Professor Cathal Kelly:

I thank the Chairman and members of the joint committee for inviting us to make a presentation to them.

The Royal College of Surgeons in Ireland, RCSI, is a long-established health sciences institution with an international reputation for the delivery of high quality medical programmes nationally and internationally. It is Ireland's truly international centre of higher education in medicine and health sciences. It is an international organisation. Our campus in Dublin has over 3,800 students and 1,000 full-time members of staff, mainly graduates. In collaboration with Irish Aid, we are the largest international surgical trainer in sub-Saharan countries. In addition, we run training programmes throughout the Middle East, with a training campus in Dubai and a university in Bahrain. We also run undergraduate and postgraduate programmes in the Far East, mainly in Malaysia. While the RCSI has traditionally been acknowledged as the lead higher education institution in attracting international third level students to Ireland and bringing Irish education to international settings, this is now an important aspect of the work of many higher education institutions and a key part of Ireland’s development as a knowledge economy.

The RCSI has worked closely with Enterprise Ireland and we are proud that many of our graduates have played a key role in opening doors for Irish business in the Middle East and worldwide. It has had a relationship with Bahrain for over 30 years. The college established the Medical University of Bahrain in 2003 and the students who attend RCSI Bahrain are now drawn from more than 30 countries across the globe, including the United States, Australia, Canada, France, New Zealand and the United Kingdom. There are 1,240 students enrolled in medicine, nursing and masters programmes. There are over 130 academic and administrative staff drawn from across the globe at RSCI Bahrain. In addition, there are over 200 associated clinical faculty staff who support the training of our students in the hospital environment.

The RCSI delivers the same curriculum across three campuses in Dublin, Bahrain and Perdana. When it comes to examinations and despite significant logistical challenges and differences in time zones, a medical student in Dublin will turn over his or her examination paper at 8 a.m. local time and his or her counterparts in Bahrain or Kuala Lumpur, Malaysia, will turn over the same paper at 10 a.m. and 3 p.m. local time, respectively.

