 It’s a historic new position to represent the views of thousands of trainees within one of the UK’s biggest surgical colleges. Mark Baillie caught up with Issaq Ahmed to find out how he is handling life as the RCSEd’s first-ever Trainee Member of Council
As he was stepping into his first Council meeting as Trainee Member of Council, a senior member of the College remarked to Issaq Ahmed, ‘You do realise that you’re about to make history.’ This was no hyperbole – the RCSEd is the first of the UK and Ireland’s four surgical colleges to formally appoint a trainee as a member of their governing bodies, and to do so after 506 years is a clear signal of the importance of trainees in today’s medical politics.
Given that his is arguably one of the most important positions within the RCSEd, you might expect him to show some sign of the weight of expectation now resting on him, both from trainees and from the RCSEd. But if he is feeling the pressure, he’s keeping it well hidden. Talking to him fresh from his second Council meeting, he does not give the impression of someone who is still getting to grips with a big role – nor is there any hint that he is feeling under pressure in his ‘historic’ new position.
So how does one approach their first outing in such a major role? ‘Prior to applying for the position I spent time looking into the history of the College and its role within the surgical community. My first meeting was really an opportunity for me to introduce myself to the Council and begin getting to grips with the College business.’
His second Council meeting was a slightly different affair. Coming just the day after the College’s annual trainees’ meeting, there were some pressing issues which he needed to get across to Council. ‘I had the opportunity to discuss trainees’ views on the role of the JCST. Having put across the trainee view and my own feelings, it became very apparent that the College shares similar views to trainees on the issue of JCST.’
Graduating in Electrical Engineering from Dundee in 1998, and after spending a brief time with Jaguar Cars he decided to fulfil a lifelong ambition to study medicine. Once into medicine, he didn’t waste any time, winning the AK Johnston Prize for an audit project and picking up a Scottish International Scholarship for research.
So what made him move from engineering into medicine? ‘The desire to study medicine and become a doctor stemmed from my early school years. However, at that time I was very much interested in computers, cars and technology and that’s really where I saw my career headed. I really didn’t see a link with medicine at that time.’
It wasn’t until he began studying engineering and was living with three medical students that Issaq realised there was a lot of common ground between engineering and some fields of medicine.
‘Fortunately in my final year as an engineering student I had the opportunity to work with an orthopaedic surgeon on a research project investigating the use of simple x-rays to predict fracture risk. It was through this research project that I became interested in orthopaedics. But most importantly it was through his help and support that I managed to obtain a place at medical school.’
Although the conversion to medicine was not without its challenges, once into orthopaedics training he found there were distinct advantages to having a background in engineering: ‘When it came to learning about the science of orthopaedics, it was very helpful to have a previous understanding of mechanics, materials, and engineering principles which form the basis of various orthopaedic implants.’
Past greats of UK orthopaedics who had experience of engineering such as Sir John Charnley would no doubt have agreed with this sentiment.
Issaq passed his MRCSEd in 2006 and since then has worked as an e-tutor for the College’s ESSQ programme, as well as being a peer-reviewer for several orthopaedic journals including the Cochrane Musculoskeletal Group. Out of programme work is another area that he believes is vital for trainees in order to broaden their experience. He described his own out of programme visit to South Africa as a tremendous opportunity to experience orthopaedics in a region with limited resources.
Like many Fellows and Members, Issaq was attracted by the College’s rich history and its reputation. ‘Although a lot of my consultants were Edinburgh Fellows, there wasn’t any pressure from them to affiliate with the RCSEd – it was more a case of feeling inspired to follow a similar path to them.’
But even before that, during his medical school years, he recalls that he was always aware of the College’s presence in some capacity – ‘… either through open days or courses for undergraduates. And I think that early exposure to a particular college is very important.’
Although he is a member of BOTA, he decided against standing for election to BOTA’s governing committee. As he carefully puts it: ‘I didn’t want to be perceived as representing too strongly the interests of BOTA in my position on RCSEd Council. I want to be credible as a representative of trainees from all surgical specialties.’
The first question many trainees will want to ask is where he stands on the Working Time Directive. Given the strongly anti-WTD position that some prominent trainee associations have taken, his view on the topic is both surprising and refreshing: ‘In continental Europe, everyone trains within 48 hours. They’ve been doing it for a lot longer than we have but we don’t hear anyone saying surgeons in Europe aren’t being adequately trained. So perhaps we need to look to our European colleagues to see how they do it.’
Drilling down to the root of the issue, he continues: ‘It’s not a question of whether you can train in 48 hours, the challenge is putting the service commitments back and allowing training to happen at the right time and in the right situation.’
Looking at the wider picture of trainee representation across the UK, he says the situation is healthy and that interlinking between trainee and non-trainee associations is working well. But this doesn’t mean he’s complacent about his role: ‘The way the College’s Surgical Specialty Groups are structured with a trainee rep from that specialty on each group should ensure that all trainee views are heard. But if any trainee or trainee group did have a particular concern or point to raise then I would encourage them to contact me – that’s why I’m here.’
He’s well aware this could lead to situations where he is the bearer of opinions and comments that are contrary to those of the senior members of Council. But, as he matter-of-factly puts it: ‘There will be times when the President and I don’t agree on certain issues. It would be wrong for me to sit on the fence and say “yes, I agree with every view expressed on Council.” My role is to represent trainees.’
And that’s want he plans to do.
Note from the author, Issaq Ahmed:
“Following on from responses to the online publication of this article, and to avoid possible ambiguity, I would like to emphasise that, as a trainee myself, I do not endorse restricted hours for surgical trainees, but share the view of many others, including the RCSEd , that such a reduction has had a detrimental effect on our training – a view that I shall be voicing during my time on Council.
“What I wanted to share were the views of some people in Europe who were indicating that they were managing to work and train in 48 hours, albeit in some instances excluding oncall commitments, and to put forward this model as a possible means of training within the restricted hours.”
Note from the Editor, John Duncan:
“The view of Council, in response to the Temple Report, is that the introduction of EWTR has had a negative effect on training, a view backed up by a College membership survey.
“The College supports continued lobbying to re-examine the hours available for training, particularly the SiMap and Jaeger rulings. This position is similar to that expressed by the AoMRC earlier this year.
“Council established a Short-life Working Group to explore how to maximise training opportunities and quality within the existing regulation. The SLWG reported to Council last year; the report was published and initiatives such as simulation and support for trainers are being pursued actively by the College.”
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The rest of Europe tends to ignore the EWTD and this is how they cope. We stick to it and it is killing our training.