Anne Sooria Prakasam Eoin Ó Rathallaigh Paul Stewart John O’Connell Shaista Sulaeman Liam O’Driscoll Debbie White Irena Popinceanu Juan Yong Wong Naomi Quigley Yosef Awad Atallah Yosef
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Successful Candidates FCAI 2017
Ahmed Abbas Elsaid Abbas Craig Delavari Darshana Maheshwari Ahmed Abdelaal Marton Deli Orlaith McMahon Ahmed Abdelaatti David Devlin John McNamara Richa Agarwal Amy Donnelly Abdul Rahim Memon Mushtaq Ahmad Kevin Doody Sandeep Miglani Mohamed Hussein Ahmed Mohammed Doula Ankita Miglani Olawale Ajetunmobi Mahmoud Elebiary Khaled Mohsen Walid Saad Alhabashy Ahmed Elwakil Osmond Morris Zia Ali Paul Fennessy Maeve Muldowney Ahmed Ali Ruth Fenton Cormac Mullins Ahmed Ali Darragh Gogarty Brian Murphy Omnia Askar Greta Gormley Satishkar Narayanaswamy Muhammad Zohaib Aslam Wael Hassan Tyng Yan Ng Niamh Barnwell Rania Haydar Murugananth Nithiyananthan Damian Barry Muhammad Ikram Aogan O Muircheartaigh Ahmad Mohammad Ben Tareef Sobia Jahan Patrick O’Connor Manoj Bhavaraju Muhammad Jamill Kate O’Donnell Claire Broe Louise Judge Ahmed Abdelhamid Omran Irmina Bukowska Muhammad Sajid Kamran Abdelrahman Christoleenan Christudas Leela Rosemarie Kearsley Mark Owens Eamonn Coleman Feby Korandiarkunnel Paul Chandar Parkash Moninne Creaney Kirk Levins Vijai Paulsen Pauliah Niall Cribben Adam Livingston Manoj Prappanadan Ann-Marie Crowe Hina Lodhi Tarique Aziz Qureshi Paudie Delaney Tai Jiun Ma Fadi Mohammad Qutishat
ANNUAL REPORT | COLLEGE OF ANAESTHETISTS OF IRELAND
CAO Annual Report_2018_V13.indd 34 22/05/2018 08:33 35 EXAMINATIONS COMMITTEE
Binu Ravindran Ann-Marie Crowe Abdul Rahim Memon Mahfouz Sharapi Paudie Delaney Sandeep Miglani Vittaldas Shetty Craig Delavari Ankita Miglani Shaista Sulaeman Marton Deli Khaled Mohsen Vimalraj Sundaram David Devlin Osmond Morris Muhammad Shafique Tahir Amy Donnelly Maeve Muldowney Kah Heng Tan Kevin Doody Cormac Mullins Ahmed Abbas Elsaid Abbas Mohammed Doula Brian Murphy Ahmed Abdelaal Mahmoud Elebiary Satishkar Narayanaswamy Ahmed Abdelaatti Ahmed Elwakil Tyng Yan Ng Richa Agarwal Paul Fennessy Murugananth Nithiyananthan Mushtaq Ahmad Ruth Fenton Aogan O Muircheartaigh Mohamed Mustafa Hussein Ahmed Darragh Gogarty Patrick O’Connor Olawale Ajetunmobi Greta Gormley Kate O’Donnell Walid Saad Alhabashy Wael Hassan Ahmed Abdelhamid Omran Abdelrahman Zia Ali Rania Haydar Mark Owens Ahmed Ali Muhammad Ikram Chandar Parkash Ahmed Ali Sobia Jahan Vijai Paulsen Pauliah Omnia Askar Muhammad Jamill Manoj Prappanadan Muhammad Zohaib Aslam Louise Judge Tarique Aziz Qureshi Niamh Barnwell Muhammad Sajid Kamran Fadi Mohammad Qutishat Damian Barry Rosemarie Kearsley Binu Ravindran Ahmad Mohammad Ben Tareef Feby Korandiarkunnel Paul Mahfouz Sharapi Manoj Bhavaraju Kirk Levins Vittaldas Shetty Claire Broe Adam Livingston Shaista Sulaeman Irmina Bukowska Hina Lodhi Vimalraj Sundaram Christoleenan Christudas Leela Tai Jiun Ma Muhammad Shafique Tahir Eamonn Coleman Darshana Maheshwari Kah Heng Tan Moninne Creaney Orlaith McMahon Niall Cribben John McNamara
ANNUAL REPORT | COLLEGE OF ANAESTHETISTS OF IRELAND
CAO Annual Report_2018_V13.indd 35 22/05/2018 08:33 36 CEPDCONGRESS COMMITTEE
CEPDCONGRESS COMMITTEE
Prof Donal Buggy, Chair of the CEPD-Congress Committee
Formerly the Education Committee, this e Abbvie Scholarship 2017 competition the Audit Oral Presentation and to Dr Ian committee’s activities include organising the was also held during the Annual Congress, Geraghty for his presentation ‘ICU Referral Annual Congress and regular CEPD activities the €10,000 scholarship was awarded Dr Ste- Audit in Galway University Hospital’ who won and was re-titled to more accurately re ect its phen Du. e scholarship supports original the Audit poster prize. work. research by an Irish anaesthetist provided by e Annual Congress 2017 was held at Abbvie. Workshops UCD’s O’Reilly Hall and adjacent O’Brien A Core Topics Day was held in September, e Vascular Access Workshop, which is man- Science Building, it included a number of where we continued our live web streaming datory for our trainees, was held on the 20th high-pro le international speakers, in addi- of these lectures to multiple hospital sites of February and was run by Dr Alan McShane. tion to harnessing the wealth of local talent throughout the country. e Echocardiography Workshop was run by within our own community of colleagues. e Inaugural National Patient Safety Meet- Dr Michael Gri n and Dr Kathryn Byrne e meeting covered a broad range of topics ing has held on November 17. e KP Moore on the 3rd of March. e Local Anaesthesia including sessions devoted to obstetric anaes- Competition was held in conjunction with for Ophthalmic Surgery Workshop was held thesia, patient safety, anaesthesia and Alzhei- this, and candidates were invited to submit ab- on the 10th of October in the Royal Victoria mers’ disease, neuro-critical care and periop- stracts on the topic of Patient Safety. Eye & Ear Hospital, and was coordinated by erative management of lung diseases. e Irish e KP Moore Medal was awarded to Dr Dr Muhammad Mukhtar. A Di cult Airways Society of Regional Anaesthesia (ISRA) held Martina Melvin for her presentation entitled Workshop was held on the 22nd of September their Advanced Ultrasound in Regional An- ‘Neuro-T, a Smartphone App to aid in the safe and was run by Prof Ellen O’Sullivan and Dr aesthesia Workshop. We also held a Di cult transfer of the Emergency Neurosurgical Patient Caitriona Murphy. Airways Workshop for the rst time. Dan Ses- to Beaumont Hospital’. e best E-Poster prize e Professionalism in Practice Workshop sler, Cleveland Clinic, and Hugh Hemmings, was awarded to Dr Timothy Moore for his pre- was held on the 8th of December and run the rst non-British Editor-in-Chief of BJA, sentation entitled ‘Lipid Rescue