Message fromthe PresidentDear Members,

Welcome to our latestedition. I look forwardto meeting many of youat our forthcoming ICO Winter Meeting.The clinical session on anterior segmentfocuses on aggressive conjunctivalconditions, dermatology and glaucoma inthis context. We will also hear from the HSEwith regard to the roll out of an IT systemto support integration of community andhospital care. I have recently met with theMinister for Health Simon Harris, hisDepartment colleagues and the HSE todiscuss the progress of the Primary EyeCare Review and the Winter meeting willgive me the opportunity to talk with youabout the status of the report and to hearyour opinions and concerns.

I recently attended a Medical Councilseminar which brought together repres -entatives from across the Post GraduateTraining Bodies and other agencies todiscuss a number of proposals for futuredevelopments in the professionalcompetence scheme.

I would like to remind you all of yourProfessional Competence Scheme obliga -tions and encourage you to both attend andrecord CPD activity. I would also like tothank our colleagues who arrange meetingsaround the country throughout the year.Their efforts are much appreciated by us all.Should you need support and guidance onthe PCS process College staff are more thanhappy to help you get everything up todate. Whatever question you may have,you will not be the first person to ask it! Theautomatic uploading of points from ICOmeetings is still in its infancy. It will makelife easier but if there are hiccups, let theoffice know and please be patient with theprocess.

This newsletter reports on the achieve -ments of many of our younger colleagues.Congratulations to Rory Murphy onreceiving the ICO/Novartis Eye ResearchBursary 2017-18, announced at the 9th

Annual Adare Retinal meeting. In thisedition, the recipients of the 2016 Bayer /ICO Clinical Fellowship, Elizabeth McElneaand Andrea Ryan give an update on theirFellowship programmes. Elizabeth andStephen Farrell are also recipients of theHSE’s Dr Richard Steevens Scholarship foroverseas fellowship training. I encourageall of our trainees to compete for bothCollege and external bursaries.

Congratulations to Claire Quigley onreceiving the 2017 John Henahan Prize,awarded by Eurotimes. I would also like tocommend her on her involvement in theSOE Young Ophthalmologists programme.

Louise Hendrick has recently beenappointed as the HSE Lead for NCHDs.This is a very important and busy role andI wish her well in her endeavours.

As we enter a new century of theMontgomery lecture, it will be my pleasureto introduce Prof Michael O’Keeffe as thisyear’s lecturer. Michael has made asignificant contribution to Irish ophthalm -ology during his career and I am lookingforward to celebrating with him onNovember 24th.

With best wishesDR ALISON BLAKE

ICO NEWSLETTER | WINTER 2017 PAGE 1

NewsletterISSUE 19 WINTER 2017

Published byIrish College of Ophthalmologists121 St Stephen’s Green, Dublin 2. Tel 01 402 2777 · info@eyedoctors.ie www.eyedoctors.ie · t: @eyedoctorsirl

If you would like to make anysuggestions for future issues of theCollege Newsleer please contact Siobhan on siobhan.kelly@eyedoctors.ie

Pictured at the 9th Adare Retinal Meeting, which took place on September 28th in the DunravenArms Hotel, Limerick, were meeting co-ordinator Marie Hickey Dwyer, Doreen Curran, NovartisIreland and Alison Blake. The meeting included a excellent presentation from guest speaker IanFlitcroft on the management of myopia and a most helpful and practical session from DaraKilmartin on difficult cases in ophthalmology. The extensive programme also featured an updateon treatment for proliferative diabetic retinopathy, guidelines for the management of DME andthe efficiency of ocriplasmin in the treatment of VMT. More on the Adare Retinal Meeting on page 8.

9th Annual Adare Retinal Meeting

The concept behind the 2017campaign theme ‘See the Whole Picture’

was to create a narrative about life withAMD with real people telling theirstory.

The launch event took place in theNational Gallery of Ireland on MondaySeptember 25th with a portraitexhibition from celebrated Irishphotographer Barry McCall.

The focus was to capture eachindividual’s passion as seen throughtheir eyes, to show how AMD hasimpacted on their life. The imagesshow the progression from the earlystages of the condition, blurred orwavy vision, through to the advancedstages. The striking visuals served as areminder to the public to get their eyestested regularly, to ensure they ‘See the

Whole Picture’.Thanks to Mark Cahill, Marie

Hickey Dwyer and all our memberswho gave their time during the week to

participate in radio and mediainterviews.

ICO NEWSLETTER | WINTER 2017PAGE 2

Miriam O'Callaghan, Photographer Barry McCall and Loretto Callaghan, Novartis Irelandpictured at the AMD Awareness Week launch event in the National Gallery of Ireland.

Public Urged to ‘See the Whole Picture’ During AMD Awareness Week

This year marks the 10th Anniversary of AMD Awareness Week (September 25th-30th). The ICO continues to

support the initiative, alongside other eye health organisations in order to create greater public understanding of

AMD, and encourage those aged 50 and over to have their eyes tested regularly.

L-r Siobhan Kelly, Elaine Howley and Sally McEllistrim, NCBI, Lynda McGivney Nolan, AOI, Chris White, NCBI, Kevin Whelan and Amanda Kenny,Fighting Blindness, Miriam O'Callaghan, Mark Cahill, Doreen Curran and Loretto Callaghan, Novartis

ICO NEWSLETTER | WINTER 2017 PAGE 3

ICO WINTER MEETING

The clinical session at this year’smeeting looks at ‘Skin to Disc’ linkingdermatology, the ocular surface andglaucoma.

Prof Frank Powell, ConsultantDermatologist at the Mater Hospital andthe Charles Institute of Dermatology inUCD will talk about new developments inacne rosacea. Prof Powell will be followedby Billy Power who will discuss rosaceaand other skin conditions that haveconjunctival and corneal effect. Aoife Doylewill talk on the management of glaucomain the context of those challenges.

We will also hear from Niall Synott,HSE Assistant National Director inInformation Technology and GregoryJohnson, HSE Programme Lead fore-referrals with regard to the roll out of arobust IT system and electronic patientrecord (EPR) to support integration ofcommunity and hospital care. GerryKelliher, statistician with the NationalSurgery Programme will talk about thedata that is currently collected by theHSE and how that data influencesdecision making.

