February 2020 | Feabhra 2020

Prof Helen Heneghan in Conversation

Mon, 24 February 20 20:48

Helen Heneghan, UCD’s first female Professor of Surgery, wants to make Surgery one of the most popular career choices among medical students at the UCD School of Medicine, attracting the brightest and the best into the Irish surgical training programme.

“UCD has a world class school of medicine, offering a modern comprehensive curriculum, and within that I want to strengthen both the undergraduate and postgraduate surgical education programme.”

She also wants to attract and retain trainees in Ireland, develop a national bariatric surgery programme and a research centre in UCD which will focus on Obesity and Women’s Health, particularly female cancers, pelvic floor disease, and maternal and foetal health.

The year 2020 is an auspicious one for UCD School of Medicine, with the appointment of Prof Helen Heneghan as the first woman to the Chair of Surgery and Prof Yvonne O’Meara as the first woman to the Chair of Medicine & Therapeutics.

Career Journey

A native of Corofin in Galway, Helen Heneghan graduated in Medicine from NUI, Galway in 2005.  She did her internship in Galway and towards the end of this, decided she wanted to specialise in surgery.

“As a medical student I was inspired by Michael Kerin, the Professor of Surgery in NUI Galway.   His enthusiasm for the art of surgery and also for academic surgery was infectious.  In addition, many of his colleagues were very enthusiastic about teaching surgery and involving students. As a result, I thoroughly enjoyed learning and studying Surgery as a medical student and decided it was the career for me.

“I got on the surgical training scheme during my internship in 2006.  At the time it was a two-year basic surgical training programme, followed by a three-year gap period, when surgical trainees undertook translational research.  I chose to do a PhD, knowing the importance of such research for patients, for surgeons, and for advancing our understanding of surgical diseases.  The subject of my PhD thesis was to investigate the molecular expression of breast cancer and obesity.  I had developed an interest in obesity and breast cancer.  There is a strong association between the two and it is underexplored. I completed my PhD in 2012 and then was appointed to the Irish Higher Surgical Training scheme.

“I got a two-year Fellowship in bariatric surgery at the Cleveland Clinic in Ohio in the US.  I was fascinated by the disease of obesity, its many complications, and its treatment, particularly surgical therapies. I couldn’t get much exposure to that in Ireland, so I went to Cleveland to see if it was something which I would like to pursue as a career.  The Bariatric & Metabolic Institute in the Cleveland Clinic had the highest volume bariatric centre in the US. I stayed for two years and did a lot of clinical and laboratory research, as well as training in surgical procedures for obesity and metabolic disease.  I then came back to Ireland for the next four years of my higher surgical training, rotating in the major academic Dublin hospitals. I got experience working with Prof. John Reynolds in St. James’s Hospital, which has one of the best upper GI cancer centres in Ireland. That was a valuable part of my training”

At the end of that four years, she decided bariatric surgery was what she wanted to focus on in her career. 

“I felt I hadn’t enough current experience in it, so I decided to do another Fellowship in the UK. I went to Liverpool, to a high-volume bariatric surgery centre near Aintree.  I spent a year there getting further training and exposure to bariatric surgery.” 

When she completed that training, she was appointed in 2017 to Ireland’s first bariatric surgery Consultant post at St. Vincent’s University Hospital and St. Colmcille’s Hospital, Loughlinstown, Dublin.

“The establishment of the first dedicated bariatric surgery Consultant post was great progress for the management of obesity in Ireland, acknowledging that treatment is important and enabling development of treatment programmes.

“The Professor of Surgery post at UCD/SVUH opened up a year ago. I wanted an academic commitment in my career, in addition to my clinical work.  I wanted to be more involved in teaching both undergraduate medical students and postgraduate surgical trainees.  I really enjoy teaching and I am good at it.  I did consider that I could be too young for such a senior role at the time.”

Prof Heneghan is now aged 38, and she and her husband Sean Martin (UCD Medicine 2000) have celebrated 2020 with the birth of their first child, a beautiful daughter, Ella.

“Then, there had never been a female Chair of Surgery in Ireland. I was worried the timing was not right, but I couldn't let the opportunity pass.  I felt I could be a really good role model for students and other healthcare professionals and it provided an excellent opportunity to further academic research into the disease of obesity.  I thought the roles of Chair of Surgery and Consultant in bariatric surgery would be a really good fit.

“I am very motivated and ambitious and know my best career years are yet to come, so I believed this was a great time to take on the role rather than at the latter end of my career when I would be very experienced, but perhaps less energetic.   I also think my age makes me more relevant to students and trainees. I can relate to them very well.”

Priorities and Ambitions

Prof Heneghan said her appointment, following a competitive recruitment process, now means that she would hope to have 25 – 30 years to achieve her priorities and ambitions. She has three main ambitions from a clinical perspective.