Papers are jointly set, centrally reviewed and moderated, and external examiners are appointed by the National University of Ireland and the RCSI and shared across the campuses. Examination boards are held jointly using video conference facilities. Graduates from the School of Medicine of RCSI-Bahrain are conferred with the degrees of MB, BCh, BAO from the National University of Ireland, NUI, and in addition they will receive licentiates of the Royal College of Physicians of Ireland and the Royal College of Surgeons in Ireland.
The RCSI (Charters Amendment) Act, 2003, included a provision that allowed the Minister of Education and Skills to commence RCSI independent degree-awarding powers. Since 2010, as directed by the Minister, the RCSI is both an independent degree awarding body and a recognised college of the NUI.As a designated awarding body under the terms of the 2012 Act, the RCSI deals directly with Quality and Qualifications Ireland, QQI, and other State agencies. The RCSI and the NUI operationalise the provisions of the 2012 Act through the RCSI-NUI working group executive, established in 2013. A key point here is that the academic qualifications awarded to RCSI-Bahrain graduates are identical to those awarded to all RCSI graduates, including those in Dublin. These are subject to both internal and external oversight which I will now describe in some detail. The RCSI medicine and health sciences board is responsible for oversight of the degree-awarding activities of the college. The RCSI awards and qualifications committee has the authority and operational responsibility to evaluate and consider programmes which fall under the National Framework of Qualifications, NFQ, for approval, accreditation and periodic review.
At the RCSI we believe that providing an accessible, high-quality education and experience for all our students will ultimately translate to better health outcomes for patients. The RCSI has invested heavily in a quality agenda both in Ireland and overseas. In recent years we have come through many quality assessments, including the rigorous assessment mentioned earlier in regard to independent degree awarding status in 2010. All RCSI activities, nationally and internationally, are subject to oversight by QQI, the statutory body which was established by the Oireachtas in 2012.
We have just recently come through an institution-wide review by a six-member international review panel, commissioned by QQI. This review encompassed our RCSI-Bahrain campus and included a review of our undergraduate, postgraduate and research activities. The report is expected shortly, but the chairman, Professor Simon van Heyningen, honorary fellow and emeritus professor at the University of Edinburgh, commented at an exit meeting that it was a privilege to conduct the review in such an impressive institution with a pervasive culture of quality.
As our awards are professional in nature, they are subject to what I describe as a triple-lock approach to quality. First, they are subject to our own internal quality assurance and enhancement procedures; second, they are subject to external oversight in Ireland by the NUI and QQI, and in Bahrain by the Higher Education Commission and the national authority; and, third, because they are professional in nature, they are subject to professional accreditation by the relevant authorities such as the Irish Medical Council and, in Malaysia, the Malaysian Medical Council.
The Irish Medical Council’s accreditation mechanism is highly valued by all of the Irish medical schools with international activities. The RCSI believes that the Irish Medical Council review helps to support the ambition and strategy of the Department of Education and Skills to internationalise Irish higher education. Importantly, it helps to protect and further enhance the overall reputation of Irish higher education institutions in the competitive international market where evidence of the quality of transnational activity is essential. The primary purpose of accreditation by the Irish Medical Council is to provide additional external assurance in relation to the quality of the qualification. Accreditation of RCSI-Bahrain by the Irish Medical Council will be based on the World Federation of Medical Education Standards. RCSI-Bahrain has completed a self-assessment report and we are confident that it meets these standards and that the resources available to staff and students meet the requirements specified. The RCSI-Bahrain campus is a state-of-the-art medical campus, completed in October 2008 with a built-up area of more than 15,750 m².
It is important to note that the accreditation of RCSI-Bahrain by the Irish Medical Council gives no legal advantage to graduates of RCSI-Bahrain, nor does it improve access to employment opportunities, but we believe that accreditation by the Irish Medical Council would be a further demonstration of our commitment to quality. In addition to seeking accreditation by the Irish Medical Council, RCSI-Bahrain has previously been accredited by the Gulf Co-operation Council, GCC, committee of medical school deans; it is included in the World Health Organization directory of medical schools, the International Medical Education Directory of the Foundation for the Advancement of International Medical Education and Research, FAIMER, and the health profession education directory of the World Health Organization; and is recognised by the Medical Board of California and the UNESCO-run International Association of Universities.The National Health Regulatory Authority, NHRA, is the licensing authority for medical graduates undertaking internships in Bahrain. As a testament to the educational standards in RCSI-Bahrain, I am pleased to advise the committee that the pass rate in the last licensed exam for RCSI-Bahrain was 100%, compared to a national pass rate of 40%.
Our RCSI-Bahrain graduates have been accepted into postgraduate training posts in the GCC countries, the United States, Canada and several European countries, including the United Kingdom. Earlier this year, the Canadian federal authorities designated RCSI-Bahrain as an eligible institution for student financial assistance purposes in the different provinces.
Since 2010, in conjunction with the NUI, we have graduated four cohorts, a total of 611 graduates, in the different programmes offered by the university. As in Dublin, each RCSI-Bahrain graduate proudly stands at the graduation ceremony and recites the Declaration of Geneva. I will not read this in its entirety, but it contains the following points:

I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
I will maintain the utmost respect for human life;
I will not use my knowledge to violate human rights and civil liberties, even under threat.

As Irish companies and universities increase their activities abroad, as we all must do, we will find ourselves working in countries with very different political systems and cultures from our own. To work in these countries, we must find a way to be true to ourselves and our core mission while being respectful to the cultural, judicial and political norms of the countries in which we work. We at the RCSI are proud of our staff and students in Bahrain, where we provide a high-quality medical and nursing education in a non-sectarian environment. It is our intention to continue to contribute to the future of Bahrain through the provision of high-quality education in the health sciences. With respect, I would say to the committee that the proposed Irish Medical Council visit is a mark of quality for our students. It confers no legal advantages. If it does not go ahead, the only people punished will be our students. While all of us in this room may have different views, I hope we are united in wanting the best outcome for these students.