The development of integrated carepathways will involve sending patientdata, including photographs, to multiplelocations, and a proven, robust IT system

will be needed instead of a paper-basedsystem in all locations participating in thepathway. The implementation of an EPRis essential in order to facilitate thetreatment of patients in the community, sothat all those involved in treating thepatient can view the section of thepatient’s records necessary for their rolein the eye care pathway.

The proposals from the Ophthalm -ology Clinical Programme and therecommendations from the Primary EyeServices Review group are in line with allof the major health policy positions of thisGovernment. During the recent 2018budget announcements Minister forHealth Simon Harris reaffirmed theGovernment’s commitment to “shiftingthe model of healthcare towards a morecomprehensive and accessible primarycare service in order to deliver better careclose to home in communities across thecountry.”

The Winter Meeting presentations willgive an opportunity to discuss in moredetail the next steps that must be taken toimplement the appropriate IT infra -structure and software.

The RAMI meeting will follow after lunch

in the same venue, the Institute of Chartered

Accountants on Pearse Street.

MontgomeryLecture 2017 The ICO is

delighted to

announce that the

2017 Montgomery

Lecture will be

delivered by

Professor Michael

O’Keeffe on the

evening of Friday, November 24th

in Trinity College. The title of

Professor O’Keeffe’s lecture is

“The Evolution of Paediatric

Cataract Surgery”.

Professor O’Keeffe has been anoutstanding and influential figurein the ophthalmic field both here inIreland and abroad throughout hiscareer. The ICO is honoured toinvite him to deliver this year'slecture in recognition of hissignificant contrib ution to thespecialty and paediatricophthalmology in particular.

Professor O’Keeffe’s lecture willdiscuss classification, surgicaltechnique, complications and recentadvances to improve visualoutcomes in paediatric cataractsurgery. In an overview, Prof.O’Keeffe said childhood cataractsaccount for 10% of all blindnessworldwide and are an importantcause of lifelong visual impairment.Successful outcomes require earlydiagnosis prompt referral, surgicalintervention, prompt visualrehabilitation and treatment ofamblyopia.

Although paediatric eyes differfrom adults, Prof O’Keeffe willoutline how the advent of phacoemulsifica tion has changed surgicalapproach to childhood cataracts.Many obstacles remain such as eyegrowth, manage ment of Aphakiaand glaucoma. However, advancesin pharmacology, surgicaltechnique, contact lenses and abetter understanding of glaucomashould improve outcomes.

A pre-lecture drinks reception will

commence at 6pm, with the Lecture

scheduled to begin at 6.30pm.

From left to right; Jim Miley Sightsavers Ireland Chairman, Daragh Fahey Director of QualitySafety & Risk Management, Tallaght Hospital, and Dr. Imran Khan Sightsavers Chief GlobalTechnical Lead at Sightsavers’ recent event in Powerscourt. The information evening demonstratedSightsavers work to develop costs efficient and sustainable eye health interventions that transformlives. Dr. Imran Khan discussed the critical nature of partnerships with local governments in develop -ing cost-effective approaches that can be scaled up and replicated, and the support Sightsaversprovide in the training of eye health professionals to deliver quality, affordable services.

The Irish College of Ophthalmologists Winter Meeting takes place on

Friday, 24th November at the Chartered Accountants House on Pearse

Street in Dublin.

Sightsavers Ireland

ICO NEWSLETTER | WINTER 2017PAGE 4

European Society of OphthalmologyYoung Ophthalmologists

by Claire Quigley

The SOE meeting included the firstever election of the SOE youngophthalmologists (YO) committee,which, inspired by the AmericanAcademy of Ophthalmology (AAO)YO, was established in 2009 to servethe collective needs of YOs in Europe.YOs are defined as ophthalmologists intraining, or in their first five years ofindependent practice. In the Barcelonameeting the SOE YO organised aseparate track specifically focused onrelevant topics for YOs, includingsurgical videos, dry labs, and popularsessions such as; "Top Tips on Makingthe Most of Training Opportunities inEurope", "Training opportunities in theUK for European YOs post Brexit", and"Essential Surgical Skills – Top Tips forYoung Ophthalmologists".

Beyond their meeting, which will beheld again in Nice in 2019, the SOE hasseveral activities relevant to YOs. TheSOE organise travel grants for EasternEuropean YOs to visit ophthalmiccentres in Europe, and on their websitethere are archives of video presen -tations from prior congresses, and adatabase of some of the fellowshipsavailable across Europe, which is beingupdated on an ongoing basis. Therewill also be a biannual newsletter,focusing on subjects relevant to YOs.

The latest newsletter from the SOEYO was released on September 1st. Itrecaps the SOE 2017 congress, looksforward to some other upcomingmeetings, and highlights some of theaims of the current SOE YO chair,Marie Louise Rasmussen. Among herkeynote projects are support fornational YO groups, which couldenhance awareness about education

and improve the standards of training.Aims of the Irish College ofOphthalmologists at present include todevelop a YO-friendly session at thenext ICO annual meeting. At the SOEYO meeting I volunteered to representYOs in Ireland, taking over the rolefrom Max Treacy and Ghaleb El-Farouki, and I will also contribute tothe society newsletter.

If you would like to contact Clare

about the SOE YO please email

quigleyclare@gmail.com

Davit Shahnazaryan and Aida Hajjar picturedat the biennial European Society ofOphthalmology (SOE) meeting in Barcelona,June 10th-13th, 2017.

The biennial European Society of Ophthalmology (SOE) meeting took

place in Barcelona, on June 10th-13th, 2017. The meeting was preceded by

the European University Professors of Ophthalmology course, which this

year focused on anterior segment disease. The didactic course included a

lecture from Prof. Conor Murphy of the Royal Victoria Eye and Ear Hospital,

Dublin, on the topic of meibomian gland dysfunction.

Training & RetainingOphthalmologists

As both a training and

professional body, the

College has an important remit in

actively engaging with all of the

Institutions across the health

service, to ensure that the best

medical graduates continue to be

attracted to the specialty and most

importantly that the specialist

skills of our trained ophthalm -

ologists are retained in Ireland

and that a career in ophthalm -

ology in this country is a

rewarding experience.

To ensure that the guidancegiven to policy makers is evidencebased, the ICO is carrying outresearch to examine why Doctorschoose to specialise as Ophthalm -ologists and what issues inspecialty practice influencewhether they stay working asophthalmologists through-out theirmedical careers. The researchfurther aims to understand; whytrained ophthalmologists are nottaking up consultant posts orcommunity posts or in some casesnot staying in those posts through -out their careers?