Kit’. by the module coordinator Dr Barry Lyons. were the keynote speakers among other inter- e Winter College Lecture was also held ank you to all workshop organizers who national guests. during the Inaugural National Patient Safety kindly dedicate their time to ensure the suc- e Dr Mary Lehane Medal Competition Meeting and was presented by Dr Jannicke cess of these meetings. was held during the Annual Congress on the Mellin-Olsen President Elect, World Federa- As Chairman, I wish to thank all my col- 4th and 5th of May and was awarded to Dr tion of Societies of Anesthesiologists. e title leagues who contribute regularly to the com- Ciara Hayden for her E-Poster presentation of the lecture was ‘Helsinki Declaration on Pa- mittee’s activities, including CAT representa- entitled ‘Perioperative glycaemic control and tient Safety in Anaesthesiology -What is next in tive Dr David Devlin. e ongoing support of its association with post-operative infection in Europe and the World?’. Ms Orla Doran, Administrative O cer and patients undergoing cardiac surgery on cardio- e Gilmartin Lecture was delivered by Dr the President, CEO and Council is as always, pulmonary-bypass (CPB)’. Barbara Dawson is Director of Dublin City warmly appreciated. e Delaney Medal Competition 2017 Gallery e Hugh Lane, the lecture was enti- which took place during the Annual Congress tled ‘Who needs art?’. Donal Buggy, was won by Dr omas for his presentation e Audit Study Day and presentations Prof Donal Buggy, entitled ‘Do supraglottic airways increase the event took place on the 9th of March and was Chair of the CEPD-Congress Committee accuracy of cricothyroid membrane identi ca- chaired by Dr Wouter Jonker. e Audit Priz- tion in female patients? - a prospective obser- es went to Dr Cillian Suiter, ‘Stop Before You vational study’. Block Campaign; Compliance Audit’, who won
ANNUAL REPORT | COLLEGE OF ANAESTHETISTS OF IRELAND
CAO Annual Report_2018_V13.indd 36 22/05/2018 08:33 37 QUALITY & SAFETY ADVISORY COMMITTEE
QUALITY & SAFETY ADVISORY COMMITTEE
The Quality & Safety Advisory (QSA) Lecture which was delivered by Dr Jannicke Mel- Prof Gerry Fitzpatrick Chair, Quality and Safety Committee is a standing committee of college lin-Olsen President Elect of the World Federation Advisory Committee whose overall aims are: of Societies of Anaesthesiologists. e KP Moore medal for the best presentation on • To promote and maintain a culture of patient a topic related to safety was awarded to Dr. Martina safety Melvin – Neuro-T, a Smartphone App to aid in the • To provide leadership for patient safety and safe transfer of the Emergency Neurosurgical Pa- quality of care tient to Beaumont Hospital and Dr Timothy Moore • To provide timely information to support for Best Poster - Lipid Rescue Kit patient safety and quality of care. e Chairman would like to acknowledge the Anaesthetic Activity Audit support of the President, Professor Carson and the Council in progressing the Safety & Quality agenda. e Annual National Anaesthetic Activity Audit for e Chairman would also like to acknowledge the the years 2014 and 2015 was published in 2017. is help and support of the committee members and project jointly sponsored by CAI and the National the College administrative sta . Clinical Programme for Anaesthesia and led by Dr. John Cahill provides key information on anaesthesia Quality & Safety Prof Gerry Fitzpatrick activity nationally and will continue to be developed Advisory Committee Chair, Quality and Safety Advisory Committee and supported by College. Members: Prof Gerry Fitzpatrick Safety Issues and Information Prof David Honan e committee continues to keep members and fellows Dr Jeanne Moriarty informed of important safety issues via regular e-news- letters and safety advisory notices. e committee has Dr Brian Kinirons worked with HSE to ensure implementation of a stan- Dr Kevin Clarkson dardised European cardiac arrest call number (2222) Dr John O’Dea in hospitals throughout the country. e committee Dr Kevin Bailey continues to work on developing the national safety network – Safe Anaesthesia Network Ireland (SANI). Dr Terence Montague Dr Jeremy Smith NAPSAS 2017 Council & Executive e inaugural National Patient Safety in Anaesthesia Symposium was held in November 2017 in the college in conjunction with the European Board of Anaesthe- Committee Meetings siology. e event which was fully booked featured ex- 2017: perts from Ireland, the UK and Europe who addressed 19th January key safety concerns in anaesthesia. e meeting was 31st May opened by Dr Kathleen McLennan, Director of the National Patient Safety O ce in the Department of 20th September Health. e meeting included the Winter College 1st November
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CAO Annual Report_2018_V13.indd 37 22/05/2018 08:34 38 PROFESSIONAL COMPETENCE SCHEME COMMITTEE
PROFESSIONAL COMPETENCE SCHEME PCS COMMITTEE
Prof David Honan, It is my pleasure to provide anoth- meeting/course organisers. We would Chair of PCS er report as Chair of the Professional once again urge colleagues to ensure Committee Competency Scheme (PCS) Commit- that they remain compliant with PCS tee. Much has changed on the PCS requirements, as in the past a small landscape since last year. In particular, number of anaesthetists have been in- several engagements have taken place, vestigated by IMC for failing to engage both with the Forum of Postgraduate with the process. When this happens, Training Bodies and with the Irish there is unfortunately nothing that Medical Council (IMC). We are cur- CAI can do to assist these doctors. rently engaged in a new process with is has been another busy year IMC to optimise our delivery of PCS for CME activity, with high numbers services, in accordance with our agree- of CME/CPD points being approved ment