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30 December 2016
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Making the change

Victoria Twigg

Today I will head into work at the venerable institution that is the Royal College of Surgeons of England (RCSEng). Just a few months ago I would have been rushing into work in a busy university hospital as a core surgical trainee, focused on my career in Ear Nose and Throat (ENT) surgery.

If it was a good day, I might have taken a few patients’ consent before an operation, performed a couple of tonsillectomies, and undertaken a more complex procedure, for example a thyroidectomy, under the supervision of my boss. If it was a bad day, I might have struggled to find a cubicle to review a patient in A&E, pleaded with a busy radiologist for a scan to be performed for a patient, or tried to squeeze another patient onto an already full emergency list, all the while thinking: ‘there must be a better way’. All I needed was the time, the know-how and a few willing members of NHS management.

This year is very different. I’m now working as a National Medical Director’s Clinical Fellow, based at the Royal College of Surgeons in Lincoln’s Inn Fields, central London. The scheme, organised by the Faculty of Medical Leadership and Management (FMLM) and sponsored by Professor Sir Bruce Keogh, has been a fantastic opportunity so far. Three months in and I’m excited about putting some plans into action over the next nine months.

The ‘imposter syndrome’ now settled (the initial feeling of unease at office life when I’m most comfortable running around a hospital, packing noses and popping quinsys), the last three months have been eye opening and what I affectionately refer to as the ‘normalising stage’.

Being privy to Council meetings and the innermost workings of the college, I’m now more in tune with how the organisation functions. Council provides the direction for the college, the CEO leads the business side, and the President oversees it, taking it forward in the most efficient manner. I’ve seen where the membership fees go – on setting standards for patients and surgeons, supporting the surgical membership, and influencing healthcare policy. Words such as carcinoma, cholestasis, and epistaxis have been (temporarily) replaced by business buzzwords – risks and issues, stakeholder engagement, working groups, and products.

As well as understanding the functioning of RCSEng, the NHS and its various bodies have now been demystified, mostly by the stellar induction programme run by FMLM at the start of the fellowship. This educational component is then continued by NHS England and organised by Professor Sir Bruce Keogh throughout the year. Highlights of my fellowship so far include meeting many important players in the NHS management and related healthcare organisations, and getting to grips with politics, by meeting MPs and visiting Parliament.

Despite all this, the best highlight has to be sharing this experience with the 30+ other fellows, with backgrounds in all areas of medicine and pharmacy, enthusiastic about the ongoing improvement of the NHS, despite the current economic climate.

In my day job, so far I have provided input into several of the ongoing projects at the Royal College of Surgeons, including giving my own feedback on how things currently work and how they could be improved. I’ve engaged with nationwide quality improvement collaborative work, and realised the benefits that the ‘extended surgical team’ can bring to surgical trainees and the wider health service. I’ve also written a blog for the college website.

Going forward, now that I have my feet under the table, I will focus on several of my own projects, including looking at the provision of surgical education in medical schools, contributing to implementing the recommendations of the Extended Surgical Team report, and collaborating with ENT UK on improving learning materials for ENT trainees. Within the RCS, I’m hoping to contribute to the improvement of surgical training within the UK, and to continue to work with the Women in Surgery team to support and encourage female surgeons of the future. And who knows what else may lie in store.

Returning to the frontline of healthcare in September next year, I hope I will be well prepared to try and realise some of those simple but important changes that can make working and being cared for in the NHS a much smoother journey.

Interested in applying to the National Medical Director's Clinical Fellow Scheme 2017/18 cohort? Find out more and submit your application by 16 January 2017.

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