President's Message - December 2008
As the year draws to a close it is timely to reflect on the main issues for the College over the autumn.Although the appointment system for junior doctors in the UK worked better in 2008 than the disaster of 2007 there is still considerable room for improvement both in selection and training. The College is leading the development of more objective selection techniques and more flexible early training and also stressing the case for training more doctors through to CCT and consultant level. I led the writing of the UK Academy of Medical Royal Colleges report on the Medical Workforce which majors on the added value fully trained doctors bring to healthcare. Hopefully this will go some way to counter the drive in England towards the increased use of “credentialed” sub-consultant doctors as exemplified in the NHS employers document “Medical Training and Careers – the Employers vision”.
The employers propose that many UK doctors’ training should cease below CCT level and that the Specialty doctor grade would become the new backbone for the NHS. Such a system would neither provide the highest level of patient care nor meet the aspirations of the excellent medical students and junior doctors. Indeed such stultification of their career aspirations would seriously damage the future intake to the profession, thus damaging the profession, patient care and research in the future. The College will firmly resist any decrease in the availability of training to CCT level.
On a more positive note, Fellows and Members may be interested to read the Consensus Statement on Acute Medicine, produced at the College’s Consensus Conference in November 2008. This well attended event produced much-needed new guidance on the developing sub-specialty of Acute Medicine and Fellows and Members around the world will shortly be able to access an online Joint Supplement with the British Journal of Hospital Medicine containing the proceedings of this meeting.
November also saw the publication of the College’s new clinical guidance on Transition Medicine, ‘Think Transition – developing the essential link between paediatric and adult care’ which received glowing reviews. The guidance covers a number of generic issues (including education and independence, inequalities in health, remote and rural issues and fertility and sexual health) in addition to addressing patient-specific issues in relation to cystic fibrosis, chronic renal disease, Type 1 diabetes and survivors of childhood cancer. The development of this guidance was initiated by the late Dr Gordon Pillar, a Trustee and enthusiastic supporter of the College, and latterly Chief Executive of Great Ormond Street Hospital. We are grateful to him and the Children’s Research Fund for supporting this work.
Council approved a short document on the College’s medium-term direction at its November meeting. This builds on the results of the survey of Fellows and Members on the Future Direction of the College conducted earlier this year and provides a benchmark with which to assess new opportunities and agreed work streams.
The autumn also saw 2 new ventures in video-linking for the College. As you may know we make enormous use of high quality video-linking for educational events and committee meetings to save travel time, cost and the environment. October saw our first venture into low-cost video-linking broadcasting 2 lectures from the College to the Ceylon College of Physicians annual meeting by Skype! This worked extremely well – with thanks to Professor Andy Greening and Dr Jane Goddard - so any overseas Fellows running major meetings wishing the College to provide remote speakers please let me know. The other “first” was to have an endowed lecture at the Expedition Medicine symposium delivered to our own conference centre by video-link and again the audience was enthusiastic about the resulting quality - many thanks to Dr Charles Clarke. However Dr Colin Mumford used old fashioned air travel to deliver a series of talks on neurology for the College at the invitation of the Jordanian Society for Internal Medicine.
This month got off to a busy start with the 48th St Andrew’s Day Symposium. This year’s flagship event focussed on updates in acute and internal medicine and proved very popular with Fellows and Members, as it has in recent years. Webstreamed presentations of the two endowed lectures from this event are on the website.
Finally, I would like to welcome Prof Brian Frier as our new elected Vice President. Brian takes over from Prof Peter Brunt who has demitted office and whom I would like to thank for his tireless contribution to the College, most recently in relation to the establishment of the medical advocacy group on alcohol Scottish Health Action on Alcohol Problems. Brian will work alongside Professor David Webb who continues as the other Vice President. I would also like to thank Fellows for giving me the opportunity to serve the College as President for a final year.
In closing, I would like to thank all those who have contributed to College activities this year and to wish all of our Fellows and Members a good break - if you are getting one -and a happy and prosperous 2009.
Results of Elections of President, Vice Presidents and Council
Royal College Re-Elects Longest-Serving President in 250 Years
Prof Neil Douglas has been re-elected as President of the Royal College of Physicians of Edinburgh (RCPE) for a sixth year in office, making him the longest serving RCPE President for almost 250 years. 
Prof Douglas, Professor of Respiratory and Sleep Medicine, University of Edinburgh, became President of the RCPE in March 2004 and has now been re-elected until March 2010. In addition to being an internationally recognised expert on sleep medicine, Prof Douglas has been an influential figure in medical education and training at a UK level. In March 2007 Prof Douglas was appointed by the then English Secretary of State for Health, Patricia Hewitt, to Chair the MTAS Review Group charged with reviewing the discredited online selection system for recruiting doctors into specialty training (Medical Training Application Service (MTAS)) which encountered serious difficulties and led to unprecedented concern including a protest march by 10,000 junior doctors through London.
