15 minute read
e Dublin Hospitals Cup
by RCSI
THE DUBLIN HOSPITALS RUGBY CUP HAS BEEN CONTESTED BY THE TEACHING HOSPITALS IN DUBLIN SINCE 1881. A NEW BOOK BY DRS CONLETH FEIGHERY, MICHAEL FARRELL AND MORGAN CROWE, CELEBRATING 140 YEARS OF THE COMPETITION, IS PUBLISHED THIS MONTH
Jervis Street Hospital
Richmond Hospital
much loved and ercely contested trophy played annually between competing hospital teams, the Dublin Hospitals Rugby Cup was established in 1881 by a group of surgeons and physicians from Dublin hospitals. Sport played a huge part in the student experience throughout the medical schools and teaching hospitals of Britain and Ireland in the Victorian and Edwardian periods, and team sports were preferable to individual sports as they were considered to promote responsiveness to authority and discipline, as well as fostering character development and loyalty to each other. e Richmond, Jervis St and Mercer’s Hospitals, the major teaching hospitals of the Royal College of Surgeons in Ireland (RCSI), participated in the competition from its earliest years, with Richmond winning the cup for the rst time in 1896 when they were captained by Larry Bulger. He received the rst of his eight caps for Ireland eight weeks later on 30 March against England in Leeds. Later that year, Bulger was selected to tour South Africa with the British Isles touring party. e Richmond Hospital was represented at the inaugural meeting of the Dublin Hospital Rugby Committee by FR Cassidi and Henry Stoker, cousin of Bram. Richmond went on to win the cup on a further nine occasions and were most successful in the mid 1920’s when led by Paul Murray and Morgan Crowe. Both were selected for the 1930 Lions tour of New Zealand and Australia but only Murray travelled, Crowe having broken his collarbone in the drawn 1929-30 Hospitals Cup nal against Sir Patrick Duns.
Jervis St was led to its single victory in 1948 by Karl Mullen, the only man in history to have captained the British and Irish Lions, Ireland and a Hospitals Cup winning team! His rst Irish cap came when Ireland lost 8-12 to France in Lansdowne Road on 25 January 1947. Just ten days previously, Mullen led
Mercer’s Hospital Beaumont Hospital
out the Dublin Hospitals against their London counterparts in Richmond Rugby Club’s home ground in southwest London.
In spite of reaching a few nals, Mercer’s Hospital never managed a victory and in later years joined the Federated Hospitals. In anticipation of the move to the Beaumont campus, Richmond and Jervis St joined forces, winning their rst cup as a combined team in 1976 followed by further victories in ‘77 and ‘79 and an incredible ve in a row from 1981 to 1985 in teams which featured players such as Dave Fennelly,
Bill Twomey, Jim McShane and Conor O’Brien. eir dominance was total, repeatedly defeating Vincent’s sides that included icons of medicine and surgery in Dublin and abroad, such as Arnie Hill, Justin
Geoghegan, David Moore and Hugh Brady!
Finally, when transfer to the Beaumont campus was completed in 1987, the new Beaumont team in their blue Dublin strip won the cup at the rst attempt and went on to dominate the competition, winning another ve in a row. Eventually, the other hospitals began to adopt Beaumont’s methodical approach. According to a notable St Vincent’s rugby man, himself a medallist and perennial competition administrator, “We were fed up losing to the Blazers from the northside” – a reference to the very professional Beaumont squad who always turned up to the nal resplendent in white shirt, RCSI tie and blazer. Beaumont last won the cup in 2017.
Of the many students who played hospitals rugby and later went on to achieve fame as surgeons several stand out. Michael “Mickey” Butler, William “Billy” Hederman, Frank Keane, Stanley McCollum, omas Myles, Eoin O’Malley, Harry Meade all became Presidents of RCSI as indeed did Frederick Conway-Dwyer, Francis Crawley and William de Courcy-Wheeler in the earlier years of the competition. Perhaps the most famous of all rugby-playing surgeons was the great Terence Millin who captained Duns to victory in 1926-27 Hospitals Cup, captained the Trinity
Professor Arnold Hill, RCSI Fellow (1992) Professor Frank Keane, RCSI Fellow (1991), President 2005-2010 Mr David Moore, RCSI Fellow (1985) Mr Billy Hederman, RCSI Fellow, President 1990-1992
Sir William de Courcy Wheeler, RCSI Fellow (1874), President 1922-1924 Michael “Mickey” Butler Dr Terence Millin, RCSI Fellow, President 1963-1966
team to victory in the Leinster Senior Cup, scored a try on his debut in Ireland’s victory over Wales on 14 March, 1925, in Belfast, became FRCSI two years a er graduation from Trinity and by the early 1940s stood on the threshold of a majestic career in the new eld of urology. Famously, in a seminal Lancet publication on 1 December, 1945, he gave details of a new extravesical technique for prostatectomy that was to project his career into the stratosphere. Amidst all the calls on his skills he still found time to take on the role of Vice-President of London Irish RFC. Millin’s work as President of RCSI for an unprecedented three terms witnessed his in uence on the implementation of the highest standards in Irish surgery. An enormous debt is owed to Millin for the work he and Harry O’Flanagan carried out to secure the future of the undergraduate medical school in RCSI. Commemorated in the annual Millin Lecture at RCSI, Terence Millin’s legacy will never wane.