with them originally arranged by CAI for both external courses and under the Medical Practitioners Act College courses. CAI has given a com- 2007. mitment to IMC to continue to make We continue to audit three per cent CME opportunities available to our of our PCS Registrants randomly, as set registrants over the PCS year. We also out in the IMC Agreement. is pro- continue to allow application of ap- cess involves our IT Consultants, who proved overseas CME credits to CAI provide us with a randomly-selected PCS activity. list of names from amongst those reg- As changes to PCS evolve over the istered. Doctors whose names appear coming year, CAI will advise regis- on this list are then contacted by Col- trants of these periodically. In the lege, and requested to submit evidence meantime, any colleagues who require of CME activity. e College reviews further information about the work- these submissions and the doctors in- ings of the existing PCS arrangements volved are contacted to con rm com- may contact the CAI PCS Administra- pliance. In the event that an individu- tor, Ms Sinéad Byrne on sbyrne@coa. al is not compliant, there is a process ie or under the PCS section on the CAI whereby IMC are statutorily noti ed, website. and they then pursue the matter, in their role as regulator of medical reg- Prof David Honan istration. Chair of PCS Committee Just to remind colleagues once again, CAI has decided in the past that Internal CME points may be certi ed by letter from Head of Department, but external CME points still require the production of a designated CME Certi cate, as issued by the appropriate
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CAO Annual Report_2018_V13.indd 38 22/05/2018 08:34 39 CREDENTIALS’ COMMITTEE CREDENTIALS’ COMMITTEE
Credentials’ Committee Members: in the College document “Competence As Chair of the Credentials’ Com- Dr John O’Dea, Dr John O’Dea (Chairman), in Professionalism for Independent mittee, I convened a symposium at the Chairman of the Dr Kevin Clarkson, Dr Deirdre Mc Coy, practice”. Congress in 2017 in order to facilitate Credentials’ Dr Rory Dwyer, Dr Mohammed Faheem, Applicants may be recommend- doctors practising in Anaesthesia in Committee Dr Brian O’Brien, Dr Camillus Power ed for immediate registration where Ireland who might be considering an documentation is complete. e appli- application to the Medical Council for cation form includes substantial and inclusion on the Specialist Register for is is my third report as chair of the veri ed evidence of training including Anaesthesia. Approximately 40 doc- Credentials’ Committee, which met on rosters, logbooks with a breakdown of tors attended. e session provided an two occasions during the year. caseload and structured references re- opportunity for an in-depth discussion e Committee reviews applications quested by the Committee. ere is a on issues facing doctors seeking regis- on behalf of the Medical Council for Service Level Agreement between the tration and some important guidance the purposes of Registration as a Medi- Medical Council and the Postgraduate was provided. We intend to run a simi- cal Specialist. e Committee is guided Training Body, which sets out the time- lar symposium at the 2018 Congress at by the Medical Practitioners Act 2007 lines within which applications must 12.45 on Friday, 25th May. and European Directive 2005/36/EC. be reviewed and determined. e fee e role of e College is advisory e Medical Council usually supports for such applications to the Irish Medi- and the Medical Council makes the - the College recommendation but re- cal Council is €4,000. nal decision on eligibility for inclusion tains discretion in the nal decision. Assessors undertake the assessment on the register of medical specialists. is process allows doctors who have of the applications on behalf of the e Medical Council has an appeals not taken part in the College of Anaes- CAI Credentials Committee. In 2017, process for doctors whose applications thesia National Training Programme the Medical Council referred 11 new are refused. e Committee also assists to demonstrate equivalence of training applicants to the Committee. ese College Council with applications for and experience. Doctors who have rec- completed application forms were for- Ad Eundem fellowship of the College. ognised Specialist Training Recogni- warded to the College of Anaesthetists I would like to thank Ann Kilemade tion within the EU are entitled to apply of Ireland for assessment and recom- on behalf of the Credentials’ Commit- directly to the Irish Medical Council mendation. Following assessment, tee at the College of Anaesthetists for for inclusion in the Irish Specialist reg- the Credentials’ Committee approved her wonderful support and help. ister. one applicant and following Council For further information on how to e Irish Medical Council also ac- approval this was communicated to apply and the detail involved pleased cepts applications from doctors who the Medical Council. e remaining contact the Medical Council for an ap- quali ed from recognised Medical ten applicants were recommended to plication – or refer to http://www.medi- Schools outside the EU. ese appli- undertake further training or provide calcouncil.ie/Registration-Applications/ cations are forwarded to the relevant additional evidence and two of these recognised Training Body for assess- were subsequently approved. Two ap- Dr John O’Dea ment and require a recommendation plications that had been originally sub- Chairman, Credentials’ Committee in a speci ed time from date of receipt. mitted prior to 2017 were re-submitted Candidates are assessed for compe- during the year and were recommend- tence in clinical modules as well as in ed for inclusion in the Specialist Reg- nonclinical competencies as outlined ister.
