Professor Pierre Mallia
St. Francis Family Clinic
12 School Street, Tarxien, Malta
Tel: 21347787, 2767868312 May 2014 President’s Report, AGM, May 2014 It has been my pleasure to be president of the Malta College of Family Doctors ten years ago when we celebrated our fifteenth anniversary. As circumstances have had it I am again in this post to celebrate our 25th anniversary as a College next year. Twenty five years is a significant amount of time. Those of us in our fifties have nostalgia already for our twenties. That is the amount of time passed. Indeed the college was at its infancy when I graduated. The fifteenth anniversary has already been a significant event. But twenty five is a quarter of a century and we must pause to reflect the past in order to understand better the future. The first fifteen years were significant in forming a foundation for the College. We established ourselves as a speciality of Family Medicine and formed links with other national and international bodies as well as academic communities such as EurAct, Europrev, and others. Following the fifteenth anniversary we could boast having made it on the Specialist Register in Malta, a significant event in itself, given that many important European bodies of general practitioners are not on their respective speciality register. To confirm this it was a natural consequence that, Malta being a ‘royal college culture’ we should seek the International Membership of the Royal College of General Practitioners. An AGM then, confirmed this direction; a direction which we maintain today when this year the MCFD became the first body to be accredited by the RCGP. We now produce a yearly examination for Vocational Trainees with which they can become members of the MCFD and (in turn) become international members of the RCGP. A significant percentage of College members have their MRCGP(INT) and we shall be introducing a path for those members who are on the specialist register to obtain this prestigious membership. It should be noted that whilst we are honoured considerably with the MRCGP(INT), the RCGP is actually recognising our own membership exam – that of the MMCFD. Therefore we should not only not underestimate the membership of the Malta College but recognise that it is of the same standard of the MRCGP. In fact maintaining membership of the MRCGP depends on maintaining membership of the MCFD. We plane a new memorandum of understanding between the two colleges will confirm this. Fellowship of the RCGP depends in fact as well on Fellowship of the MCFD. The council will form a committee of people to plan several events for next year. Amongst the activities I will personally suggest, besides conferment of the first group of fellowships, visits to important political and social persons, a special historical edition of the journal, social events and social events in which doctors and students can promote health issues to the public. With some luck we can also celebrate premises. Talks with Ministers Indeed discussions of premises have been part of the subject with several meetings we had with the minister of health and now the new parliamentary secretary, the Hon. Mr. Chris Fearne. A premises is needed for meetings and training courses, to host some social events and to keep records and databases. There may be a possibility of sharing a government sponsored place with other medical colleges. Upon the resignation of the Hon. Godfrey Farrugia we sent him a letter of thanks for the excellent work he did in promoting our college in his short tenure, and indeed in promulgating the tripartite agreement between us and the RCGP and DH. My personal thanks to him and we welcome him back hopefully into the education team. Upon the appointment of the Hon. Mr. Chris Fearn, a congratulatory letter from the College prompted an immediate invitation for the Hon secretary and myself to meet with him. During the meeting he explained his concerns on primary care and we discussed our involvement in improving both government and private practices by our educational activities. Indeed an accreditation system to maintain one’s specialist accreditation will be presented in the future to the AGM as this will certainly increase the specialist standing of our members. This needs to be discussed at council and voted upon during an AGM. Whilst many countries have introduced re-accreditation, having a system of credits, which is already in place in our college, translated onto the specialist register, will give the MCFD a stronger hand in the leading body of specialists and indeed set an example. Fellowship and honorary Fellowship The Honorary Fellowship is the highest honour a College can confer. It is given to people who have contributed significantly to medicine and especially Family Medicine. Last year we gave this honour to the first President of the MCFD, Dr. Denis Soler. It was my pleasure and honour to present him with the certificate during the yearly graduation ceremony. This year we decided that it would not be appropriate to give any further honorary fellowships as in fact many are suited to receive a Fellowship. However Fellowships need to have specific criteria which the council will present for approval at a general meeting. It is envisaged that fellowship can have several criteria one of which is a contribution to the MCFD for several years in some way or other. The significance of a fellowship is that a member shows that he or she has interest in family medicine beyond one’s own practice and is interested in the development of the speciality. This in turn shows an aptitude for interest in delivering optimal care in the community. Early next year we will therefore present criteria, following which applications will be issued and a board of respected members will be approved