|Stepping up to the challenge|
|Friday, 23 November 2012|
Surgeons’ News Editor John Duncan speaks to RCSEd’s new President Ian Ritchie about the priorities and opportunities of the next three years
The new President is no stranger to the College. An Orthopaedic Surgeon in Stirling, he was first elected to Council in 2000 and chaired ICBST from 2004 to 2007. In the College he was Director of Training for seven years and has been Vice-President for the last three years. It is a long time since an Orthopaedic Surgeon has been President, the last was Sir Walter Mercer in the 1950s. I recently interviewed Ian and asked the questions which Fellows and Members had suggested to me.
JD: Ian, you are about to embark on your period as President. What do you hope the College can achieve during those three years?
IR: The most important thing for me is increased contact with Fellows and Members and I hope to do that through visits to regions and meeting face-to-face. In the UK the important regional visits programme is already well underway and I would hope to encourage further development of the Regional Surgical Advisor activity to help to achieve this contact. On a wider front, as well as supporting our International Fellows and Members, we need to enhance our international presence and develop our activity in partnership with institutions and individuals with whom we have existing relationships. It will also be important to develop new partnerships within the context of the College’s strategic priorities.
IR: For the College the biggest challenge is to prove its relevance to the Fellows and Members and to persuade young surgeons to join the ‘friendly college’. We also need to maintain intercollegiate contacts in an era when national politics and economic stringency have potential to drive a wedge between surgeons working in different parts of the British Isles. For the profession we need to recognise that, along with the obvious and exciting changes in treatments and techniques, there are fundamental changes occurring in the structure of the NHS which will affect the way we practice each day.
Our relationship with other surgeons and with trainees, as well as all the other healthcare professionals who work with us and care for our patients, have changed. If we do not lead in that process of change then we will have change forced upon us by others. We have to continue the surgical tradition to seek the best for our patients by cooperation and in some cases compromise, but at all times we should think of the 500-year-old tradition of maintaining standards.
IR: The pressure on time to do College activities is a real problem, but the Chief Medical Officers of the Four Nations have written in support of individuals’ efforts to undertake College activities. It is up to the College to demonstrate, through the outcomes of our activities, that we are contributing effectively to training the next generation of surgeons. We all need to work towards the development of an effective surgical workforce to respond to challenges of the future, positively and pro-actively.
IR: This is but one example of the effects of change on the way that we have operated in the past. Medical students are coming into surgical training with a heavy burden of debt and are now faced with an increase in the training fee to JCST as well as the costs of obligatory courses and examinations. This is unpalatable, but there is no doubt that the Colleges are unable to continue to fund this fee for very long from existing resources. While other sources for the funding have been discussed by the College Presidents, the unvarying response has been that the beneficiary should pay. In the longer term this may well be correct, but it does not alter the immediate pain for the current generation of trainees.
The structures in place to support training are second to none so the shortfall must be addressed so that the future of surgical training is secured in an affordable way. Individual Colleges will have their own contributions to solving this problem. RCSEd is looking at ways to help ease the burden but, ultimately, any contribution that the College makes now will represent a further burden on the Fellowship in the future. A long-term view is essential in these matters.
IR: The professional activities of the College are the primary reason for our existence and all other activities are in support of that work. It is a matter of pride for me that our College has managed to get the balance right through the foresight, courage and initiative of Office Bearers, Trustees and staff. I believe that the balance of our commercial and heritage activities is correct and that the balance will continue to be correct in the future because the governance of the college will ensure that such matters are continually kept under review.
Any institution which has been in existence for as long as the College will have a legacy of buildings and artefacts which it needs to maintain and add to for posterity. I believe that we have a good balance in these matters. The Museums and holdings of the College are a fabulous resource for surgeons and the public alike. Under the guidance of the Director of Heritage and the Heritage Board, the College is continually striving to make the contents of the Museum and our buildings available for the public so that they can view the long transition from sixteenth century medicine to the exciting developments of twenty-first century surgery and have an insight into the contribution of Edinburgh and Scotland to the worldwide delivery of high standards of surgical care. There is little choice in this so we have to ensure that we hand the Heritage on to the next generation in good shape.
IR: This is a special relationship which the College values. Both institutions have addresses in Edinburgh but a worldwide reputation for excellence. I believe that this relationship should be fostered to the benefit of both. The obvious benefits are the ESSQ and the further development of the ChM in General Surgery, T&O and Urology are examples of a flowering of ideas and initiatives. I anticipate that this will continue and the immediate objective is to enlarge the number of specialties in the ChM programme. I have confidence that this will encourage new initiatives in the future.
IR: This is where it becomes personal – a bit more difficult. These will be great and far-reaching. In effect, I will be unable to continue to deliver the service to patients in Forth Valley which has been my privilege over the past 20 years. However, I have a team of colleagues from Stirling and Falkirk who have uncomplainingly supported me through many years of College-related work. I am grateful for that continuing support.
While I will continue with a limited practice, I see that the role of President will demand a lot of time away from Stirling with the need to further develop other skills beyond the familiar surgical ones. Communication remains as important in this new role as ever it was with my patients. I expect that I will do rather more travelling than had been the case previously. I have been supported by my long-suffering wife Alyson. In the adage that behind every prominent man there is an astonished wife is very true in my case. I will have to make good use of my time at home and relax and de-stress, but I have not got very far on that aspect of planning to be honest.