Dean and surgeon
Authors: R. Williamson
Journal: Journal of the Royal Society of Medicine (2005)

The word dean derives from the Latin decanus—a person set over ten. Since the RSM boasts an Associate Dean, an Emeritus Dean and eight Regional Sub-Deans, the arithmetic tallies. I somehow doubt, dear reader in 2055, whether this will be so in fifty years’ time. What do the Deans of the RSM actually do, and how did the Society manage without such creatures for nigh on 190 of its 200 years? When appointed to the post four years ago, my list of duties began with ‘directing the academic policy and strategy of the RSM Academic Department and ensuring high quality educational activities’. These activities are basically of two types—those of the 54 Sections and those of the Society as a whole—and each component has its own team of administrators within ‘my’ department. Since the RSM is historically the sum of its semiautonomous Sections, it would be a rash Dean who strove to interfere greatly with their activity when they run smoothly, although we do check every programme with a view to accreditation for continuing professional development. By contrast, the Deans play a direct role in Society conferences, and it is the rapid growth of this activity over the last twelve years that especially justifies their existence. On the milled edge of our current two-pound coin we read that we are ‘standing on the shoulders of giants’. My own lofty position is due to my predecessor Deans, Professor Paul Turner (1992–1994), Mr Adrian Marston (1995–1999) and Dr Jack Tinker (1999–2002); their portraits grace the passage to the Academic Department on the third floor at No. 1 Wimpole Street. As Associate Dean, Dr John Scadding is poised to spring onto my own shoulders—alas not gigantic—next year. From this succession it can be seen that various species of doctor have held the deanly post. Experience in hospital medicine has been a consistent credential, while some knowledge of postgraduate education has proved equally useful. Much of our week is occupied with organizing the academic events of the Society as a whole. Many RSM conferences have a strong multidisciplinary nature, as befits an organization that embraces doctors of all description as well as dentists, veterinary practitioners and ‘lay’ people with an interest in healthcare. Some conferences stick to a narrower clinical theme (‘Key Advances’), others have a pronounced scientific content (‘Bench to Bedside’) while others are informal conversaziones. We also arrange various courses—for example, information technology for doctors, medicine for lawyers or coroners. An important part of the job is to represent the Society in dealings with other academic bodies both within medicine (e.g. the Royal Colleges) and beyond (e.g. the Royal Society of Arts), but also overseas (e.g. the New York Academy of Medicine). The breadth of activity is exciting: within the past week, as I write, we have taken part in a conference on ageing held jointly with the King George VI and Queen Elizabeth Foundation, have helped convene a course for the MRCGP examination and have planned the forthcoming Bicentenary Service of the RSM to take place at St George’s, Hanover Square. It is also highly educational: over the past four years my own narrow focus on the pancreas has broadened remarkably to include topics as disparate as asthma and bioterrorism, acute neurology and the physiology of sport. My own week combines the duties of practising surgeon with those of RSM Dean in roughly equal measure. Many doctors cope well with this type of dual role, balancing their clinical duties with those of research scientist or hospital/ practice administrator or society officer. Is it any more difficult for a surgeon? The answer is no, except with regard to the disruptive effect of postoperative complications, which occur unpredictably and at inconvenient times. It is not just that a sudden haemorrhage can interrupt a committee meeting (which might sometimes be welcome); it is that they monopolize one’s thought processes until the problem is sorted and sometimes even afterwards. Generally it is only the operating surgeon who knows what is likely to have gone wrong—which is one reason why I prefer operation notes that have been written by the hand that wielded the scalpel. One unresolved problem with 218 J O U R N A L O F T H E R O Y A L S O C I E T Y O F M E D I C I N E V o l u m e 9 8 M a y 2 0 0 5