We had all our lectures in Earlsfort Terrace. I remember the anatomy labs there, and physiology. In our first year we had chemistry, physics, social and behavioural science lectures out in Belfield. 1st Med, 2nd Med, 3rd Med was all in Earlsfort Terrace. Then in April of the 3rd Med year, you elected to go to Vincent’s or the Mater and that’s when we started in the Mater in April of 1994.
My very first rotation in April 1994 was on GI in the medical rotation. I worked with Dr John Lennon, Dr John Crowe and Dr Padraic MacMathúna. Dr Padraic MacMathúna had just returned to the Mater from doing an advanced fellowship in endoscopy in Boston. These were key interactions on that first rotation. Also the GI registrar at that time was a guy called Dr Ray Merriman. I remember working with Ray on that very first rotation. Greg Leonard was my colleague on these rotations and Greg is now a medical oncologist in Galway, a great friend, a great colleague.
I remember we had a patient with advanced liver disease, decompensated with ascites. We were doing a paracentesis and going through the analysis of the fluid and it was really, really cool. And then the next case came in and I remember it being a variceal bleed and being down in the endoscopy centre and seeing the colleagues treating variceal bleeding and I thought that was really cool as well. These were all very impressionable moments, and first impressions last. Given my vague interest in gastroenterology beforehand, this was further consolidation that this was going to be pretty high up on my list of career pathways.
In the GI profession you’re hands-on, you’re doing procedures, you’re doing endoscopies, colonoscopies. I spend a lot of time in the office seeing patients, I do procedures, I do hospital service consults, I do lots of different things. There is good variety in it. The procedural side of the practice is something that attracts all people who go into that speciality. You spend some of your time seeing patients and figuring things out and some of your time fixing things. It’s that nice balance which attracts people.
I will tell you in medicine, no matter what area of medicine you’re in, just like any job, variety in a person’s work day is key to sustainability and long-term satisfaction. I still like it as much now as when I went into it. My career has changed a little bit though.
After I finished at UCD, I did a year of internship in the Mater. On my first rotation I had a fantastic time working with Prof Hugh Brady, who had just returned from the United States as a Nephrologist and was a Professor of Medicine in UCD at the time. Again, myself and Colm O’Donnell who is now a neonatologist in Dublin, were the first interns for Prof Brady since his return. He spoke so highly of the United States – again another major impression made!
I then worked with the endocrinology service. I spent 3 months in colorectal surgery with Prof Ronan O’Connell and he had spent time at the Mayo Clinic in the 1980s. Listening to Prof O’Connell speaking, I was beginning to set my eyes on travel and the United States. I had also worked with Professor John Fitzpatrick in the Mater and other colleagues who spoke highly of travel and further education.
I applied to the SHO scheme which rotated me to the Mayo Clinic, so I came out [to Rochester, Minnesota] for 6 months in 1997 and just loved it. I loved Rochester. The level of organisation and education! Things happen – bang, bang, bang – everything flows very quickly. It suited my personality. It is a phenomenal establishment to work in, but you are still in a rural setting. Going back to my rural setting in Ballingarry, it suited me perfectly. I could be out in the countryside in 5 minutes and yet working at one of the foremost medical establishments in the world. It was very exciting.
I spent 6 months [at the Mayo Clinic] in 1997 and went back to the Mater for an additional year in 1998. I then rotated out to Dundalk for 6 months, where I worked with Dr Tom O’Callaghan who was an internal medicine-trained gastroenterologist also. This was another major influence in my career pathway. Dr O’Callaghan had gastroenterology training in the Mater. He had a procedure clinic up in Dundalk every Wednesday afternoon and he taught me to do my first upper endoscopy and flexible sigmoidoscopy. That experience cemented my desire to do gastroenterology, so when I returned to the United States and returned to the Mayo Clinic in 1999 it was with the fixed intention of doing 2 years of internal medicine residency and then going into gastroenterology.
I came back [to the Mayo Clinic] and did 2 more years of internal medicine in Rochester, and then came into a fellowship in gastroenterology. The benefit of doing the 2 years of internal medicine residency is that you can become board certified and this gives you a greater foothold going forward.