While there is significantdemand for ophthalmologyservices with long waiting lists,many posts, particularly those inthe community are currentlyunfilled. A greater understandingof the lived experience of doctors inthe specialty of ophthalmology,both during training and inpractice, will enable the College toadvise the HSE on the impact of theissues identified on the work forceand the implications for futureplanning.

During November a survey is beingcirculated to ophthalmologists inpractice and in training as part ofthis research project. The surveyresponses are anonymised and yourcontribution to the project is veryimportant, please do take part.

ICO NEWSLETTER | WINTER 2017 PAGE 5

Explaining the project rationale,Rory said, “Our study focuses onpreventing sight loss in glaucoma, theleading cause of irreversible blindnessglobally. Unmyelinated retinalganglion cells, which form the opticnerve, exit the eye posteriorly througha mesh-like porous structure called thelamina cribrosa. In glaucoma, fibrosiscauses maladaptive, structuralremodelling of the lamina cribrosa,resulting in nerve cell death andsubsequent sight loss. Our prelim inary

work has involved developing a novel3D biomimetic Lamina Cribrosascaffold for in-vitro use, to closelyresemble the natural cellular micro -environment in-vivo. Using alteredscaffold stiffness as a stimulus for pro-fibrotic cellular activation, we willdetermine the ability to inhibitmechanotransduction of matrixstiffness, reducing subsequentprofibrotic epigenetic alterations andpreventing the ultimate structuralremodelling and sight loss seen in

glaucomatous neuropathy. Theseinhibitors could offer a novel andcompletely different therapeutic optionin glaucoma management from thecurrent, but often inadequate, goldstandard of reducing intraocularpressure. I am most grateful to bothNovartis and the Irish College ofOphthalmology for the opportunity toconduct this research.”

Now in its 6th consecutive year, theannual ICO/Novartis ResearchBursary is an unrestricted educationalgrant awarded to a doctor who wishesto undertake a research project orspecific training in the field ofophthalmology. The bursary has beeninstrumental in facilitating eye doctorsin Ireland to undertake pioneeringresearch into potential cures andtreatments for sight-threateningconditions.

ICO Trainee Winner of 2017 John Henahan Prize

Clare’s winning essay was on thetopic of ‘How does commercial interest

affect my career’. The Henahan prize isnamed in honour of John Henahan,who edited EuroTimes from 1996 to2001 and whose work has inspired ageneration of young doctors andjournalists.

Clare received a travel bursaryworth €1,000 to attend the XXXVCongress of the ESCRS, and a specialtrophy was presented to her at theVideo Awards Session.

Emanuel Rosen, chief medicaleditor of EuroTimes and chairman ofthe judging panel, said all thesubmissions were of the highestquality, making selection of a winnerextremely difficult.

“The shortlisted essays werepublished in EuroTimes, and anybodywho read them will see what adifficult decision the judges had tomake. But in the end, there could be

only one winner, and Dr ClareQuigley is a very worthy recipient ofthe 2017 John Henahan Prize,” hesaid.

The judging panel also includedThomas Kohnen, chairman of theESCRS Publications Committee, JoséGüell, former president of the ESCRSand Oliver Findl, chairman of theESCRS Young OphthalmologistsCommittee.

On winning the Prize, Clare said“Writing for the John Henahan Prizewas a rewarding experience – mymedical writing has thus far beenscientific, and ordered into abstract-friendly sections. It was engaging towrite in a less restricted way aboutcommercial interests, which we allencounter. It’s an honour to have myessay chosen for the prize, and I’mespecially delighted as I very muchenjoy writing, of scientific and othervarieties.”

Claire Quigley, recipient of the John HenahanPrize 2017.

Congratulations to Clare Quigley, a trainee at the Mater Misericordiae University Hospital, who was announced

the winner of the 2017 John Henahan Prize by Eurotimes at the Video Awards Session on the 8th October.

Winner of ICO/Novartis Eye Research Bursary 2017

Rory Murphy was announced the winner of the ICO/Novartis Eye

Research Bursary 2017-18 at the Annual Adare Retinal Meeting in

September. His research which focuses on novel therapeutic pathways in the

treatment of glaucoma is being carried out between the facilities at

University College Dublin and The Catherine McAuley Research Centre,

Mater Misericordiae University Hospital, under the supervision of Prof.

Colm O’Brien.

ICO NEWSLETTER | WINTER 2017PAGE 6

Medical Ophthalmology Sub Specialty Day

The 3rd Medical Ophthalmology

Sub Specialty Day entitled

‘Practical OCT’, chaired by Fiona

Kearns, was held on the 15th

September in the Learning Centre at

the Royal Victoria Eye and Ear

Hospital.

Frank Kinsella opened the meetingwith an informative and practicalapproach to interpretation and manage -ment of Macular OCT followed by aquestion and answer session.

This was followed by a demon -stration session from Fergal Byron,Topcon and John Walsh, MED on theirrespective OCT’s, showing the scopeand many uses of OCT in clinicalpractice. Demonstration of an OCT machine.

Maureen Hillary and Sacha Hutchinson Sheena Creaven and Marie Sweeney

Siobhan Kelly and Emer Doolin Dharm Pandeya, Caroline Gardiner and Rashid Nahar

Alison Blake and Susan Mullaney

ICO to host Royal College ofOphthalmologistsExam

The ICO is delighted to announcethat trainees on the Irish

ophthalmology programme will beable to sit the Royal College ofOphthalmologists Part 1 FRCOphthexam in Dublin as of January 2018.Prior to this, the exam was taken byour trainees in London. The exam ismandatory for trainees on the Irishprogramme and having Dublin as alocation will make it significantlyeasier for our trainees to sit. We areespecially delighted to work withour colleagues in the Royal Collegeand look forward to the furthercollaborations between our twoColleges.

The ICO also welcomes therecent decision by the RCOphthExams Committee that as of October2017, interns are now eligible to sitthe Part 1 FRCOphth exam.

The dates for the 2018 exam areMonday, 15th January, Tuesday, 8thMay and Monday 1st October.

ICO NEWSLETTER | WINTER 2017 PAGE 7

From July 2018, a reconfiguration ofthe existing accredited programme inthe form of two separate trainingpathways, one for medical ophthalm -ology and one for surgicalophthalmology, will be implemented.The new training pathway for MedicalOphthalmology continues to placepriority on subspecialty expertise in theareas of paediatrics, glaucoma and

medical retina. A main aim of thestand-alone programme is to deliverthe required Medical Ophthalmologistsworkforce needed to respond to thecurrent and future patient demand.