“I want to develop a national bariatric surgery service. At present, there are two centres, one in St. Vincent’s and one in Galway University Hospital, and I would like to see an expansion of the service nationally, so that bariatric surgery is more accessible to patients in a timely fashion.  I am in a position to lead on that, having, over the last two years developed the surgical service in St. Vincent’s, which is now comparable to international centres.  We need at least four bariatric surgery centres in Ireland.  St. Vincent’s bariatric centre is now a high-volume unit and we can make a meaningful contribution to research internationally. Neither of the two Irish bariatric surgery centres are funded specifically, the hospitals finance them out of general funding.  I am working on addressing that issue with Prof. Donal O’Shea, the National Clinical lead for the Obesity Programme.

“Another priority is to align my research expertise with research centres in UCD.  I would like to develop a research centre there related to women’s health.  I would like to look at the impact of obesity and significant weight loss on women’s health.  There are three specific areas I would like to look at in the coming years- obesity and female cancer, particularly breast and endometrial cancer; obesity and pelvic floor disease; and the impact of obesity on maternal and foetal health.  Between UCD and the St. Vincent’s Group, we have all the relevant expertise in the national pelvic floor clinic in St. Michael’s Hospital, and with the co-location of the National Maternity Hospital at St. Vincent’s in the coming years, I think this research theme would be particularly appropriate.  I plan to collaborate with leading UCD researchers Prof. Fionnuala  McAuliffe, Prof. Cecily Kelliher, Prof. Donal Brennan, Prof. Carel Le Roux and Prof. Catherine Godson.  They have similar research interests, and I think my expertise with bariatric surgery could strengthen and develop this research further.

 “I want to see us becoming world experts on obesity and women’s health.  We already have great expertise but I believe it can be further strengthened in the three areas I have mentioned.    Each is a huge undertaking, but we have expertise to develop them and I can drive them.  The clinical programme in St. Vincent’s is vital and complementary to that.

Prof Heneghan says she is

“passionate about being a good role model for medical students.  I want to encourage them to consider surgery as a career.  It is not one of the most popular career choices at the moment.  We are not attracting as many students and newly qualified doctors into the surgical training programme.  I want to change that and demonstrate that surgery is a fulfilling career, with many subspeciality options.

“The students are the life and soul of our hospitals and I want to focus on them and their experience, and modernise training and education for them.”

Major Challenges

What does she see as the major challenges facing her? 

“As I said, it is a challenging time to attract the brightest medical students into surgery and make surgical training attractive. I want to be a good trainer and role model for students.  We also need to work with RCSI to ensure surgical training in Ireland continues to be excellent, but also modern and appealing to students, and supports them. There is a lot of work to be done with the HSE National Doctors’ Training and Planning Department, to attract and retain trainees in Ireland. We want them to come back and work in this country after they've trained to the highest standard abroad.  We need to retain their expertise and I will advocate for that, so that we can keep the surgical consultants we have trained in Ireland.

“Fulfilling our research ambitions with limited funding opportunities is also a challenge.  We are working hard to get funding through grants.  It is important to collaborate nationally and internationally to attract funding. Also, involvement by patients and the public, which is strengthening UCD research, makes us more attractive for international funding opportunities as well.”

Change in Healthcare

How does she see healthcare changing?

“Surgery is changing and evolving continually.  Technology is constantly evolving.  The last 10 years have seen the introduction and expansion of robotic surgery. I think minimally invasive approaches to bariatric surgery will evolve further, which is really exciting. The research that we and others do results in better treatments that are personalised for patients.  Obesity is a very complex disease, with many contributing factors, and treatment should be tailored to the right patient at the right time.  I think that the future of medicine is that it will be more personalised for patients rather than the ‘one treatment fits all’ model.  Precision medicine already exists for many cancers.  Many cancer multidisciplinary teams now evaluate patients’ tumours at an individual level and tailor oncology treatment specifically for that tumour.  This lowers the morbidity of treatment, as it spares patients side effects of treatments from which they would not benefit.  Cancer treatment is far ahead of many other treatment programmes in this regard, and I think that other chronic diseases will follow that approach and become more tailored to individual patients.

“Artificial intelligence will also play a much bigger role in healthcare in the coming years.   It is so very exciting to incorporate new technology in medicine.  It will make us more efficient and ultimately make care and treatment more specific and less expensive.”

Advice to Students

What advice would she give to young students considering a career in medicine?  

“I would like to encourage students and tell them what a wonderful career medicine is. It is hard work, but is the most challenging, rewarding and fulfilling career. Students can also get wonderful training in Ireland. The Irish surgical training programme produces excellent trainees, well-trained clinically and operatively, and with a strong interest in translational research. Irish doctors are sought after internationally. It requires passion and dedication, it is still a vocation, so persist with it and don’t be turned off by the challenges.  It is very worthwhile and so rewarding to be able to change peoples’ lives.  It is hard to get that satisfaction in any other career.”

Prof Heneghan was in conversation with the health analyst and commentator, Ms Maureen Browne of Hartcliffe Communications.