to act as referees. Graduation The graduation this year was held at the Xara Lodge in the outskirts of Rabat. It was a special occasion as usual but we are actively promoting this event as an important yearly landmark of the College with all the academic protocols and celebrations which such an event merits. Suggestions to use the Maltese language have been put forward and as from next year we hope to adopt a protocol similar to that of the University of Malta, giving space also to a short speech by one of the gradaunds. Indeed the reading of the Oath is a moment in which one can see the pride in the faces of relatives present. This year was also a special year as we received the RCGP accreditation. A feature of the event was put on the JMCFD. (see also speech published on May issue of the JMCFD). Education Education remains the main strength and objective of the College. It therefore stands without reason that it also presents the main headaches. Decisions about individuals involved sometimes have to be taken. These are very difficult times for council and are not taken lightly. It makes being at the helm very difficult. Whilst doing one’s best to protect the individuals, and trying to be as charitable as possible, one has to maintain a process of due diligence and inform the relevant bodies. This has been the case and I am happy to have found the whole support of council. Mistakes do happen and how we all move forward is a sign of the strength of the College. It has also thought us several lessons which we are addressing, such as to what extent one should extend a period of suspension. I am pleased to say that on speaking with our RCGP IDA, he said that the College proved its integrity. On the other hand the education process has its merits and the hard work of the people involved, including examination leads, examiners, organisers and logistics, coordinators etc all contribute so that together they orchestrate an excellent outcome. I am sure that this year will produce another excellent process and one cannot begin to imagine the amount of work, meetings, training sessions, and organisation which are already taking place. Indeed I feel that on becoming President, it was like taking over a ship which already had an excellent crew. Our main worry is sustainability. We cannot move forward only with the present members. Even worse, we cannot have a situation in which when someone resigns there is no one to take over. All members have to feel responsible to train people and not leave a sense of vulnerability. It is this which gains people trust and not leaving vacuums. We are investing a lot of time in encouraging those who have done the MMCFD exam to become involved as examiners, questions writers, examination leads, etc., themselves. This year we experienced another international call. Libya, through an agent in Malta, asked for our help in training general practitioners there. We discussed the possibility of offering a diploma in Libya. This would have generated considerable sums and indeed individual remuneration for tutors involved. However, following three months of intense meetings, both the volatile situation in Libya and our own sustainability militated that this did not materialise. We can still be asked to provide trainer courses locally as the Libyan government is contemplating the MRCGP(INT) as well. The RCGP has already approached us in the past to act as a Mediterranean hub. Increasing our capacity and sustainability in this area will be very important in the near future. If MRCGP(INT) graduands want a future fellowship of the malta and Royal colleges, this is an area in which investment will pay off. Another important educational activity was an application for an ERASMUS+ project. Camilleri & Camilleri helped us with the application and indeed the prospects look good that we will win the EU funds. These funds will amount to 450,000 euros over three years which will be used to organise innovative courses and training methods, which include the use of webinars etc. This will help us communicate our CME to our GOZO colleagues and perhaps also to those who cannot make it physically to an event. This will help one obtain the necessary credits more easily. Of course management of the fund is strictly supervised to be used solely for the intended purpose on the application. Conclusion I would like to conclude by reflecting again on our 25th anniversary. Whilst looking at our history we have to look at our future. We need to have a vision for this future. Even ministers in government without a vision waste their five years. Certainly we cannot waste member’s fees. A vision for the next ten years is important. We need to increase our capacity for being able to impart educational activities abroad, for participating in EU projects even more, for investing in our own members to being part of an active body of doctors. Teamwork requires resolve and humility, even if one is the best in one’s field. Council has already invested the seeds of these activities and we will be reaching out to receive feedback from members as well. I am proud that, notwithstanding the headaches we all go through as a council, we come out stronger and more humble. Members accept the decisions of the majority and together with all those working, helping and participating around the college council, we are building a stronger college. My sincere gratitude to all council members and to members coming forward to give their help and experience. Were it not for the fact that I hold this position I would not have realised the personal effort many you put in. A strong college makes family medicine strong as a speciality and family doctors strong as a group but more importantly contributes to stronger, better and safer family practice for our patients.