Dean of Postgraduate Education,Yvonne Delaney gave a presentation tointerns and final year medical studentsand facilitated a round-table discussionat the careers clinic session, a new

feature to the event this year whichallowed delegates designated timewith a Consultant from their chosenspecialist field to ask further questions.The College would like to thankYvonne and Sarah Gilmore for theirparticipation and time at the event.

The ICO was also invited to presenton the new training pathway inophthalmology at a number of Interncareer events at the various InternNetworks, including the Mid WestNetwork, UCD and TCD.

Re-configured Ophthalmology Training Pathwayannounced at Medical Careers Day 2017

The ICO formally announced details of the new training pathway for Medical and Surgical Ophthalmology at

the Annual Medical Careers Day. This day is organised by the Forum of Irish Postgraduate Medical Training

Bodies and was held in Dublin Castle on Saturday, 23rd September.

Siobhan Kelly and Alison Blake pictured with medical stucents Diane Kelly, Eleanor Morris andChloe McDermott at the Medical Careers Day 2017 in Dublin Castle.

Yvonne Delaney pictured with Medical Students, Amy O’Regan, Niall Byrne, Jocelyn IP andMohammad Bajilan.

ICO NEWSLETTER | WINTER 2017PAGE 8

9th Annual Adare Retinal Meeting

Ian Flitcroft, Catherine Cleary, Patricia Quinlan, Eamonn O’Connell, Dara Kilmartin, Marie Hickey Dwyer, Robert Acheson, Frank Kinsella

Margaret Pierse, Marie Hickey Dwyer, Katherina Tobin

Declan O’Brien, Robert Acheson, Eamonn O’Connell, Robert King Hall

The 9th Adare Retinal Meeting, coordinated by

Marie Hickey-Dwyer, took place on September

28th in the Dunraven Arms Hotel, Limerick.

The extensive programme of talks attracted an audienceof ophthalmologists from all over the country, from traineeto those in practice. Following the meeting, Marie Hickey-Dwyer said she was delighted to see so many peoplepresent, and that the spread from NCHD to practicingophthomalogists was a key ingredient to its success withgreat audience engagement and participation each year.

Marie paid tribute to all those who spoke. Inparticularshe mentioned Ian Flitcroft, who gave a presentation on theactive management of myopia. Ian is currently coordinatinga large European study on myopia, which we congratulatehim on and wish him every success with.

In an excellent and most practical presentation, DaraKilmartin examined a selection of difficult cases andscenarios that ophthalmologists may have to deal with.This was followed by robust audience discussion andprovided a helpful platform for delegates to explore suchscenarios and hear expert opinions and advice fromcolleagues.

The programme of talks also included updates on thetreatment of proliferative diabetic retinopathy, guidelinesfor the management of DME, vitreous haemorrhage,hydroxychloroquine maculopathy and the efficiency ofocriplasmin in the treatment of VMT.

The Teaching Faculty was Frank Kinsella, Marie Hickey-Dwyer, Dara Kilmartin, Patricia Quinlan, Catherine Cleary,Eamonn O’Connell and Robert Acheson. They facilitatedan excellent interactive component to this year’s Adaremeeting.

ICO NEWSLETTER | WINTER 2017 PAGE 9

The Union of European MedicalSpecialists is an EU wide represent ativebody liaising with the EU Commissiondivided into sections by specialty. UEMSrepresents over 1.6 million medicalspecialists in all the different specialties.It also has strong links and relationswith European Institutions (Commis -sion and Parliament), the otherindependent European Medical Organ -is ations and the European Medical /Scientific Societies. The UEMS has 39Specialist Sections, which representindepend ently recognised specialties.They each created a European Board asa subgroup, in conjunction with therelevant European Society, with a viewto defining European standards ofmedical education and training.

They also contribute to the work ofMultidisciplinary Joint Committees(MJC) which address fields of amultidisciplinary nature. The Section ofOphthalmology encompasses theEuropean Board of Ophthalmologywhich awards the EBO Diploma.

The current President is HankBonnemaijer from The Netherlands,who will be in the role for a four-yearterm. Our own Denise Curtin is theGeneral Secretary and the Treasurer isEija Vesti from Finland.

Accounts are held in Brussels and theannual accounts were accepted by theSection at the plenary session.

The European Accreditation Councilfor CME (EACCME) plays a major partin setting the standards for CME/CPDthroughout Europe. This leading role isbeing increasingly recognised bypolitical organisations such as theEuropean Commission and Parliament,educational and funding organisations,and doctors. It has mutual recognitionwith the American Medical Association.

European Union Training

Requirement (ETR)

Minimum requirements are beingidentified in all specialties. This isrequired by the European Commission.Competency based Curricula andminimum training requirements will beapproved by National MedicalAssociations.

The EBO exam has become sopopular, that the location no longer canaccommodate all who apply. Thepossibility of a second location in Berlinwas discussed. The EBO now has anadvisory committee to takeresponsibility for the exam. 27 countrieswere represented at the 2017 exam with

280 examiners and a 92% success rate.The Peter Eustace medal was presentedto Prof Roger Hitchings from London

The UEMS is now over 60 years old. The section is an observer at the

European Coalition for Vision. Clear understanding of the “medical

act” will be increasingly important infuture to ensure safe care of eye patients

The president’s term will finish in2019 and Wagih Aclimandos was electedunopposed as President Elect.

The plenary session of the Section ofOphthalmology will be held inRungsted, Denmark, June 9th and 10th,2018 and in Valencia, Spain in 2019.

Report on UEMS Section of Ophthalmology Plenary Session – Santorini, Greece June 2017

by Alison Blake

Professor Constantino Bianchi

With greatsadness

we have to reportthe sudden deathof our belovedand appreciatedcolleague. Foryears he hadbeen the figure -head of the UEMS section ofOphthalmology. For several years, heworked strenuously for our sectionas successive Vice President,President, Past President and Liaisonofficer. He cemented the links withthe executive of the UEMS and as aresult Ophthalmology has becomemore intensely involved in thewider UEMS.

He played an important role intimes when the UEMS was infinancial difficulties. He always hadthe preservation of theOphthalmology section in mind. Wewill miss him very much, especiallyhis clear analytical thinking and hisvery diplomatic way of interactingwith the UEMS executive.

