The President’s Message

July 2018


“What have the Romans every done for us?!” So begins the brilliant section in Life of Brian before the Pythons list all the wonderful things the Romans had done, finally concluding that peace was their only undesirable contribution! Much of an organisations’ work is done behind the scenes and I hope this newsletter demonstrates to members that their annual fees are being well spent and that AUGIS membership remains relevant to them and their patients.

Council has met twice so far in 2018. In May, we invited allied healthcare professional (AHP) & clinical nurse specialist (CNS) representatives from each region to join us for the first two hours of the meeting. We had a great turn out and discussed how we can make AUGIS more relevant and useful to this important group; we and our patients would be lost without them. BOMSS has fantastic engagement from its non-surgeon members and we are determined to learn lessons from them to help improve things for the whole organisation.

The new AUGIS IT system is now working well and members are renewing their direct debit instructions relatively easily. If you have not yet done this please contact Nichola Bartlett  in the office. We have had some difficulties with the electronic BJS subscriptions but these appear to have been resolved. Although investment in new IT is always painful, we are optimistic this will pay dividends in the longer term. The regulations around GDPR were always going to require us to refresh our relationship with members, so a complete re-set made sense.

AUGIS runs a lot of meetings each year and you will read about the recent ones in this newsletter. Hepatic, pancreatic, oesophageal, gastric and bariatric surgery have all been covered in the past six months. These meetings are well attended and we get great feedback from attendees. This in no small part due to the enormous efforts of Mark Taylor as Education and Training Lead and, of course, Sarvjit and Nichola in the office.

Meetings generate vital revenue for AUGIS but balancing the books is becoming increasingly challenging. Our Hon Treasurer, Steve Fenwick, continues to do a great job with this but the pot of industry sponsorship money is shrinking. Consequently, AUGIS Council is exploring new ways of delivering more-with-less which may mean different formats for meetings in the future. To stimulate local AUGIS meetings around the UK e now provide modest financial support of up to £500 pa. If you have ideas for these please contact your Regional Representative.

During my term as President I have investigated what can be done to re-invigorate our Trainee membership and engagement but, so far, have made little headway. The triumvirate of HPB, OG & Bariatric surgery, which is at the heart of AUGIS, does not lend itself easily to a single club for trainees. Having seen the success of The Dukes Club for Colorectal trainees I know that it is both possible and beneficial to pursue a solution for AUGIS trainee members. Individual trainees are beginning to come forward and offer suggestions and leadership which is encouraging and I remain optimistic that fresh ideas can move this issue forward.

AUGIS has been working with the Coloproctologists (ACPGBI) and surgical trainees (ASiT) to highlight the importance of gastro-intestinal surgeons being competent endoscopists. The UK is unusual in this regard as in many countries surgeons do not scope. We believe that luminal gastro-intestinal surgeons should be endoscopists, properly trained and accredited, even though this is not mandated in the current general surgical curriculum. A position statement to this effect will be published soon. So, how are we to ensure that trainees have appropriate access to endoscopy training lists? It’s not simple but we have the support of the Joint Advisory Group on Endoscopy (JAG) and are working with the British Society of Gastroenterology (BSG) to find solutions. If you are a BSG member, voting for surgeons who put themselves forward for vacancies on the endoscopy committee will help us influence the direction of travel.

Proposals to change the training curriculum for general surgery were recently rejected by the GMC. The precise details have not yet been made public but we do know that the inherent tension between “Generalist” and “Specialist” is a core issue. We have managed to fudge this for many years in the UK and continue to train many more super-specialists than are required to staff our hospitals. Unlike countries such as Australia, a UK CCT in General Surgery can mean many different things. Perhaps it is time for us to think again and re-create the General GI Surgeon who is competent to perform common procedures such as cholecystectomy and colectomy in their elective and emergency practice. Should this be the CCT in General Surgery? Super-specialty training would logically follow during subsequent fellowship years and be accredited accordingly. Heresy, I hear you say! Maybe, but we need to look at this with fresh eyes if we are going to make General Surgery an attractive career again. It’s tricky stuff with many vested interests.

AUGIS has worked with three important charities recently to fund new research posts through the Royal College of Surgeons of England SSL project. These senior leadership roles are intended to initiate multicentre surgical research trials. Generous funding from Heartburn Cancer UK, the Pancreatic Cancer Research Fund and Pancreatic Cancer UK has allowed the appointment of two research leads, one for oesophageal and the other for pancreatic cancer. We are extremely grateful to these charities for their support. I know that AUGIS members will be keen to get involved in the research that will flow from this.

This will be the last newsletter I write in as AUGIS President. It has been a considerable honour to serve the Association, a lot of hard work and generally very rewarding. Inevitably, we have made progress in some areas but not in others. I am grateful for all the advice I have received, solicited or otherwise. I am also grateful to AUGIS Council and Executive for their hard work on your behalf to make things happen and for their support to me personally. Professor Giles Toogood is ready to take the reins and I know he will do a great job as your new President. The Edinburgh meeting looks to be a cracker so please come! The programme really does have something for everyone and the longer format means you get more for your money. If you’re still undecided go on the microsite –  and take a look. The dinner may seem expensive but that’s what it costs I’m afraid and it will be a great evening. Throw caution to the wind and book the lot so you can catch up with friends, update your knowledge and get CPD points for your appraisal.

Richard Hardwick