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It is taken for granted in this country that all the best medical colleges are Royal. That they have the royal seal of approval from on high and therefore must be the best. I have been somewhat confused for a long time as to why this is, but lately it is strange indeed that there has been no whisper at all from any quarter about removing this relic of ages past. Why?

I should start by declaring a conflict of interest I suppose; I am not English. It is entirely plausible that feelings of loving or loathing toward the monarchy are very different amongst the constituent people of the United Kingdom. One of my earliest formative experiences involves attending a concert with my extended family at the Brangwyn Hall, organised by my school, where they had a full orchestra playing and toward the end of the otherwise interminably dull evening a song was played which caused widespread dismay in the audience. For every other song everyone had stood, sung and then sat down again but for this song a quarter of the audience remained seated, including my grandmother. I was very aware of an electrical tension in the air and was mortified my grandmother had stayed resolutely in her seat in front of so many of my teachers. There were also audible protestations amongst the audience elsewhere so I reasoned it could have been worse. This was the first time I had ever listened to God Save the Queen sung live.

I spoke to my grandmother at length afterwards and it was clear her reservations were entirely about the glorification of a monarch. A descendant of tyrants and murderers who was head of state only because she was the descendant of tyrants and murderers. It was certainly not meant as any disrespect to our English cousins; they were if anything greater victims of this unearned deference to hereditary authority. It is said that the Queen has no real power. That she only has a ceremonial role. But she is the head of state of this country and numerous others and she achieved this position purely because of an accident of birth. This opinion of Royalty is extremely common in Wales, though I can’t speak for the Irish or Scots; and if being aware of our own biases is important before stating an opinion I do so now. It sticks in my craw that no matter how talented an individual may be, they can never become the head of state. You have to be born to it. Surely this is against all that is good and true in the world?

It is taken as given that we as ophthalmologists believe all people are to be treated equally and promoted to roles based on their skills and general likeability. Our current president was elected by us and all of us who took part in that election feel some sense of having participated in a process and therefore that Bernie is ‘our’ president. We put him there. He is of us and belongs to us. The president is not chosen by being born the son of Mike Burdon, the last president, though with presidents being replaced every three years a hereditary system would be extremely difficult to pull off. We would all recognise that this would be an unfair system, however.

Is the royal family of such distinctive quality, however, that they deserve to hold the exalted place they do in our society? I imagine we all know the answer to that. I remember listening, I think at a College Congress, to a talk by our previous Royal patron about the Navy and life lessons that could be derived from life on the high seas. I sincerely doubt anyone in future will benefit from his wisdom at future college congresses following that whole Epstein episode. What about the so-called Prince of Wales? Or any of them? The Royal College of Ophthalmologists is the highest authority in all things ophthalmic that we have in this country. Where the most talented people in the land shape training, run exams, issue guidance, advise government on issues of healthcare systems and provision of sight saving eye treatment. Why are we so excited to bless our college of experts with an anachronistic title that implies hereditary servitude to our ophthalmic inferior? I have not seen the Queen perform a phacoemulsification procedure, but I am willing to bet she would be in the bottom centile. There would need to be a vitreoretinal surgeon on standby in the next room ready to fish out the dropped nucleus which would inevitably occur with every case. As with medical retina specialists who also indulge in a bit of cataract surgery.

There has been much talk of late about the role of privilege; male privilege, white privilege, privately educated privilege and myriad other sorts of privilege. Much of this talk is divisive and unhelpful and divides ordinary working people against each other; but all the time everyone seems to ignore a very obvious example of obscene privilege that is present in Buckingham Palace, on our stamps, on the names of our hospitals, in our courts and even in the title of our own college. Why? Is it a sort of acceptable societal blindspot? Was there a meeting I missed where it was discussed what to do and everyone decided to ignore it? Is there a hidden plan to keep quiet until Bonnie Prince Charlie takes over and then get rid of the whole thing then? Or are people just generally so unbothered by it that they don’t consider it an issue?

Perhaps becoming a republic has many advantages. Perhaps it has few. It is pointless to think of this though, as it may well be beyond even the power of the Royal College of Ophthalmologists to get rid of the Queen altogether. We do have the power to drop the ‘Royal’ though. For much of our history we never had it. What a statement it would be to do so now though. To have something and then give it up is infinitely more powerful than to refuse something that is not being offered. If we dropped ‘Royal’ and perhaps adopted a more useful descriptor such as ‘British’, it might herald the way for other colleges to do likewise. We would be famous as a trailblazing group of professionals shaking off the shackles of the Medieval period and going forward boldly into the future as free people. It only takes one person; one group, to change history. In case I am wrong and there is in fact a huge reservoir of monarchist members of the college, a referendum might be useful. We could be heroes just for one day. And many years from now (I hope) after I meet my end and I strike up a conversation with my grandmother in the Next World I can apologise for being so annoyed at her continuing to sit down in that concert years ago and say I was part of a group that did something significantly more far-reaching in the fight against inequality and injustice.


The views expressed are those of the author and do not represent those of the editorial team or the publisher.


I also desire for “Royal” to be dropped from our college name.  Looking at the college website now, it is unclear if we still have a patron, but none or a laudable one would be preferable to the previous title holder.   A democratic vote would be the next step in assessing the appetite of the college members for these proposed changes.
Rosie Brennan




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Gwyn Samuel Williams

Singleton Hospital, Swansea, UK.

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