The Irish Gerontological Society awards Prof. Cillian Twomey its highest honour, the Presidential Medal, at its 64th Annual General Meeting in Killarney in September 2016.
Prof. Cillian Twomey
Prof. Cillian Twomey is a native of Mallow, Co. Cork. After secondary education at Glenstal Abbey, he began his medical education in UCC and qualified in 1970. Following internship at St. Finbarr’s Hospital Cork, he initially pursued a career in primary care on the newly established Cork Vocational Training Scheme in General Practice. Whilst working as a trainee in primary care, Cillian developed a particular interest in the medical and social needs of older people. With this growing interest in the emerging specialty of Geriatric Medicine, he decided to acquire more knowledge and experience in this area. He competed successfully for the post of Registrar in the recently established department of Geriatric Medicine at St. Finbarr’s Hospital under the direction of Dr. Michael Hyland, Ireland’s first vocationally trained geriatrician.
Following a busy, but highly motivating year working with Dr. Hyland, Cillian decided on pursuing a career as a specialist in Geriatric Medicine. He moved to the UK in 1975, first to a registrar post in Northwick Park Hosital in London where he worked with Dr Michael Denham and subsequently to a senior registrar post in Liverpool where he worked with the late Prof. Gordon Mills (one of the great early pioneers of the specialty), with Prof. Colin Powell who later occupied the chair of Geriatric Medicine in Dalhousie University in Canada and with Dr. Jeremy Playfer who went on to serve as President of the British Geriatrics Society.
In 1979, Cillian was appointed to a new consultant post in Geriatric Medicine at the recently opened Cork Regional Hospital (now Cork University Hospital). He was only the sixth consultant to be appointed in the specialty in the Republic of Ireland; 10 years previously, there had only been two consultants in the entire country, Dr. Jack Flanagan at St. James’s Hospital in Dublin and Dr. Hyland at Cork University Hospital. His remit was to partner Dr. Hyland in the development of the new specialist Geriatric Medicine unit at CUH and the wider specialist service for Cork City and County. This remit encompassed a wide range of specialist services, including acute unit care of emergency cases at CUH, consultations for patients over 65 at CUH, running an 80-bed rehabilitation unit (opened in 1976) and oversight of over 200 extended care geriatric beds at St. Finbarr’s Hospital, domiciliary visits and consultations on older patients requested by specialists working at the Mercy Hospital, North Infirmary, South Infirmary, Orthopaedic Hospital, Victoria Hospital and Bon Secours Hospital in Cork City. These clinical services were provided on a 1:2 rota with Dr. Hyland for over 20 years before additional geriatrician colleagues were appointed in Cork City. In addition, there were major UCC undergraduate and SHO/Registrar postgraduate teaching and training responsibilities. Despite the large scale of his clinical and teaching/training duties, Cillian quickly developed and sustained a reputation for excellence across all aspects of his work. It is no co-incidence that undergraduate electives and postgraduate rotations were highly popular throughout his tenure as Consultant Geriatrician at CUH and St. Finbarr’s Hospital.
Cillian's dynamic, engaging and persuasive personality was soon brought to bear in the area of medical politics. Shortly after his appointment as Consultant Geriatrician at CUH, he was involved in the Irish Medical Organization (IMO) at a high level, working for the improvement of staffing levels and better employment conditions for doctors throughout Ireland both in the hospital sector and in primary care. His qualities as a skilled and energetic negotiator led eventually to his election as President of the IMO in 1988, at a time of constrained resources and widespread contraction in the Irish hospital sector. With like-minded Consultant Geriatricians, he worked tirelessly to persuade the Department of Health to implement the policy document “The Years Ahead” which was published in 1989. Over the next 10 years, Ireland saw a marked expansion in the numbers of Consultant Geriatrician posts, such that by 2000 all but a few of the nation’s general hospitals had specialist departments of Geriatric Medicine.
In 2000, Cillian was invited by the new Minister for Health, Micheal Martin, to become chairman of Comhairle na nOspideal, the body overseeing the development of specialist services and consultant posts throughout Ireland’s hospital network. This was a highly challenging assignment, given the need to make rapid progress throughout the hospital network as directed by government-funded strategies in a variety of key areas, including Cardiovascular Medicine & Surgery, Oncology, Radiology, Geriatric Medicine and Old Age Psychiatry. In this role, Cillian carried out his duties with typical energy and efficiency. Around this time, he worked closely with other key health policy makers, including David Hanley who co-ordinated new policy on staffing in the hospital sector. Despite the tasks of chairmanship of important national policy implementation bodies, he also took on the role of President of the Irish Gerontological Society in 2003 for a period of 4 years.
In the international academic setting, Cillian has made several important contributions. After representing Ireland for a number of years on the board of the European Union of Medical Specialists (UEMS), he was persuaded to take on the task of chairman, a post he held with distinction for several years. During his tenure, he oversaw the very precise definition of all specialist services throughout the EU as well as the development and publication of specialist training curricula in all recognized specialties.
He has served on the scientific advisory boards of the landmark PROSPER trial of pravastatin in older people and the EU-funded SENATOR project (as chairman) examining software-driven optimisation of pharmacotherapy in older people. UCC acknowledged his wide-ranging contributions to teaching and research locally, nationally and internationally by appointing him as Clinical Professor in 2006.
Cillian retired from clinical practice in 2011, by which time the Cork City-wide Department of Geriatric Medicine consultant staff had expanded to 8 consultants (including 3 full-time academic appointees) and specialist departments of Geriatric Medicine had been set up in Kerry General Hospital, Bantry General Hospital and Mallow General Hospital. In recent years, he has continued to make important contributions in a variety of areas, most notably in the area of palliative care. He recently spearheaded the Hospice-friendly Hospitals initiative promoted by the Irish Hospice Foundation. He has also served as chairman of Marymount University Hospice in Cork, a newly developed international model of excellence opened in 2011.
Cillian Twomey’s career has been characterized by energy, focus, hard work, determination and persuasiveness in the development of specialist services for older people locally, nationally and internationally and in his parallel work in teaching & research. His achievements are significant and lasting, fittingly acknowledged by the IGS President’s Medal in 2016.
Prof. Denis O’Mahony,
Department of Medicine (Geriatrics),
University College Cork & Cork University Hospital.