Rugby established itself as the most popular team sport in the Dublin and Cork teaching hospitals despite Gaelic games and soccer being more popular throughout the country at large. Reasons for this were varied. Many medical students came from schools where rugby was the main sport. Even if a student had not previously played rugby, the game of rugby lends itself to individuals of di erent sporting backgrounds, skills, and physiques, with a potential place for everyone on the hospital XV. Rugby was and still is strongly supported by hospital consultants and many had trained in England including some in the British Army where rugby was played to a high level. e relationship between rugby and medicine was exempli ed by the experience of Michael Davitt’s two sons who, despite their father’s strong nationalist and GAA credentials, both captained the Mater Hospital’s rugby XV and played for the UCD club where both would serve as honorary secretary. A third son Cahir, who became a high court judge, was also president of UCD Rugby Club on two occasions. e interest of the medical profession in rugby was demonstrated by its involvement at committee level in rugby clubs in the 1960s and 1970s; for example, in UCD RFC, to be elected as president of the club at that time, a sine qua non was to be medically quali ed! Back then, medical students were commonly playing rst team rugby, with many achieving higher honours, playing for the provinces or even for the national side such as Con Feighery, Barry Bresnihan and the more than 70 Irish, South African, Canadian and Romanian internationals who played in the competition. Playing rugby was never a barrier to a successful career in medicine.
In recent years, however, rugby has changed from being a bastion of amateurism to a highly professional business with downsides – as can be seen in the failure of new international teams to emerge, and the continued trawl of the Paci c Islands and South African schools by professional club sides from New Zealand and the northern hemisphere. Player weight, speed and strength have reached unprecedented proportions leading to increasing numbers of severe musculoskeletal injuries and concussions which have prompted rule changes to enhance player safety.
Although the amateur game continues, it is poorly supported and some clubs struggle to eld teams. Previous high-pro le competitions such as the Leinster League and Leinster Senior Cup no longer occupy key dates in the rugby calendar. A recent ESRI report (2019) commissioned by the IRFU reveals that although increased numbers are playing rugby, there has been a dramatic drop
Sir Frederick Conway Dwyer, RCSI Fellow, President 1914-1916 Sir Thomas Myles, RCSI Fellow, President 1900-1902 Mr Harry Meade, RCSI Fellow, President 1948-1950
Leinster Senior Cup no longer occupy key dates in the rugby
In 2017, RCSI-Beaumont Hospital won the 129th Dublin Hospitals Cup.
o in participation when students leave second level education. Rugby is not alone in this post-school failure to participate in team-based eld sports. For medical students and their teachers, the urge to squeeze more and more information into the medical curriculum must be arrested before it is too late. Already the demands of an increasingly busy undergraduate
curriculum combined with postgraduate intern and registrar duties make it di cult for a player to meet the training and playing commitments of an All-Ireland League club team. Medical students, doctors and surgeons now rarely feature on club senior sides with participation by doctors in club administration dropping dramatically.
Never in the history of medicine has the team approach become so important to patient care whilst, paradoxically, involvement in teamwork on the eld of play has declined for today’s medical students. ere is now compelling scienti c evidence to link physical activity with reduced risk of several diseases with doctors encouraged to prescribe exercise for patients and to extol the psychological and social bene ts from involvement in team sports.
In this era of declining participation in team sports, the Dublin Hospitals Cup competition represents an opportunity for medical students and junior doctors to play a competitive team sport in a tournament which is well organised by an enthusiastic group of senior physicians and surgeons. Staged over a short time period, the competition and its round-robin format lends itself to maximum participation by students and doctors. In addition to the physical bene ts of training and playing rugby, other advantages include being part of a squad which promotes social interaction with fellow students, doctors, and senior sta which in turn creates loyalty to a hospital. e Dublin Hospitals Cup nal, played at the same venue in Anglesea Road on the last Friday before Christmas, has become a major sporting occasion in the Dublin medical school calendar. Despite the seismic changes in the status of Rugby Union in recent years and the rapidly increasing academic and service demands on medical students and doctors, the competition for the Dublin Hospitals Cup is now more organised and more competitive than at any time in its 140-year history. e competition between rival hospitals has retained its essential vibrancy to this day and games are fought with an intensity and skill that is a testament to rugby as a sport.