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CAO Annual Report_2018_V13.indd 39 22/05/2018 08:44 40 INFORMATION TECHNOLOGY AND COMMUNICATIONS’ COMMITTEE
INFORMATION TECHNOLOGY AND COMMUNICATIONS’ COMMITTEE
Dr Miriam Langdon, is year the College has invested in College App will house the Congress Chair of IT & a complete upgrade of IT systems, app, the EPA app and information on Communications’ redeveloping the website, and College events. Inclusion of Fellows Committee expanding national and global access practicing outside of Dublin and to educational meetings. overseas Fellows continues with video links to live college events. CAI Website Redevelopment of the website has College Hardware Support been a major project encompassing Contract and College IT Systems a wide range of functions; it informs Rationalisation and cost e ectiveness trainees and Fellows, manages PCS and are under review over this year with a logbook data and administers for the tendering process underway to ensure exams and training o ces. Each area value for money for IT support. In will comply with GDPR regulation and June 2018 the process of looking at the website content can be updated systems for all departments to replace by administrators within the College. Filemaker will commence and is For continuity, the new system is expected to be a two to three year integrated with Filemaker so all project. e boardroom audiovisual integrated features from the old system systems are currently being updated are available to it. e Safety button for improved quality and accessibility. has been an important step forward e President, Kevin Carson; the COO, in disseminating updates on patient Margaret Jenkinson and the CEO, safety and Prof Gerry Fitzpatrick has Martin McCormack have driven these championed this advance unfailingly. projects to completion with vision and e new website designed by JET determination. I would also thank the Design will be ready to go live in the College Council members and the CAI second quarter of this year following departments for their support and testing and feedback. It is modernised, work towards the complete upgrade of practical and future-proofed and we the College IT projects. think it will make a real contribution to your professional development and Dr Miriam Langdon, governance. Chair of IT & Communications’ Committee CAI App and Educational Events Each year so many delegates have planned their conference schedules using the Congress app. is year the College App expands that opportunity to engage with Fellows about all educational events and meetings. e
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CAO Annual Report_2018_V13.indd 40 22/05/2018 08:34 41 COMMITTEE OF ANAESTHESIA TRAINEES CAT
COMMITTEE OF ANAESTHESIA TRAINEES CAT
e past year has been a period of along with the cycle raised €2,800 for and are very grateful to Ms Ann Kile- Dr David Devlin, growth and development for both the charity. made and Dr Power of the Training Chair of Anaesthesia Committee of Anaesthesia Trainees I must take this opportunity to sin- Department for the opportunity to Trainees Committee and the College in general. I must cerely thank Ms Orla Doran of the engage on this issue and the hours of commend the College with regard to College; I have been plaguing her for gra that they have put in to this proj- its ardent engagement of trainees and two-years now on the CAT, and she has ect, assessing all the permutations and our issues at every level of the organ- always been so helpful, so well organ- combinations of placements, making isation. e support and engagement ised and so approachable – none of the them as fair and equitable as possible. with trainees on a wide variety of is- events that we organise or participate We also undertook work with the sues is of key important to trainees in would be possible without her con- Training Committee in relation to the and the College alike. e College tinued diligence and hard work. formalisation of the position and ap- continues to pave the way for other plication procedure for Special Interest Post-Graduate Training Bodies in the Communication with Trainees Years and Fellowships in Irish hospi- way in which it works with and for tals. is has streamlined the applica- e Lead Anaesthesia Trainee (LAT) trainees. tion process and will mean that rota- network is now well established as a tions are known further ahead of time port of call for direct communication than previously. CAT Calendar from teaching departments around the An update to the logbook system is We continued to run and grow our country to the CAT and the College in afoot in the College, with contributions repertoire of events over the past year; general. I am very grateful to the hard to this valuable trainee portfolio sys- making contributions to the Anaes- work that Dr Moran put into keeping tem being made on behalf of trainees thetics Induction Day for new train- the LAT network alive and active over through the Committee by Dr Ving- ees, helping to give them an introduc- the past year. ares. tion to the training scheme; we also Special mention must go to Dr Ving- One of the key issues a ecting train- attended the National HSE Careers ares, who edited the CAT Newsletter ees today is fatigue and burnout. I must Day (special thanks to Drs Owens, again this year. We published a quar- commend Dr Kelleher for his active Purcell and Singleton), extoling the terly bulletin on trainee issues, such work and engagement as a co-opted bene ts of a career in Anaesthesia, In- as fellowship opportunities, case re- member, representing us at the Irish tensive Care and Pain to medical stu- ports, and updates from the College. Standing Committee and Group of dents who attended from around the is year we updated the distribution Anaesthesia Trainees in the AAGBI. country as well as to the College Open methods of the newsletter to increase He has undertaken work on fatigue in Day, held annually in November. its circulation and impact. the Irish context and highlighted the Again, this year, the committee has issue as one of the utmost import. As a participated in the organisation of Trainee Issues result of this work, the College has en- an Interview Skills workshop, which e College actively engaged with the dorsed the Association’s guidelines and continues to be one of our most pop- CAT in relation to changes to the way policy in relation to fatigue amongst ular events, and the development of in which rotations were distributed anaesthetists. a symposium session at the College’s and developed and accepted points of Following the Bawa-Garba case Annual Scienti c Meeting. We intend feedback throughout the process. We in the United Kingdom, the College to run our now famous Fun Run event welcome the new approach and trans- has made moves to address the issues again this year – last year this event, parency to the division of placements
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CAO Annual Report_2018_V13.indd 41 22/05/2018 08:34 42 COMMITTEE OF ANAESTHESIA TRAINEES CAT
CAT Members Dr David Devlin, Chair Dr Peter Moran Dr Gabriel Beecham, Vice-Chair Dr Andrew Purcell Dr Sinead Farrell, Treasurer Dr Eoin Kelleher Dr Georgina Duignan Dr Barry Singleton Dr Sinead Egan Dr Camilius Power Dr Mark Owens Ms Ann Kilemade Dr Joao Vingares Dr Martina Melvin