Prof Brian Frier, Consultant in General/Internal Medicine and Diabetes at the Royal Infirmary of Edinburgh, and Honorary Professor of Diabetes at the University of Edinburgh, has also been elected as Vice President of the RCPE for a three year period of office.
Prof Neil Douglas, President of the RCPE, said
“I am honoured to continue my Presidency for a further year and welcome the opportunity to ensure that the views of practising physicians are represented at the highest level in discussions relating to medical education, training and standards of clinical practice in Scotland and throughout the UK.
“The College plays a vital role in advising the NHS and government in Scotland and the UK and has in recent years worked with others to influence the introduction of smoke-free legislation in Scotland and was instrumental in establishing Scottish Health Action on Alcohol Problems (SHAAP). Through SHAAP the College has continued to influence the development or more robust evidence-based governmental policies aimed at reducing the increasing harm caused by excessive alcohol consumption and I will ensure that improving the public health remains a key focus of the College’s work.
“I am also delighted to welcome Brian Frier as Vice President. Brian is a highly respected diabetologist, who brings a wealth of experience which will be invaluable to the College in internal and external discussions”.
Contact Graeme McAlister on 0131-247-3693 or 07808-939395
Notes for Editors
 Prof Neil Douglas is the longest serving RCPE President since Sir Alexander Dick who served from 1756-1763. In addition to being a leading physician of his time, Sir Alexander Dick is perhaps best known as a host in his home, Prestonfield House in Edinburgh. Notable guests of Alexander Dick’s included Benjamin Franklin, one of the Founding Fathers of the US, in 1759 and James Boswell and Samuel Johnson who stayed there in 1773 on their famous journey to the Highlands.
Biographical details for Prof Neil Douglas
Professor Neil Douglas MD(Edin) DSc(Edin) HonMD(StA) FRCP FRCPE is Professor of Respiratory & Sleep Medicine at the University of Edinburgh and an Honorary Consultant Physician at the Royal Infirmary of Edinburgh. He has championed the provision of clinical services for sleep apnoea in the UK and directed the Scottish National Sleep Service. Professor Douglas has published over 200 original papers on sleep and breathing and is an international authority on the causation, consequences and treatment of Sleep Apnoea. .
He has been President of the Royal College of Physicians of Edinburgh since March 2004. He chairs the Education & Training Committee of the Academy of Medical Royal Colleges (AoMRC), was Vice-Chair of the AoMRC and is Chairman of the Academy of Royal Colleges & Faculties in Scotland. He is a member of the Postgraduate Medical Education & Training Board (PMETB), a member of the General Medical Council (GMC) Education Committee and the GMC Assessment Group and was previously a member of the General Medical Council. In March 2007 Professor Douglas was asked by the Secretary of State for Health in England, Patricia Hewitt, to chair a Review Group to manage the Medical Training Application System (MTAS) crisis.
High-resolution images of Prof Douglas can be obtained from Graeme McAlister on 0131-247-3693 or 07808-939395.
Biographical details for Prof Brian Frier
Professor Brian Frier, BSc(Hons), MD, FRCP (Edin), FRCP(Glas), is a graduate of Edinburgh University and trained in Edinburgh, Dundee and Cornell University, New York, where he was a Clinical Research Fellow in Metabolic Medicine. He was initially a Consultant Physician with a special interest in Diabetes at the Western Infirmary and Gartnaval General Hospital in Glasgow (1982-1987) before being appointed to his present post. His principal research interest is the effects of hypoglycaemia in humans, with particular relevance to diabetes, but also in insulin therapy and diabetic complications. He has published extensively in hypoglycaemia and is editor of a new journal called ‘Diabetic Hypoglycaemia’. He was awarded the Somogyi Award in 2004 by the Hungarian Diabetes Association. He is currently Chair of the Honorary Advisory Panel on Driving and Diabetes to the Secretary of State for Transport. He has also served as an elected member of RCPE Council (2002-2008).
Added 04 December 2008
MHRA/EMEA drug safety reviews: antipsychotic drugs and nitrous oxide
The Medicines and Healthcare products Regulatory Agency (MHRA) has asked the College to alert website users to the findings of two recent drug safety reviews -
European Medicines Agency review of antipsychotic drugs
A recent review of conventional (typical) antipsychotics by the European Medicines Agency's scientific advisory committee has concluded that conventional antipsychotics are likely to be associated with an increased risk of mortality when given to elderly patients with dementia.
Further information is available from the European Medicines Agency:
MHRA review of nitrous oxide
The MHRA has today published information about the potential neurological and haematological risks associated with prolonged use of nitrous oxide.
Added 03 December 2008