The 71st Plenary Session of the UEMS Section of Ophthalmology was held in Santorini, Greece,

17th-18th June 2017.

The Ophthalmic Postgraduate

Teaching Programme Lecture on

December 14th will be held in

memory of our esteemed colleague

Mr Peter Barry, who sadly passed

away in May 2017.

Guest lecturer Professor OliverFindl, Head of the Department ofOphthalmology at the HamuschHospital in Vienna, will give a lectureon ‘Lens Surgery and RetinalDetachment: Risks and Prophylaxis’.

Prof Findl is a Board Member of

the ESCRS and the Head and Founderof the Vienna Institute for Research inOcular Surgery (VIROS). His researchinterests are in the areas of posteriorcapsule opacification, opticalbiometry, and the patho genesis ofmyopia and has authored more than250 articles in international peer-reviewed journals.

The lecture takes place at theEducation and Conference Centre,Royal Victoria Eye and Ear Hospitaland will be chaired by Dara Kilmartin.

Mr Peter Barry Memorial Lecture

ICO NEWSLETTER | WINTER 2017PAGE 10

The inaugural Bayer/ICO ClinicalFellowship in Ophthalmology2016/2017 was awarded to traineesElizabeth McElnea and Andrea Ryan atthe ICO Winter Meeting in December2016. The Fellowship is open to allsenior ophthalmology trainees in theIrish health service, who are nearingthe end of their specialist training.

Andrea Ryan has now completedher Medical Retina Clinical Fellow shipat Moorfields Eye Hospital in London.She explains that the ultimate goal ofher fellowship was to move towardsbecoming competent to specialist levelin the assessment, diagnosis, treatmentand follow-up of patients with medicalretina disease including retinalvascular, genetic and uveitic disorders,in light of the demand for theseservices. In addition, she said theadvent of new effective treatments forthese conditions has only served toaugment this demand.

Andrea said, “As a specialty,ophthalmology is finally getting theattention it deserves within the Irishhealth service, not only in terms ofawareness, with high profilecampaigns relating to age-relatedmacular degeneration and the diabeticretinopathy screening programme, butalso in terms of policy and funding.”

“It was recently announced thatthere is going to be a roll-out of therecommendations of the HSE Reviewof Primary Care Eye Services, whichwill reform primary care eye services.There is an increasing recognition ofthe demand for it and the need todevelop the service. Ophthalmologystill has one of, if not the longest,waiting lists when it comes toprocedures and operations. Hopefullyit is becoming more of a priority.”

Andrea now hopes to bring theexpertise she has gained during the

fellowship back to the Irish healthcaresystem and the large and growingpopulation of Irish patients affected bythese disorders.

“During my Fellowship pro -gramme I got to see a very high volumeof cases in this specialty, and of courseas Moorfields is one of the leading eyehospitals in the world, it receivesreferrals from everywhere, all over theUK, so they would have a much higherproportion of more difficult andchallenging cases you may not seeelsewhere. There is also such a largenumber of consultant specialistsworking here that you have theopportunity to learn from.”

Meanwhile, joint winner ElizabethMcElnea commenced her fellowship inthe UK in July this year, where she iscompleting training in ophthalmicplastic lacrimal, orbital and recon -structive surgery. Working betweenAintree University Hospital, TheCountess of Chester Hospital, andMacclesfield District General Hospitalunder four different supervisingconsultants, she says that she isreceiving invaluable experience in thehighly competitive subspecialty ofocular plastics.

“This is a recognised subspecialtybut I suppose it’s not that common thatthose three are undertaken together asa subspecialty; there are people whoare qualified in plastic surgery but maynot have as much experience in orbitalor lacrimal surgery, so it’s great that Iam able to do all three together,” sheexplains, adding that she has also beenable to avail of the teachingprogramme at the University ofLiverpool.

Elizabeth adds that she is carryingout a high volume of surgery, includingcomplex variations of cases. “It’s asingle fellow training post, and I amgetting unrivalled theatre exposure.”

Drawn to ophthalmology as anundergraduate, Elizabeth says thecombination of surgery and medicinewas what initially attracted her.

During her training in Ireland, sheworked in University Hospital Galway,and also the Mater Hospital in Dublin.She explains that, for her, the goal of

Bayer/ICO Clinical Fellowship inOphthalmology

Winners of the Bayer/ICO Clinical Fellowship in Ophthalmology 2016/17, Andrea Ryan (centre)and Elizabeth McElnea (2nd from left), pictured with Yvonne Delaney, ICO Dean of PostgraduateEducation (far left), Katy Carroll, Business Unit Manager and Neil O’Connor, Product Manager,Specialty Medicine of Bayer Limited.

In the following article, joint winners of the inaugural Bayer/ICO Clinical

Fellowship, Elizabeth McElnea and Andrea Ryan speak to health journalist

Danielle Barron about the invaluable experience of their chosen fellowship

programmes and the positive impact it has had on their training career.

ICO NEWSLETTER | WINTER 2017 PAGE 11

the fellowship is to obtain intensiveexposure to her chosen subspecialty.

“I have had great training in Irelandbut the reality of the services here isthat many consultants have largegeneral clinics in addition to theirspecialised work. The idea of going tothe UK is to get lots of exposure tosubspecialty work, which isn’t dilutedby general ophthalm ology work,” shesays.

She echoes Andrea in highlightingthe many differences betweenophthalmology practice in Ireland andthe UK. “It is highly subspecial isedhere – the sheer volume of cases meansophthalmic surgeons are not doing anygeneral ophthalmology, all their clinicare subspecialist clinics. That is thebiggest advantage of doing thisfellowship that you easily get lots ofexperience in the area you want. I amtrying to learn as much as I can in arelatively short period of time.”

It’s also interesting to see thedifferences in health service manage -ment and organisation between thetwo jurisdictions, she adds. “You cansee advantages and disadvantages toeach, and then decide which might beapplicable to your own service ordepartment. I have to say it is a lovelyworking environment, everyone has

been so nice and welcoming, from theconsultants to the rest of theophthalmic surgery team and thenursing staff.”

After the fellowship ends nextsummer, Elizabeth aims to return toIreland, with the hope of obtaining aconsultant post. She sees the fellowshipas a prime opportunity to broaden herhorizons before coming home to workin the Irish health service long term.