surrounding supportive training and well as participating as facilitators at Conclusion re ective practice. A Hot Topics eve- the Tutor Training Day. I would like As I alluded to previously, much of the ning is planned for late April; and it is to thank Drs Josephine Boland, Eilis work, activities and projects undertak- hoped that a position statement from Condon and Camilus Power for their en by the CAT would not be possible the College will be forthcoming from continued hard work on the proj- without the continued and on-going this meeting. I must thank Mr Martin ect. It represents an important step support from the sta at the college, McCormack, the College’s CEO for forward in the way in which we, as and I must thank Lauren Donohue for his work in this matter. It remains to trainees, will develop our skills port- all of her e orts over the last year. be seen how the Bawa-Garba case will folio in the years ahead. I would also like to thank Prof Kevin impact on Irish clinical and education- is year the Specialist Anaesthesia Carson, Mr Martin McCormack, Dr al practice, and we will continue to Trainee Audit and Research Network Brian Kinirons, Dr Camillus Power represent trainees’ interests at College (SATARN) succeeded from the aus- and Dr Anne Hennessy and the oth- and national level in this issue going pices of CAT and is now headed by er members of Council for all of their forward. Dr Pierce Geoghgan. Its continued support, tips, winks and nods over the Mr McCormack has also raised development represents an important last year; steering me in the right direc- several trainee issues with the HSE di- step for trainee research opportunities tion (from time to time!). I am grateful rectly, such as P45 delays, centralised in Ireland, and we wish them every to have had the opportunity to work payroll and course refunds; and we are success with their on-going projects. with you all. grateful for his e orts on these issues. Dr Sinead Farrell has undertaken As I step down from my role as chair e Entrustable Professional Ac- work in relation to the improvement of CAT, I would like to thank Ms Mar- tivities project continued to grow and of patient safety during transport of garet Jenkinson for keeping us out of develop this year. e College aims to the critically ill patient, having at- the red. To the chairs of the other Col- move to a more robust system of low- tended courses and conducted sur- lege Committees, almost too numer- stakes workplace-based assessments veys of trainees in relation to their ous to name, I am grateful for the op- over the coming years. We have been experiences. I am hopeful that her portunities you have a orded CAT to actively involved in the project, provid- project will bear fruit over the com- participate in your respective projects ing feedback, and questioning logic as ing year. and decision-making processes. I wish the incoming committee, of which there will be seven new mem- The College actively engaged with the CAT in relation to bers following election, the very best of luck with their endeavours and proj- changes to the way in which rotations were distributed and ects over the coming year. developed and accepted points of feedback throughout the Dr David Devlin, process. We welcome the new approach and transparency Chair of Anaesthesia Trainees to the division of placements Committee
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CAO Annual Report_2018_V13.indd 42 22/05/2018 08:35 43 JOINT FACULTY OF INTENSIVE CARE MEDICINE OF IRELAND JOINT FACULTY OF INTENSIVE CARE MEDICINE OF IRELAND
e Board met on four occasions, Dr Jeanne Moriarty, Tenure of the Dean February, June, September and FFARCSI, FJICMI, and Board Members FRCA, FAMM (Hon), November 2017 e Board agreed to extend the ten- Dean JFICMI ure of the Dean to three years and Honorary Oicers Establishment of the the Board members to ve years, re- Dr Jeanne Moriarty Dean Specialist Register in Intensive newable by election for a further ve Care Medicine. Dr John Bates Vice Dean years. e changes have been incor- Discussions continued through 2016 porated into the Memorandum and Dr Vida Hamilton Honorary Secretary with the IMC culminating in sub- Articles of Association. Dr Maria Donnelly Honorary Treasurer mission of its specialty training pro- Dr Andrew Westbrook Chair Examinations, gramme for accreditation to the IMC Examinations Representative to EDIC Board. in September 2016. In September Dr Andrew Westbrook continued as 2016, JFICMI met with Professor Eilis Dr Brian Marsh Chair Training Chair of the Examinations Committee McGovern of the National Doctors’ and the JFICMI representative to the Dr Michael Scully Accreditation Training O ce, who agreed that the EDIC committee. e Fellowship Exam- HSE would fund 14 trainees in Inten- Dr Donal Ryan CPD ination of the JFICMI was held in May sive Care Medicine over a two year Dr James O’Rourke Webmaster 2017. Ten candidates sat the examina- programme from July 2017. e JFIC- tion of whom eight were successful. e Dr Martina Healy Paediatric Intensive Care MI Accreditation team met with the successful candidates listed below will be Mr Lars Nolke RCSI IMC Accreditors in January 2017. Fol- conferred in May 2018. Dr Ted Keelan RCPI lowing this meeting there was further engagement with the IMC through Training Dr David Hickey Lay Member 2017 with submission of a revised ap- Dr Brian Marsh is Chair of the Dr Sinead Egan Trainee representative plication, addressing the comments of Training Committee. Drs Brian the IMC team. At the time of writing Dr Lindi Synman Trainee representative Marsh and Enda O’Connor under- this report the process is close to being Dr Kevin Carson President CAI took a review of the training syllabus nalised and have written a revised curricu- Dr Catherine Motherway President ICSI Opening the Specialist Register in lum, which formed the major part of Dr Michael Power NCCP Intensive Care Medicine is dependent the submission to the IMC Accredi- on accreditation of the training pro- Dr Dermot Phelan, Co-opted tation Review team. gramme as the training programme is the benchmark against which a Level 5 Education In attendance assessment will be made for applicants Dr Donal Ryan is convenor of the Mr Martin McCormack CEO CAI to the Specialist Register in Intensive Refresher Courses. e Faculty is Ms Ann Kilimade CAI Care Medicine. Graduating trainees partnering with the ICSI Annual will be entered onto the Specialist Reg- Ms Rebeca Williams Scienti c Meetings. ister through the completion of Spe- cialist Training. All other applicants Honorary Fellowship Outgoing Council Members: will have to undergo Level 5 assess- Professor Martin Tobin was con- Dr John Bates ment. ferred with an Honorary Fellowship e College of Anaesthetists has Dr Maria Donnelly in June 2017 at the Annual Scienti c agreed to be the Training body with- meeting in Belfast in recognition of in which the Faculty exists for gover- Mr David Hickey joined the Board in his contribution to pulmonary criti- nance purposes. 2017 as our rst lay member. cal care.
