2016 Medical Conferring Address by Dr. Rob Landers

27 May 2016

UCC's School of Medicine waved goodbye to 203 students' this afternoon as they enter a new life as doctors, surgeons and clincians.  Dr. Rob Landers, Chief Clinical Director SSWHG & Surgical Pathologist UHW Ireland delivered the conferring address:

"I would like to begin by congratulating you all on your great achievement. Today, after many years of hard work, after long hours of study at school and university, and long hours of duty in different clinical settings and I have no doubt, more than a few anxious moments, you can truly celebrate with your families and friends who have supported you along the way. This is a day to remember and cherish.

Today you enter one of the oldest, most rewarding, most demanding professions on this earth. All of the great civilizations of our world – European, Arab and Oriental – can point to great figures in their past who have advanced our knowledge of human health and disease. You are now the inheritors of those traditions and in the future you will each contribute in your own way to this great profession of medicine.

You have been awarded a degree by one of the best medical schools in the world. Medical graduates from UCC work in virtually every major teaching hospital in the developed world at the highest levels.

I hope you are excited by it; I hope you are a bit scared by it; I hope you are challenged by it; most of all, I hope you are humbled and inspired by it. 

Collegiality

During these past years you will have developed friendships among your classmates, friends who have stood by you and helped you through difficult times. Today these friends become your professional colleagues. As you progress through your post-graduate training others will join their ranks. Professional colleagues are those who have the knowledge and ability to advise and support you when your own ability as a doctor is put to the test. Developing professional relationships where you are able to give and receive trust in difficult and stressful situations is crucially important if you are to grow into good doctors.

Although we doctors carry great individual responsibility for our patients, it is best that we exercise that responsibility within a broad network of trusting professional relationships rather than in isolation.

Fragmentation of the Profession

Keeping the patient at the center of your thought and practice will also help you to resist the insidious tendency of modern medicine to fragment into a myriad of independent specialist interest groups where there is a risk that narrow  sectoral interests could divide us.

It is a source of regret of mine to see the development and fragmentation of associations and representative bodies into smaller more specialist groups. We must always respect each other and appreciate our diverse roles and career pathways. The neurosurgeon operating on a head trauma case in the middle of the night is no more or less important than the clinical geneticist working out complex molecular pathways in the research laboratory or the general practitioner managing a difficult patient with chronic diabetes.

All of our specialties meet in the patient and everyone of us has our own role to play in delivering patient care. If we can all agree on that, then we can become effective and powerful advocates for our patients. This is a critically important role  for all doctors – that we advocate for our patients first and ourselves second..

Making the right choice

As I’ve already alluded to, medicine is one of the most diverse professions in the world. You will find doctors working in hospital wards, in surgical theatres, in laboratories, in diverse communities in urban and rural settings, in academia, in public health and policy making…

I envy you now as you try and decide in which direction to take your career.  The choices are vast and each can be as fulfilling and challenging as the next.  Do not be constrained by the traditional career pathways and don’t be afraid to try alternative ones. Medical graduates are now being employed in business, engineering, ICT and other sectors all of which lead to successful and enjoyable careers. The secret is to discern where your own personal and intellectual gifts lie and choose a career that allows you to develop those gifts in the service of your profession. We can’t all have the perfect bedside manner and some never will – no matter how hard they try

Irish medicine has a strong track record of recruiting senior doctors to return to these shores after having trained in the very best hospitals all over the world. It is this diversity of international experience that has sustained our healthcare system and helped it develop in decades past. I would like to believe that you will all return after higher training in Ireland and abroad to find fulfilling careers in the Irish health service.

But lets face it - many of you won’t.  

The truth is that our Irish health service is near breaking point. 

Successive governments and administrations have rather cynically undermined and attacked the profession to the point where Ireland now has difficulty in attracting junior doctors to train in our system and in attracting senior doctors to return to Ireland after having gained some experience abroad.

It is depressing that we now seem to be training a significant proportion of our new graduates for permanent export.

Do not get me wrong – I strongly encourage all of you to go abroad and work in different jurisdictions and in different healthcare systems.

But I want you to come back! I want you to bring that experience and knowledge back to us here so that we can all work together to deliver the very best healthcare to our people and our communities.

All of us have to work hard to convince our policy makers of the value of highly trained medical professionals, not only in operating the health service but in leading, directing and developing it.

Making our Irish health service fit for the enormous challenges we face is a long term task.  Our economy is now entering a period of recovery after a brutal recession.  Much of our health infrastructure is not fit for purpose.  Our population is aging and its need for ever more complex healthcare is increasing.

In these challenging times, we must nurture and respect you our trainee doctors and provide you with all the necessary supports to develop your careers and skills.

However, successive salary cuts, long hours and unpleasant working conditions do not lead to a contented workforce: in fact the opposite -  they drive young doctors like yourselves away to seek fulfilling careers abroad, many permanently.

This is not in the best interests of our people or our health service. No, the state should value you, nourish you, facilitate you in going abroad but then tempt you back with good working conditions on a par with other developed countries so that you can deliver the care you’ve been so well trained to deliver and, most importantly, our patients can receive top quality care from the best, most highly trained doctors anywhere in the world.

I have congratulated you on your great achievement; I have encouraged you to develop your professional life in collaboration with your peers; I have painted what I think is a realistic picture of the Irish health service at the present time. But we cannot leave it there.

We need a vision for the future.  We need a goal to work towards. That goal has to be to deliver high quality healthcare to the right patient in the right place at a price we as a nation are prepared to afford.

With the formation of Hospital Groups I believe a vision is beginning to come into focus. Our Hospital Group together with our academic partner UCC has a clear vision of developing an Academic Health Center bringing together for the first time in the Irish Healthcare system the shared goals of patient care, education, innovation and research.

If the Groups are given the autonomy and statutory authority needed to develop, the future of our hospital services is brighter than might appear at first sight.

There is also hope in the new politics promised as a response to current Dáil arithmetic. There are less places for our politicians to hide and less opportunity for political point-scoring. Health for too long has been a political football.  Health policy and decision making must be made solely on the basis of medical need and not on the basis of political expediency which sadly has all too often been the case previously.

So let’s stop throwing good money after bad in a vain attempt to deliver on short term politically driven targets while ignoring the glaring black hole that is the lack of vision and strategy for solving our problems long term. Let’s get down to the real job of developing a strategy that will deliver a better heath service with realistic targets and timelines, a strategy that will welcome you back as fellow workers who believe, with us, that change is necessary, worthwhile and achievable.

I agree with our new minister when he commits to an all party political approach and a much longer timeframe for change.  I wish him the best.  He is not much older than you guys and he is now faced with the most challenging job of all.

The time for reviews and reports is over. Let’s stop the nonsense and fix it!

So to end, I repeat: Be proud of what you have achieved, for your alma mater, for your families and for yourselves. It is immense, but it is just a beginning. If you carry one message away today then it is this…

Treat every patient, every x-ray, every laboratory specimen, every relative you speak to as if you were treating or speaking to one of your own family. Ask yourself how would you like your father, your mother, brother, sister to be treated in the same situation.  This will not be easy at 4am when you are tired, busy and pressurized but pause and do your best - treat that patient as if he or she were one of your own family.

Now – go and celebrate and look out for each other."

For press information about todays cermonies, please contact Gregory Higgins (Gregory.Higgins@ucc.ie)