“I think it is so important to workabroad. Not only for the practicalreasons, such as the exposure to yourchosen subspecialty as I havementioned, but also it is critical to seehow other people do things. I don’t justmean clinically, or surgically, but alsofrom a managerial and leadershippoint of view. It’s so beneficial tosimply work in a different healthcaresystem and pick up ideas andknowledge from that, particularly ifyou are planning to come back with aview to obtaining a consultant post.”

As part of the fellowship, Elizabethalso has the chance to engage in highquality research, which she says willadd to the evidence-based practice ofthis ophthalmic surgery subspecialty.

“I have made it a point through mycareer to date, to try and publish even

a little bit on each job I have worked in,and I certainly intend to continue thatin the UK, as best possible.”

The registrar said that the fundingprovided by the ICO and Bayer is acritical factor in allowing her to take upthis particular fellowship. “Starting afellowship is actually quite daunting,there is a lot of transition involved, andit means a lot to have support, financialor otherwise, during this time. There isno funding associated with this post soI would have had to forego itotherwise. If this works well, the hostmay decide to fund it in the future andmake it an ongoing fellowship, whichcould benefit many doctors in futureyears.”

The ICO congratulate Andrea andElizabeth again on their award of theBayer / ICO Clinical Fellowship and intheir achievements to date under theirchosen fields of sub specialty.

The College would also like tocongratulate Dr Caroline Baily, whowas announced the winner of theBayer / ICO Clinical Fellowship at theICO Annual Conference 2017-18 inMay this year. Dr Baily is currentlyundertaking a fellowship in MedicalRetina at Manchester Royal EyeHospital in July 2017.

Surgical Skills Course

Pictured at the Skills Course held in theKiran Pathek Laboratory in York Housein September were: Amira Abdin Salih,Paul O'Brien, Muhammad Omar Ashraf,Hafiz Syed Umar Abdur Rehman, KarenCurtin, Christine Bourke, Nora Mohd,Ruth Ellard and Esraa Hegazy. Thank you to photographer Tim Fulcher.

Conor has established the SparkInnovation Programme, which offersdoctors seed funding for innovationprojects and support with the develop -ment and implementation of their ideas.

He is part of the HSE NationalDoctors Training and Planning (NDTP)Unit, which incorporates the MedicalEducation and Training Unit andConsultant Appointments and MedicalWorkforce Planning. NDTP now hasover 60 lead NCHDs around Ireland.

The Spark Ignite innovationcompetition and national BrightSparkAwards will recognise and reward thecreativity and leadership of NCHDsand their nursing, allied health,management and administrationcolleagues.

Speaking about his role, Conor saidhis priority with the programme is toencourage NCHDs to see them selves asinfluential and powerful agents forchange and to share their experiencesthroughout the country.

Conor said the initiative is not justabout big clinical sites, citing that GPpractices and smaller hospitals acrossthe country are hot houses for changeand that it is important to share theirstories of success. Speaking at theHealth Manager Ireland Conference inthe RDS on September 29th, Conor saidthat Irish doctors have always beeninnovative, and Irish NCHDs especiallyso. He believes we have a proud historyin service development and innovationin treatment and technology and theaim is to build on that legacy.

The Spark Innovation Programmehas six arms. Spark Conversation,Spark Curiosity, and Spark Debate areabout provoking thought and engagingwith NCHDs. Spark Seed Funding,Spark Ignite, and the BrightSparkAwards will recognise positive changeand put innovative ideas into action.

Ophthalmology is a particularlydynamic speciality, Conor said, “wherewe have seen many superb innovation

projects recently, such as Ms. ShivonaChetty's new oculo plastics pathway atSligo University Hospital, Dr. ChristineGoodchild’s review of referral processesat Beaumont Hospital, and of course thenew cataract unit at RVEEH. We have alot of great ideas to celebrate and share.”

Highlighting the focus over thecoming months, Conor confirmed theprogramme will be hearing stories ofinnovation from national and inter -national doctors, bring a roadshow ofworkshops around the country, andhold a series of debates on controversialtopics.

He added, “We are looking to thefuture, writing position papers on howtechnology will transform doctortraining and consultant workforceplanning. Babies born this year willbecome interns in 2040, so our themefor the year is #NCHD2040. WhatNCHDs are doing today will have ahuge impact on future patients andfuture doctors – this is why we mustvalue innovation.”

If you would like to learn more about the

Spark Innovation Programme, Conor can be

contacted by email via spark@hse.ie or

@drconormalone on Twitter

ICO NEWSLETTER | WINTER 2017PAGE 12

Conor Malone, ICO trainee was recently appointed as the first HSE

National Fellow for Innovation and Change and is leading an initiative

aimed at encouraging NCHDs to share innovation projects from their

communities and hospitals.

Princeton Lee’s Phaco Bootcamp

The Irish College of Ophthalmol -ogists recognises the importance

of setting a strong surgical skillfoundation for new trainees. Since2014, Phaco Bootcamp has been amandatory course for first yeartrainees.

Mr Princeton Lee designed thiscourse to instruct phaco-mechanics andphaco-dynamics as well as the correctuse of microscopes to the trainees.Phaco-mechnics focuses on the ergo -nomics of holding and manoeuvring theinstruments in order to achieve themaximum range of movement insidethe eye in a controlled fashion.

Phaco-dynamics helps trainees tounder stand the parameters and settingof the phaco-machine. The aim of thiscourse is to help the trainees to practiceand acquire surgical skills in a safe andcontrolled environment beforeoperating in the theatre.

The 4th Phaco Bootcamp took place in St. Vincent’s University Hospital. Niya Beings, PrincetonLee, Ate Altenburg, Anne Rafferty and Ruth Ellard.

ICO Trainee Leads HSE Spark Ignite Innovation Programme

The first day of Retina 2017,coinciding with World Sight Day,included multi-stakeholder round tablediscussion on the management ofclinical trials, with a focus on diseasesof the retina. The Scientific Programmefeatured recent updates in areas ofretinal gene discovery, diseasemechanisms, translational studies,therapeutics and clinical applications.The group discussed the challengesfaced when conducting clinical trialsand how best to navigate them.Investigators from both pharma ceuticaland academic-led trials, regulators,clinicians and represent atives from theNational Clinical Research Networkdiscussed trial sponsorship, infra -structure and design.

Fighting Blindness has urged theGovernment to prioritise the fundingof clinical genetic services, includingClinical Consultant Geneticists andGenetic Counsellors, for people whohave inherited retinal conditions. The

Charity said such funding isfundamental to the diagnosis, care andtreatment of the estimated 5,000 peopleliving with genetic sight loss in Ireland.Ireland has among the lowest numbersof genetic staff per 100,000 populationin Europe, resulting in waiting lists forclinical genetic services stretching up to18 months and longer.