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CAO Annual Report_2018_V13.indd 43 22/05/2018 08:35 44 JOINT FACULTY OF INTENSIVE CARE MEDICINE OF IRELAND
Accreditation National Critical Care in January 2017. I would like to ac- Beaumont Hospital was inspected in Programme Report to the knowledge her contribution to JFICMI 2017. e Board recommended that it Board - Dr Michael Power during her 9 years in the College. Ms be approved for one year’s ICM train- Dr Michael Power, National Clini- Ann Kilemade and Ms Rebeca Wil- ing. cal Lead, is a co-opted member of liams provided our administrative sup- the Board. He has kept JFICMI ap- port in 2017. e Examinations O ce Website praised of HSE developments. continues to support both the Fellow- ere was further development of the e Medical Advisory Commit- ship examination of the Joint Faculty website with the trainee logbook com- tee to NCCP is chaired by the Dean and the European Diploma in Inten- ing on stream. Dr James O’Rourke has of JFICMI sive Care Medicine. On behalf of the taken on responsibility for managing Board I would like to thank the sta of the website, assisted by Dr Dermot National Oice of Clinical Audit the College of Anaesthetists, who sup- Phelan. (NOCA) port the work of the Faculty. Dr Rory Dwyer chairs the Intensive Finance Care Audit Governance Group in e Joint Faculty would also like to Dr Maria Donnelly continues as Hon- NOCA. e roll out of the national thank Board Members, Course organ- orary Treasurer with her term nish- audit of Intensive Care continues. isers, faculty and indeed participants ing in 2018. Fees were set at €180 for Reporting commenced in 2017. for contributing to another vibrant and consultants, €90 for overseas members e Dean represents the JFICMI e ective year. with Trainees of the CAI, RCPI, RCSI on the NOCA Governance Com- (incl EM) wishing to become a reg- mittee, the Major Trauma Audit Dr Jeanne Moriarty, FFARCSI, FJIC- istered trainee of the JFICMI – €100 Governance Group, National Au- MI, FRCA, FAMM (Hon) once o payment. dit of Hospital Mortality and the Dean JFICMI Members in good standing are enti- Intensive Care Audit Governance tled to 1 free Refresher course, 10% re- Group. duction in meeting fees and free online learning. Sta JFICMI accounts are audited as part Ms Maria Golden, Senior Admin- of the CAI nancial audit. istrator for the Board resigned
Successful JFICMI Candidates-2016 JFICMI Events
Immanuel Hennessy John Fitzgerald Pre-exam courses: Aoife Quinn Michelle O’Mahony 2017: MMUH 1st March Laura Flood Bill Walsh St Vincent’s University Hospital 2th March St James’ Hospital 3rd March Bairbre McNicholas Aoife Lavelle Critical Care Refresher Courses: 2017: COA 27th April COA 21st September
Irish Donor Awareness Programme: 2017: COA 25th April
Basic Critical Care Echocardiography Course: 2017: MMUH March 29th - 30th MMUH November 16th – 17th
Joint ICSI- JFICMI Annual Scientific Meeting 2017: June 9th - 10th Belfast
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CAO Annual Report_2018_V13.indd 44 22/05/2018 08:35 45 FACULTY OF PAIN MEDICINE
FACULTY OF PAIN MEDICINE
e Faculty held four board meetings he made to the board with particular Professor Connail during the year. e Annual Scienti c reference to his teaching on the FPM McCrory, Chair Meeting was held in the College of An- training courses regarding addiction. of Faculty of Pain aesthetists on the 10th February (113 e exam revision course was held Medicine in attendance) and e Royal College in the college in May with a demon- of Physicians on 11th February (180 stration in the TCD Anatomy lab. in attendance). Professor Andrew Rice e external examiner was Dr Shy- was awarded the Rynd Medal and de- am Balasubrahanian from Birming- livered the Rynd Lecture. ham, UK. Dr Shyam Balasubrahanian e Clinical Research Medal in delivered a lecture on optimising an- Pain Medicine competition took place. algesic selection in the management Five submissions were shortlisted and of chronic pain as part of the Summer Professor Rice was the adjudicator. Dr Faculty meeting. Jonathon Royds from St. James Hospi- Work continues on the IMC submis- tal was awarded the Clinical Research sion document. It is hoped to conclude Medal in Pain Medicine. e confer- this process in 2018. ring ceremony took place in the Col- e interview for the National lege of Anaesthetists. Training Scheme in Pain Medicine was Fourteen candidates had sat the Part held in December in the College. One 1 FPM exam and seven were success- appointment was made to the SIY pro- ful. Four candidates had sat the Final gramme and three to the Fellowship FPM exam and three were successful. programme. is interview process Dr Hugh Gallagher completed his was the most competitive yet. term of o ce on the FPM board as ICGP representative and will be re- Professor Connail McCrory placed by Dr Ide Delargy in 2018. e Chair of Faculty of Pain Medicine board expressed thanks to Dr Galla- gher for the signi cant contribution
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CAO Annual Report_2018_V13.indd 45 22/05/2018 08:35 46 SIMULATION TRAINING CAST
SIMULATION TRAINING CAST
Dr Crina Burlacu, Mandatory simulation courses We delivered the annual A-Crisis Awards, Presentations Director of CAST for SATs and other simula- for Consultants, which was attended and Publications Programme tion-based educational events by seven consultants. e Train the At the Education Awards 2017, the Trainer Simulation Instructors Course ree hundred participants took submission with the title ‘ e College proved to be very popular again, and part in 33 simulation courses in 2017 of Anaesthetists Simulation Training was attended by a record number of 19 (Table). e vast majority of these Programme – Activity and Quality participants belonging to multiple dis- courses took place in the College of Report 2010 – 2016‘ was nalist under ciplines and specialities. Anaesthetists Simulation Centre, both Best Student Experience Awards and were attended predominantly by and Best Use of Educational Technolo- SATs. We also trained a small num- gy/ICT Initiative of the Year categories. ber of CPD-SS doctors and Interna- MCAI OSCEs Several scienti c abstracts were ac- tional Fellows. In 2017, at the request of the Exam- cepted and presented at international Simulation continued to be a very ination Chair and Committee, we meetings as in the following: well received component of several introduced new screen-based Simu- other internal and external education- lated Monitoring (SM) and Critical Society in Europe for Simulation al events such as the Introduction to Incidents (CI) OSCEs at the MCAI Applied to Medicine (SESAM), 2017. Anaesthesia Course, Di cult Airway examination. ese OSCEs are using 1. Sim is stressful! What is the inci- Management Course, Foundation state-of-the-art ALSi machines, special dence of stress experienced in med- Course for Anaesthesia and Recovery scripts and marking sheets, which were ical simulation training, and does Nurses, Anaesthesia Information Day designed, piloted and validated by the the perceived stress of participants and Medical Careers Day. CAST team during simulation negatively a ect
