Irish Medical Organisation

IMO President UCC Conferring Speech

Dr. Ronan Boland, IMO President - Speech Delivered at University College Cork Summer Conferring

President, University Staff, Graduates, Ladies and Gentlemen, it is a great honour indeed to address you today as a local doctor, as the President of the Irish Medical Organisation but most especially as a proud graduate of UCC.

To those who have just been conferred -today is truly a watershed in your lives, the end of one phase and the beginning of a new and exciting phase of your careers. You will soon begin the transition from theory to practice and you will finally get to gainfully utilise the skills and knowledge which you have acquired over the years of your university career.

But for today, you become the class of UCC 2011 – and long after the photos have faded slightly and the new suit bought for your conferring has passed its sell-by date, you will remain part of that UCC class of 2011. Friendships you have made and relationships that you have forged in university will sustain and enrich you throughout your adult lives. For many of you, your professional paths will be inextricably linked during your working lives. On the other hand, there will be classmates whom you never see again after today – or perhaps not until a class reunion decades hence.

But you will hopefully remain proud of your alma mater because it will to some extent define you throughout your working life. UCC graduates have gone on to excel in every walk of life here and abroad – and I have no doubt that many of you will go on to achieve great things, whatever professional path you choose.

Some times of course your professional path chooses you. As the old saying goes, life is what happens when you are busy making plans. Having completed the final year of my 3 year UCC postgraduate training programme in a rural GP practice, my trainer told me that I would never be fulfilled being a rural GP and that he foresaw me in some form of national leadership role. I laughed -seeing myself working happily as a rural GP into the future with my own practice.

Needless to say, he was right and I was wrong. Four years of rural practice later, I found myself much to my surprise back in Cork running a busy city practice. General Practice had suffered years of under-investment and was not fulfilling its potential. Out of frustration as much as anything else I gradually became more involved in medical politics and representation in subsequent years.

A decade long journey as a representative originally of my GP colleagues- in the media, at negotiations and other engagements with the state and with other medical bodies- culminated in my inauguration just a few weeks ago as President of the Irish Medical Organisation, the only body which represents and speaks for all doctors working in the State.

While it has been challenging, I have gained much from the journey. I have had to acquire new skills, often with no text book or manual to guide me. I have had the privilege  of meeting with and working with people from across the professional spectrum – doctors of all disciplines from all over the world, politicians, health service managers, professional negotiators, journalists, lawyers, accountants, actuaries and many many more.

First and foremost however I am a practicing doctor proud to run my practice in a solid working class area of Cork City and it is that grounding that allows me to speak with a degree of authority on the reality of working at the coalface as a health care professional and of the difficulties that my patients can experience in accessing appropriate healthcare in a timely manner.

If there is a lesson in my particular journey I guess it is that I could have paid more attention to my trainer all those years ago. Your mentors will see strengths and weaknesses in you that you may not know exist – listen carefully when advice is offered in good faith. Reciprocate when you can and help those who follow in your footsteps. There is an old maxim in hospital medicine – “see one, do one, teach one”. You can learn more from such encounters that you have in any textbook heretofore.

I was both proud and humbled to accept the invitation to address you today – humbled having read the illustrious list of distinguished speakers who have fulfilled this role in the past but also proud that in a way I was completing a circle which began with my own conferring in the Aula Maxima in 1987.
Much has changed in the thirty years since I turned up for my first lectures in Pre-Med in 1981. The student body has trebled in size and many superb buildings such as Devere Hall in which we are gathered and the Brookfield Health Sciences Complex have added immeasurably to the built environment.

While I am hopefully only half way through my career as a doctor, much of what I was taught in medical school is already redundant. The availability of new surgical and radiological techniques and of new drug therapies has radically altered the way we manage conditions as diverse as Peptic Ulcer Disease, Ischaemic Heart Disease (both in its prevention and treatment), Diabetes, Osteoporosis , Rheumatoid Arthritis and indeed many forms of cancer. This is the nature of healthcare- and each of you will, I have no doubt, strive to keep up to date with ever changing guidelines of best practice for your chosen discipline.