Kevin Whelan, Fighting BlindnessCEO, said that based on population,the Republic of Ireland should have 14consultant geneticists and 46 geneticcounsellors.

“With just six clinical geneticistsand 8 genetic counsellors working inthe State, staffing levels are woefullyinadequate for our needs. It is vital thatwe know the specific genes causingpeople’s sight loss as there istremendous progress being made indeveloping many promising gene-specific therapies that coulddramatically change people’s visionloss situations. However, without a

precise diagnosis of the underlyinggene mutation, people with inheritedretinal conditions will lose out”.

Mr Whelan also used the platformof Retina 2017 to highlight the lack ofinvestment in ophthalmology services,exemplified in latest figures from theNational Treatment Purchase Fund,which show ophthalmology had thesecond-highest inpatient/day casewaiting list at 12,025 people at the endof September, with one in five patientswaiting more than a year. Outpatientwaiting list numbers climbed by 21 percent to 38,094 in the 12-month periodup to September, with 32 per centwaiting more than a year.

A main aim of Retina is also tofacilitate networking between Irish andinternational colleagues, leading tofuture collaborations and catalysing thenext generation of vision research.

Among the high-profile speakerswas Prof Marc de Smet, MedicalDirector of Preceyes Medical Roboticsin The Netherlands, and co-developerof a robotic system that he said has thepotential to revolutionise eye surgery.Prof de Smet told delegates that the keyadvantage to using robotics is the highlevels of precision for very delicatesurgery, where even the most highly-skilled surgeon can have“microtremors” in his or her hands. Hesaid, “The results, we have found, havebeen significantly fewer haemorrhages,and less trauma and damage to theretina. We anticipate that procedurescurrently off-limits will now befeasible, such as facilitating thedelivery of gene therapy to the retina.”

His team aims to have regulatoryapproval by the end of 2018, withequipment potentially available toophthalmic hospitals from 2019. Thetechnology has undergone successfultrials in Oxford University and theUniversity of Rotterdam.

The Public Engagement Day,introduced in 2011 to the meeting, washeld on the third day of the conference.This element provides a uniqueopportunity for the general public toengage with clinicians and researchersand learn more about their conditionand the research that is aiming to findtherapies to treat it.

ICO NEWSLETTER | WINTER 2017 PAGE 13

Fighting Blindness Retina 2017

The annual Retina Conference organised by Fighting Blindness took place

at the Radisson Blu Royal Hotel in Dublin on the 12th-14th October. Now

in its 18th consecutive year, the internationally renowned three-day event

was attended by over 400 delegates, including clinicians, scientists, patient

advocates, industry, regulators and government representatives.

Mohammad Mohammad pictured with Tahleel Salih at Retina 2017

ICO NEWSLETTER | WINTER 2017PAGE 14

The meeting attracted leadingnational and international paediatricspecialists and covered a vast range oftopics including strabismus, childhoodcataracts, retinoblastoma, uveitis,neuro-ophthalmology, glaucoma andimaging in paediatric eye disease.

ICO members who presented at thisyear’s meeting included DonalBronsahan, who examined the treat -ment of childhood uveitis; CaitrionaKirwan on advances in management ofcongenital cataracts; Zubair Idrees oneye screening; John Stokes onamblyopia and Ian Flitcroft on myopia.

Tim Fulcher’s talk outlined thetypes of ptosis encountered in children,the indications for surgery, the timingof surgery and the types of surgeryrequired for different types of ptosis.

Kathyrn McCreery presented on thepsychosocial impact of strab ismus,reviewing the scientific dataunderpinning the psychosocial meritsof strabismus correction in both adultsand children. She discussed how

strabismus is often considered cosmeticand the psychosocial effects of ocularmisalignment are often under -estimated. The functional benefits ofocular realignment which includeimprovement in binocular vision,stereopsis, visual field, and eliminationof diplopia are well established. Thepsychosocial effects of strabismusinclude poor self-confidence andesteem, difficulty with social inter -action and limitations in procuringemployment have not been fullyappreciated.

Distinguished international expertsincluded Professor Scott Lambert fromStanford Children’s Health in SanFrancisco and Professor AnthonyMoore from University College of SanFrancisco, Professor Michael Repka,Vice Chair for Clinical Practice at theWilmer Eye Institute, Francis Munier,Head of the Retino blastoma Unit andthe Oculogenetic Unit at Jules GoninEye Hospital, Lausanne, Switzerlandand Professor David Taylor, UniversityCollege London.

16th International PaediatricOphthalmology Meeting

The 16th International Paediatric Ophthalmology Meeting, organised by

Professor Michael O’Keeffe, took place in Dublin on the 18th and 19th

October. It was the final meeting to be hosted by Professor O’Keeffe, who has

been responsible for its bi-annual organisation and programme co-ordination

over the past 30 years since the first meeting took place in 1985.

BACK ROW L-R: Caitriona Kirwan, Donal Brosnahan, David Taylor, Kathryn McCreery, MichaelRepka, Ayad Shafiq, Tony Moore, Michael O’Keeffe.FRONT ROW L-R: Claire Troia, Ian Flitcroft, John Burke, Gillian O’Mullane, Louise Collum, JohnStokes, Tim Fulcher, Willie Reardon.

Your TrainingCountsThe College would like to remind

and encourage trainees to

complete the Medical Council’s YourTraining Counts survey which

remains open until November 30th.

This is the fourth year of the survey,

which the Medical Council states has

been imperative in helping shape a

quality agenda for medical education

and training in Ireland.

The collective data is used by theMedical Council in a number of ways toinform the identification of priorities intraining and education which impactson your individual experience workingand training in medicine in Ireland.Three keys areas which the MedicalCouncil use Your Training Counts dataare in setting priorities for clinical siteinspections, accreditation of trainingprogrammes and in highlighting theissue of bullying in trainee learningenviron ments locally, nationally andinternationally to bring about acoordinated response.

The latest Your Training Counts

report, published on August 31st 2017,provided a comparative report of thefindings gathered since the inauguralsurvey in 2014 and include detailedreports on issues such as health andwellbeing, career and retentionIntentions and the learningenvironment.

Peer collaboration and Consult ants’role were rated the most positiveaspects of clinical learning.