COURSE NAME NUMBER OF NUMBER OF VENUE: CAST CENTRE COURSES PARTICIPANTS Anaesthesia Emergencies (AE) 3 29 Anaesthesia Related Rare Emergency Simulation Training (ARREST) 7 62 Paediatric Anaesthesia and Emergencies (PAE) 3 34 Crisis in Obstetrics Anaesthesia Simulation Training (COAST) 4 45 Simulation in Intensive & Critical Care (SICC) 2 30 Multidisciplinary Anaesthesia & Surgery Crisis Operation Training (MASCOT ONE) 4 23 Multidisciplinary Anaesthesia & Surgery Crisis Operation Training (MASCOT TWO) 4 17 A-Crisis 4 41 Clinical Decision Making Paediatrics (CDMP) 2 19 Total 33 300
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their learning experience: an evalu- three-member wireless SimFAMILY In the second part of 2017, half of the joint ation of the literature. Poster Presen- to the College (SimMan 3G, SimMom tation. Elizabeth Coyle, Aine Ca er- and SimJunior). CAI-RCSI MASCOT courses were for the key, David Greaney, Crina Burlacu. Under the vision and leadership first time delivered in the RCSI National 2. e Evaluation of a Pilot Simula- of the President, Prof Kevin Carson, tion-Based Critical Incident Station we have embarked on a very exciting Surgical Training Centre. Our CAST Faculty in a National Postgraduate Anaes- project, which involves the expansion thesia Examination. Poster Presen- of the simulation space. As I write this and Nurses were present in York Street to tation. Aine Ca erkey, Elizabeth report, the third oor of the Education support the delivery of these courses. Coyle, David Greaney, Ruth Fla- and Clinical Science Building is under- herty, Deirdre McCoy, Anne Hen- going major renovation. e new sim- nessy, Crina Burlacu. ulation area will include two simula- 3. Simulation as a necessary and suit- tion bays (Intensive Care and Obstetric able vehicle for maintaining con- Ward), a control room and an obser- dence in paediatric anaesthesia vation/tutorial room. e new area will following paediatric anaesthetic be equipped with state-of-the-art IT training. Oral Presentation. Greaney and audio-visual technology. e Sim- D, Ca erkey A, Coyle L, Burlacu C, FAMILY is moving in new housing! Bourke M, Harte S. e latter ab- Ms Louise Kelly is just aer leaving the stract went on to publication in Ad- Collaboration programme to dedicate more time to vances in Simulation 2017, 2(Suppl In the second part of 2017, half of her family. Louise has brought a major 1): 26. the joint CAI-RCSI MASCOT cours- contribution to the development, im- es were for the rst time delivered in plementation and delivery of the CAST European Society of Paediatric the RCSI National Surgical Training programme over a seven-year period. and Neonatal Intensive Care Centre. Our CAST Faculty and Nurses She has supported me personally as (ESPNIC), 2017 were present in York Street to support well as Course Leads, Faculty, Fellows 1. Con dence following paediatric the delivery of these courses. and nurses with her professionalism, ICU simulation training in Ireland On a similar note of collaboration assiduousness and friendship. from 2010-2016, a semi-quantita- and partnership, Dr Crina Burlacu A special thank you goes to our Sim- tive retrospective analysis. Poster co-delivered a workshop with the title ulation Fellows: Dr David Greaney, Dr Presentation. Greaney D, Burlacu C, ‘Simulation faculty recruitment, de- Aine Ca erkey, Dr Elizabeth Coyle, Dr Harte S. velopment & retention’ at the Irish As- Aoife Lavalle, Dr Montasser Ghazy and At the time of writing this report, I sociation for Simulation Symposium Dr Ruth Vaughan. I wish to welcome am also delighted to report that ‘ e 2017, which took place in ASSERTS Ms Sinead Byrne who joined our team College of Anaesthetists of Ireland UCC. She was invited to chair a session in 2017 in an administrator role. Simulation Training programme: a de- and co-judge posters at the Northern Finally, I would like to thank Prof scriptive report and analysis of course Ireland Human Factors and Simulation Kevin Carson, Mr Martin McCor- participants’ feedback’ has been pub- Network (NIHFSN) meeting in Belfast. mack, Ms Margaret Jenkinson and all lished in the Irish Journal of Medical the other College sta for their con- Science. To read the full paper in .pdf Acknowledgments tinuing collaboration and support. format interested readers should go to Firstly, I would like to acknowledge http://rdcu.be/JwY5 the unconditional and expert support Dr Crina Burlacu, of our Course Leads and Simulation Director of CAST Programme Development and Equipment Faculty, which continues to make the In 2017, the CAST programme was CAST programme possible. successful in securing funding from Secondly, I would like to extend my HSE-NDTP for the purchasing of special thanks to our nurse assistants new high- delity simulation equip- Ms Louise Kelly and Ms Deirdre Fly- ment. We are delighted to welcome a nn. At the time of writing this report,
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CAO Annual Report_2018_V13.indd 47 22/05/2018 08:36 48 EVENTS
EVENTS & CEREMONIES
MEMBERSHIP EXAMINATION MEDAL LEFT: Prof Kevin Carson, President, College of Anaesthetists of Ireland and Dr Eoin Kelleher Membership Examination Medal Autumn 2016
COLLEGE OF ANAESTHETISTS AUDIT PRACTICE EVALUATION STUDY DAY TH MARCH ABOVE LEFT: Dr Michael Carey, Dr Murray Connolly, Dr Maeve McAllister ABOVE RIGHT: Dr Diana Iosif, Dr Mohamad Faheem, Dr Cillian Suiter, Dr Grace Donnelly, Dr Alan Griin
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FPM ASM ABOVE: Dr Romana Durrani, Dr Brendan Conroy, Vice Dean of the Faculty, Dr Aine O’Gara winner of the Faculty of Pain Medicine of Ireland Clinical Research Medal, Prof Connail McCrory, Dean of the Faculty of Pain Medicine CAI, Prof Ralf Baron who delivered the Rynd Lecture, Mr Bernard Kennedy Mundipharma
GALA DINNER ABOVE: Mr Martin McAleese, Prof Kevin Carson, Mrs Mary McAleese & Mr Oliver Wang BELOW: Dr Tom Ryan, Dr Robert Whitty; Dr Stephanie Ryan & Dr Phillip Hu
ABOVE: 2017 CAT Fun Run
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LEFT: Dr Waleed Omer Ahmed, Dr Anne Hennessy, Vice President, College of Anaesthetists of Ireland, Dr.Janette Brohan, Dr Mohamed Omar Beleil who received their Certificate of Specialist Training.