The very lyrical French saying “plus ce change plus c’est la meme chose” has a particular resonance for me. It reminds us that the more things change, the more they remain the same. Its resonance is felt most keenly by anyone the wrong side of 40, because the longer you live the more you see just how much history tends to repeat itself- in the cycles of our economy and in life itself.

In 1987 when I qualified, there were many parallels with the predicament in which Ireland now finds itself. A new government had just come to power. Unemployment was high, public expenditure levels were unsustainable. Swingeing cutbacks, increases to already high tax rates and reducing public services were the order of the day. Some of my classmates did not even receive an Intern place in the country that had trained them. Half of my class left the country immediately after their Intern year in pursuit of adequate training and career prospects in other English-speaking countries – countries which were only too happy to employ them given the extremely high international reputation which Irish-trained medical graduates held and still hold to this day. Many never returned but thrived instead in their adopted homelands.

Then, as now, Irish medicine and health care did not operate in a vacuum. Highly educated highly trained highly motivated young professionals will do what is required to further their careers and improve their skills and expertise. And they will go where those skills are optimally utilised in the care of the patients they look after. Many of you will leave Ireland, at least in the short term, in pursuit of opportunities.

It does worry me that the State is not doing enough to ensure that new graduates in Medicine, in Nursing and in the allied health professions are given sufficient opportunity to forge a career in their chosen discipline in Ireland over the next five to ten years. It worries me also that many bright young graduates will opt to leave even when they have the opportunity to stay. While it would be hard to blame any individual young graduate wishing to escape the doom and gloom in Ireland at the moment, Ireland will recover as the cycle I referred to previously completes itself again. When recovery comes, it will be driven by the energy, professionalism and dynamism of our young professionals across all disciplines who will act as the catalyst for economic recovery.

Ireland still has one of the fastest growing populations in Europe. It is an ageing population. People are living longer all the time, requiring more and more treatment for more and more co-morbidities in their later lives. This pattern will not change. Your skills will be needed here more than ever before. I hope you can stay with us and help make things better.

Ireland will continue to need health professionals who are passionate about what they do, who are highly skilled and trained and optimistic that they will be facilitated to optimally use their hard-earned skills in this country in the years ahead. But I believe professionals also have a responsibility to get involved in shaping the health service they want to work in for the rest of their careers. Martin Luther King said “The ultimate measure of a man is not where he stands in moments of comfort, but where he stands at times of challenge and controversy”. At a time of potentially great change, it is a source of some concern to me that in my own profession too few younger doctors are prepared to sacrifice their leisure time to engage with the shaping of our health service.

I am concerned that a public expectation is being created about radical health service reform which has been inadequately thought through and which has not been costed to any meaningful extent. The concept of Universal Health Insurance is a highly commendable one but its achievement will require a clear roadmap which has been altogether lacking to date. Only with more clarity can the general public truly make an informed decision on whether this reform is both achievable and affordable. I would urge all new graduates to inform and involve themselves – it is your generation of health professionals and health consumers who have arguably the biggest stake in a debate of fundamental importance to the health service and the nation.

My briefing notes from UCC advised that I should “ congratulate, inspire and encourage” you following your conferring. I hope I have encouraged and inspired and maybe even challenged you just a little. I have however kept my first and most pleasant task till last. I want to sincerely congratulate every one of you on your achievement today. It is the culmination of many years of hard work and personal sacrifice and you will look back on this day fondly for the rest of your lives. When you get your first pay cheque (hopefully soon!) take your parents out for dinner and slip your younger siblings a few euro. Because of course it was a team effort to get you here. My four children are not yet of university age but I can already see the challenges that lie ahead, so to all the Mums and Dads here you have my particular admiration and respect!

I would finally like to thank President Michael Murphy and Professor John Higgins for their invitation to address you, it is a great honour indeed. I would like to congratulate John on his recent appointment as Head of College of Medicine & Health – I know he will bring his considerable talents and energy to his new role and UCC will be the better for it.

I hope you have a wonderful day with your families and friends and I wish you every success in your future careers. Go raibh mile maith agaibh.

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