The Report revealed some of thefollowing key statistics around thetraining of young doctors in Irelandover the past few years.• The average age of the trainee

population is 30.56 years• 54% of trainees are female, and

over 86% are graduates of Irishmedical schools

• 36% of trainees experiencedbullying or harassment in theirtraining posts, up 2% from 2014

• 4% felt physically unsafe in theirworkplace

ICO NEWSLETTER | WINTER 2017 PAGE 15

This event follows a recent visitfrom the Orbis Flying Eye Hospitalto Dublin Airport in March of thisyear which welcomed over 500individuals on board the speciallydesigned and converted MD-10aircraft to learn more about thesight saving work it enables. Orbishas forged a unique and lastingalliance between the medical andaviation industries to bringophthalmic training to commun -ities through long termpartnerships with eye careinstitutions and through the onlinelearning plat form, Cybersight.Donal Brosnahan has been an Orbis

volunteer since 2006, when he firstvisited the Flying Eye Hospital inAddis Ababa, Ethiopia. Donalspends a week every yearvolunteering for Orbis in Ethiopia,sharing his skills and expertise withlocal medical staff there.

Orbis Ireland is dedicated toeliminating avoidable blindness inEthiopia where four million peopleare blind or visually impaired. Inparticular, Orbis Ireland focuses oneliminating the blinding and lifedestroying eye disease trachoma,where currently Ethiopia has morepeople affected by the disease thanany other country in the world.

Orbis Flying Eye Film Screening in Dublin

Donal Brosnahan, Olya Scannell and Brendan Cummings are pictured at the Irish film premiereof The Hospital in the Sky – an Orbis Flying Eye Hospital film in the Light House Cinema onMonday 11th of September.

The Irish film premiere of The Hospital in the Sky – an Orbis

Flying Eye Hospital film took place at the Light House Cinema on

Monday 11th of September. Filmed over two weeks, The Hospital in

the Sky follows Cindy Crawford’s journey to Trujillo, Peru, where she

witnessed the life-changing treatments provided for young patients on

board the Flying Eye Hospital and at the local hospital.

• 25% of trainees scored their overallexperiences very poorly; andaround the same proportionscoring them reasonably highly

• 51% felt medical school preparedthem well for their intern year,their first time working in a clinicalsetting

• There was a 5% increase amongthose who reported needingsupport and accessing it in 2016

The Medical Council said theresults from 2014 – 2016 have shownimprovement across certain areas, butthat certain sectors require more work.

The survey also gathers inform ationon trainees long term career intentions,which the Medical Council said willhelp with planning for the future ofIrish healthcare.

Mr Bill Prasifka, Medical CouncilCEO said the Medical Council hadtaken direct action as a result of thefindings of these reports over the pastthree years, instigating assessmentvisits to clinical training sites. He saidthe aim is to ensure all trainees have apositive training experience and obtainthe best on-the-ground educationpossible.

Trainees can log in to the Your

Training Counts survey by clicking on the

personal link included in the email sent to

them by the Medical Council. All

responses received are confidential.

ICO Winter Meeting November 24th, 2017Chartered Accountants House, Pearse St

Montgomery Lecture November 24th, 2017 Trinity Biomedical Science Institute, Pearse Street

Ophthalmic PostgraduateTeaching Programme Mr Peter Barry Memorial LectureDecember 14th, 2017, RVEEH

ICO Annual Conference 16th-18th May 2018 Lyrath Hotel, Kilkenny

Dates foryour Diary

ICO NEWSLETTER | WINTER 2017PAGE 16

Current figures indicate that 84%of people with sight loss of workingage are unemployed. One of the mainstrategic goals of the NCBI techspecialist team is to reduce this levelof unemployment and technology isthe gateway for many to live the livesthey want, offering autonomy andopportunities.

The NCBI run a 12-weekFundamentals in Assistive Tech -nology Course which is designed togive parents and resource teachers anoverview of assistive technologiesused by people with impaired vision.The course offers full assistivetechnology training, advice andsupport to people with sight loss inthe education sector. Often theseinvolve workplace IT assessments,assistive technology training andcareer workshops in conjunction withNCBI’s employment advisor.

The NCBI Virtual Technology Clubfacilitates groups of people to cometogether and talk about technology,share and solve problems and hearfrom experts who discuss everythingfrom the latest tech gadgets to some ofthe most basic daily living aids.

Tech News, the NCBI’s quarterlytechnology e-newsletter serves tokeep people up to date with the latesttechnology trends and products forpeople with sight loss, listen totechnology podcasts and stayinformed about upcoming technologyevents.

ViaOpta AppsTwo new apps, ViaOpta Navigator

and ViaOpta Daily, have beendeveloped by Novartis in partnership

with the NCBI as part of a launch of asuite of vision assistance apps.

ViaOpta Navigator app enablesblind or vision impaired people tomove independently by providingessential information to supportorientation when walking. Similarly,ViaOpta Daily uses vocal guidanceand audible tutorials to help witheveryday activities. The cutting-edgetechnology used aims to make adifference in the lives of those wholive with visual impairment and whoseek discreet assistance.

Commenting on the apps, ChrisWhite, NCBI CEO, said the ViaOptaapps signal yet another advancementfor blind and vision impaired peopleand will help them enormously asthey go about everyday tasks liketaking their dog out for a walk,

shopping or going to a busy café.

The ViaOpta apps are free and canbe downloaded on both iOS andAndroid platforms at www.viaopta-apps.com

News Over Audio – The App

that reads your newspaper

News over Audio, or NOA is abrand new application that willprovide visually impaired peoplethirty of the day’s top stories overaudio from early morning. Theinitiative in association with many ofthe world’s leading news brands,including the Irish Times, theFinancial Times, the Independent, theExaminer and Telegraph. The app canbe downloaded to any Android orApple smart phone or tablet device.

Seeing it from the Other Side NCBI Technology Support Team

In January of this year, the National Council for the Blind of Ireland (NCBI) established its new Technology

Specialist Support Team. The remit for the new tech department is broad and hugely comprehensive. The team

has been tasked with specific areas that focus around working with NCBI’s employment service, Library and

Media Centre and Rehabilitation Training Centre. A key focus is supporting visually impaired people in education

and employment; be it someone in employment or someone wishing to seek employment in the future.

JP Corcoran, member of the NCBI new Technology Specialist Support Team providing support toservice-user Martin Kelly.