BELOW: Prof Kevin Carson, President, College of Anaesthetists of Ireland, Prof David Scott who received Honorary Fellowship of the College.
ABOVE: Dr Ravi, Dr Dilip Malkan, Dr Abdul Razaq, Dr John Shaker, Dr Lubna Shaheen.
CORE TOPICS DAY ABOVE: Dr Leo Kevin, Dr Josephine Boland, Dr Enda Shanahan, Dr Briony Berry, MSD, ABOVE: E Poster Presentations at Congress 2017 Dr Críona Walshe, Dr Harry Frizelle, Prof Donal Buggy
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AUDIT STUDY DAY ABOVE: Dr. Saleh Alabri, Dr. Ahmed Abu-Draz with ABOVE: Dr Sinead O’Shaughnessy, New ABOVE: Dr Cillian Suiter, Winner Best Oral Dr. Jeanne Moriarty, Chair of Research, Audit and Fellow and Dr Fiona Roberts with Dr Presentation, Dr Anne Hennessy, Vice-President, Innovation Committee, Dr. Fatma Ali Al-Hinai, Dr. Rachael Cusack who received their CAI, Dr Wouter Jonker, Audit Study Day Khalil Al Rawahi, Dr. Said Almunthari, Dr. Khalid Membership of the College. coordinator, Dr John Cahill, Presentator and Judge. Al Rhwahi.
OPENING OF THE WILLIAM BLUNNIE LECTURE THEATRE ABOVE: Prof Kevin Carson & Dr William Blunnie at the opening of the William Blunnie Lecture Theatre in December 2017 BELOW LEFT: Prof Kevin Carson presenting flowers to Mrs Monica Blunnie BELOW MIDDLE: Dr Josephine Boland, Mr Martin Ryan, Dr Crina Burlacu, Dr John Cronin and Dr Eilis Condon BELOW RIGHT: Dr Anne Hennessy, Mrs Marie Treacy, Prof Ellen O’Sullivan & Mr Joe Treacy
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CAO Annual Report_2018_V13.indd 51 22/05/2018 08:36 52 EDUCATION CALENDAR EDUCATION CALENDAR
January February March April
· 23rd February · 9th March · 16th April Faculty of Pain Medicine, The Regional Anaesthesia Update 2018 & CAT Consultant Interview Annual Francis Rynd Lecture, CAI Ultrasound Workshop, CAI Workshop, CAI · 24th February · 19th & 20th April Faculty of Pain Medicine ASM, RCPI Beyond BASIC, CAI · 19th & 20th April ICSI BASIC Course, Dublin (date TBC) · 27th and 28th April Western Anaesthesia Symposium, Knockranny House Hotel, Westport, Co Mayo
May June July August
· 24th & 25th May · 8th June Annual Congress of Train The Trainer Simulation Anaesthesia and Annual Instructors Course, CAI Dinner, Dublin Castle
September October November December
• 26th September • 8th – 12th October • 16th November • 14th December Irish Pain Society, Annual Scientific 20th Dingle Conference, Current National Patient Safety Conference, & A Crisis Simulation Course for Meeting, Dublin Controversies in Anaesthesia & KP Moore Medal Presentations, CAI Consultants, CAI • September Peri–Operative Medicine, Dingle, • 17th November • 14th December Echocardiography Workshop, Mater Kerry Irish Standing Committee Meeting, ISRA Consultant Foundation Hospital, Date TBC • 13th – 17th October Venue TBC Workshop, CAI • 12th – 15th September ASA, San Francisco, USA • November • 7th December 36th Annual ESRA Congress, • 19th October Local Anaesthesia for Ophthalmic Gilmartin Lecture, CAI Date TBC Convention Centre Dublin Di icult Airways Management Surgery Workshop, Royal Victoria Eye & • 26th – 28th September Workshop, CAI Ear Hospital, Dublin, Date TBC AAGBI, Annual Congress, Convention • 3rd November Centre Dublin Intern/Medical Student Anaesthesia · September Information Open Day, CAI Core Topics Day, CAI TBC • November Professionalism in Practice Workshop Date TBC • 16th November National Patient Safety Conference, KP Moore Medal Presentations & WCL, CAI • 17th November Irish Standing Committee Meeting, CAI • 22nd & 23rd November ICSI BASIC Course, CAI
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