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‘During my time on the RCP Trainees Committee, medical training in Northern Ireland has faced substantial challenges’

Reflecting on his time as a member of the RCP Trainees Committee, Dr Andrew Spence looks back at the pandemic and its effect on medical education before considering the future of healthcare in Northern Ireland.

During my time on the RCP Trainees Committee (TC), medical training has faced substantial challenges, especially during the COVID-19 pandemic. Many trainees were deployed during the pandemic, and sickness absence and out-of-hours rota gaps increased, putting pressure on the junior doctor workforce and affecting the specialty training experience. I joined the RCP Trainees Committee in 2019; my background is in medical education, and I particularly enjoy designing new courses and curricula.

I’m very pleased to say that training opportunities in Northern Ireland have increased since the height of the pandemic, and exposure to specialty training – for example, endoscopy and bronchoscopy lists, and gastroenterology and respiratory competencies – has improved (although this can vary by trust). However, we’re still seeing rota gaps and there have been some challenges adjusting to the updated specialty training curriculum and the introduction of an IMT3 year. We do recognise that the new system is in its infancy, and of course, we’re still in a transition phase.

The pandemic was a steep learning curve for many of us. In my role as TC representative, I was fascinated to learn from the other TC representatives about their COVID-19 experience in other parts of the UK; being part of the committee has been a great opportunity to share expertise, meet new colleagues and learn about how innovative technologies have transformed models of care.

If you’re thinking about what to do next in your career, I’d highly recommend getting involved with the TC. Alternatively, consider joining a local committee where you can influence change in your own hospital: it’s all excellent experience that you can bring into your specialty training. Of course, I’ll be stepping down soon as RCP TC representative for Northern Ireland, and as I come to the end of my term, it’s been fun to look back at some of the best bits. In 2021, I worked with Dr Melanie Nana (now the TC co-chair) to design an RCP ‘Call the med reg’ conference in which trainees learn more about taking on the medical registrar role. This has since become an annual UK wide online event with almost 2,000 registered delegates last year. I’m very proud of how successful it’s become!

As for me, I’m about to finish my training as an academic clinical lecturer and gastroenterology registrar in Northern Ireland. Next, I’m hoping to undertake a post-CCT fellowship, then become a clinical academic consultant gastroenterologist as a joint appointment between Queen's University Belfast and the Belfast Health and Social Care Trust.

There are a lot of unknowns about the next few months in Northern Ireland. I was part of the team that developed an action plan for the Stormont election, The time is now, and a follow-up briefing, The time is now: 6 months on. We’re also teaming up with the Royal College of Physicians of Edinburgh and the Royal College of Physicians and Surgeons of Glasgow to run an evening event for trainees and specialty doctors on 1 March 2023: we want to use the findings from this conversation to make sure politicians understand the importance of transforming the healthcare system. Book your free place!

Personally, I will be making the case for investment in community and social care to reduce length of stay, which in turn would improve working conditions for nurses, doctors and allied health professionals. What will you choose as your priority for health and social care in Northern Ireland?

Dr Andrew Spence
ST7 gastroenterology registrar, Belfast Health and Social Care Trust
Academic clinical lecturer, Queen’s University Belfast

Find out more about the RCP’s policy and campaigns work in Northern Ireland and get involved with the RCP Trainees Committee. Trainees and specialty doctors in Northern Ireland, to book your space at ‘An evening with the presidents of the royal colleges of physicians’ on 1 March 2023 at 7pm, visit our website.