Written by Drs Con Feighery, Michael Farrell and Morgan Crowe and designed by Garrett Bennis, e Hospital Pass is a riveting account of the history of the Dublin hospitals rugby competition which dates back to 1881, just three years a er the IRFU was founded. e book describes in glorious detail the players, mentors, rows, injuries, and skulduggery that have characterised the competition right up to the present day. e personalities are brought to life and the photographs, mainly black and white, are rich in detail with several dating back over 100 years. e in uence of Dublin physicians on the very foundation of the IRFU deservedly receives a lot of attention.
Even a glance through this carefully researched history will stoke memories among the hundreds, still living, who competed with varying skill levels in the competition over the years. ■
Raising the Cup, 2017. Captain of RCSI-Beaumont Hospital winning team 2017, Martin Davey.
TO BUY THE BOOK
e Hospital Pass by Conleth Feighery, Michael Farrell and Morgan Crowe celebrates the story of the Dublin Hospitals Cup competition, one of the oldest world rugby tournaments. With the Competition’s long history of characters, anecdotes and controversies, the book o ers a window on the evolution of Irish rugby and the changing face of Dublin medicine.To order your copy of e Hospital Pass, €50+ delivery, please go to https://shop.rcpi.ie/
Clinical Imaging – Issues to consider
CLINICAL IMAGES SHOULD BE TREATED LIKE ALL OTHER MEDICAL RECORDS, EXPLAINS MEDISEC’S LEGAL EXPERTS
They say a picture paints a thousand words and that can undoubtedly be true in the case of clinical imaging. Taking and sending clinical images has become a common feature of medical practice, in particular since the current pandemic with the increased use of remote consultations. In appropriate cases, sharing clinical images can be a bene cial addition and can lead to more e cient delivery of patient care.
However, there are some important factors to consider when receiving or sharing clinical images.
MEDICAL COUNCIL’S ETHICAL GUIDE
e Medical Council’s Guide to Professional Conduct and Ethics for Registered Medical Practitioners states the following in respect of recording: “Audio, visual or photographic recordings of a patient, or a relative of a patient, in which that person is identi able should only be made with their express consent. You should keep these recordings con dential as part of the patient’s record. You should be aware of security when sharing information by electronic means, including text, other electronic messaging or emailing, and you should do all you reasonably can to protect con dentiality. You should get consent before sharing videos, photos or other images of patients.
“In exceptional circumstances, you may take images of patients using your personal mobile device. You should do so only when this is necessary for the patient’s care. e images must not identify the patient, must be kept for the minimum time needed, and must be deleted as soon as possible.
Medisec is an Irish not-for-profi t company owned by its medical practitioner members. You are responsible for data protection in this regard and you must comply with any rules and procedures of your employer.”
GDPR AND CONSENT
Article 9.2(h) GDPR provides a lawful basis for the processing of special categories of personal data in medical practice. However, in the context of clinical images, we also recommend keeping a record of having obtained explicit patient consent to taking / receiving and storing the imaging. Your records should always re ect why you considered clinical imaging necessary in the context of a patient’s care.
Consent to clinical imaging should be sought from a parent / legal guardian in respect of children. Where a patient lacks capacity and there is no-one with legal authority to make decisions on their behalf, you must have regard to where the patient’s best interests lie, and whether clinical imaging is necessary in the context of their clinical care.
REMOTE CONSULTATIONS
In the absence of a face-to-face consultation, if clinical imaging is provided or requested as an aid to diagnosis or treatment, you should consider the following: • Discussing with the patient the limitations of relying on imaging and conducting examinations remotely. Explain that ultimately, a physical examination may still be required. • Whether it would be in the patient’s best interests to wait until they can attend in person. If this is not feasible and / or delaying could potentially cause further harm or delay further investigation, you may decide the use of clinical imaging and a remote examination is appropriate. Your records should re ect your decision making in this regard. • Obtaining the patient’s informed consent to proceed. • Deciding on the most appropriate modality for the imaging. A video consultation may provide a better overview whereas a photograph typically provides better resolution. • Considering the patient’s need for privacy and comfort with their environment and ensuring no interruptions at your end.
IT CONSIDERATIONS
• Doctors should ideally use a secure platform for processing clinical images, rather than rely on freeware apps or personal devices. If a patient is planning to send you a clinical image, you should advise the patient to send it to a secure account. • You should also let the patient know that any personal device they may be using to take and send the imaging may not be secure. • Any device which you use to take or receive clinical imagery should be properly secured. • Clinical images should be transferred securely from personal devices to the correct patient’s records as soon as possible. All images should be securely deleted from the personal device a erwards. • Just like clinical records, clinical images should be protected with back-up (disaster recovery), robust security, encrypted data transmission and appropriate user access controls. Clinical IT providers can provide best practice guidance on IT safeguards and controls. Whilst the use of clinical images has become more prevalent in clinical care, it is important to remember that they should be treated like all other medical records, and should be transmitted and stored securely in the patient’s records with adequate security systems in place.
If you are unsure about how to approach any particular aspect of dealing with clinical images, please contact your i ndemni er for speci c advice.
