A decade ago, Dr Sukhjinder (Sukh) Nijjer, current President of the Royal Society of Medicine (RSM) Section of Cardiology, was a member of the research team at the Hammersmith Hospital in London developing a new technology that is now being used by cardiologists in their routine day-to-day work in the UK and around the world.
The technology, ‘instantaneous wave free radio’ (iFR), was a new method of assessing the severity of coronary stenosis (narrowing or blocking of the arteries), which circumvented the main limitations of the tests available at the time.
Ten years later, Sukh recalls his colleague Dr Sayan Sen winning the RSM Cardiology Section Gold Medal after presenting his work on the iFR research. “The technology won many prizes at the time and is now firmly established in the literature and has been published in very high-end journals, including the New England Journal of Medicine,” says Sukh.
Dr Sen subsequently went on to win the 2013/14 Wesleyan RSM Trainee of the Year award and Sukh himself was recognised at the RSM for developing the iFR-Pullback technology that can map the physiology of coronary stenoses and predict the results of angioplasty before it is done. This is the subject of a major international trial running at the moment.
Today Sukh continues to work at the Hammersmith Hospital as a consultant interventional cardiologist. “I’m the sort of cardiologist where we do the plumbing – opening up people’s arteries. That means I predominantly specialise in the treatment of people having heart attacks, or who have angina with blocked blood vessels. We assess blood flow within the arteries using pressure wire technology and use intravascular imaging to see where the blockages are, assessing the cholesterol and calcium inside the arteries.”
Sukh has been a member of the Cardiology Section Council since 2010, initially as a trainee representative, moving on to represent the North West Thames area and interventional training, before becoming President in 2020.
Throughout his time on Council he has worked with a number of Section Presidents, including Professor Mike Marber, Professor Nik Patel, now Chairman of the RSM’s Academic Board and Trustee, and Dr Andrew Deaner, who shot to fame in 2012 after running from the Tottenham stands to help save Bolton footballer Fabrice Muamba’s life after he went into cardiac arrest and collapsed on the pitch.
Describing the work of the Cardiology Section today, Sukh says: “The Section is perhaps a little different from some of the other Sections because we have the remit to provide the cardiology training, including mandatory training for the more junior registrars (ST3, 4 and 5), for all trainees across the whole of London, Kent, Surrey and Sussex.
“That means we are running somewhere between 25 and 30 events each year, which include programmes of dedicated training days for the five cardiology sub-specialties. For the interventional cardiology days this includes the transmission of live procedures from hospital.”
The Section has the freedom to cover and deliver the topics within the curriculum as they see fit and Sukh and his colleagues on the Council delegate the work between various Section members who design the programmes and deliver the training.
Sukh became Section President during a time of turmoil, taking over just as the pandemic kicked in and meeting head-on the challenge of keeping the meetings running and making the change to a digital platform.
“I’m pleased to say that we have maintained meetings throughout the pandemic, with the vast majority of events being incredibly well attended. We now have many hundreds of attendees joining from across the UK and into Europe and beyond.
“The RSM team have been excellent and committee members have worked very hard to deliver programmes that people want to see and want to attend, and at the same time meet the curriculum requirements. The feedback has been very positive.”
When he was a trainee, the highlight of Sukh’s month would be to come into the RSM and talk with other trainees and meet people he and his colleagues weren’t otherwise seeing in day-to-day practice. “It was a superb central hub to come and hear the great and the good of cardiology,” he says.
During his tenure as President, Sukh’s aim for the Section has been to branch out from what had been a fairly London-centric group. Today digital technology allows people from all over the country to contribute to the Section’s programmes.
Working with colleagues from other Sections is something that Sukh has also been keen to explore. One recent event held in collaboration with the Sleep Medicine Section looked at the impact of sleep on heart health. “We know that conditions like obstructive sleep apnoea have a profound effect on cardiac health, including blood pressure and development of atrial fibrillation. Irregular heartbeats and other chronic events are very much driven by this condition, which until now hasn’t been recognised very well.”
There are also conversations underway with the RSM’s Palliative Care Section to help deliver teaching on the impacts of arrhythmias on patients being managed for palliative care conditions.
Looking ahead to September 2022, Sukh and his colleagues are hoping to run a state-of-the art session reflecting on the latest evidence and studies in cardiology. They will draw on the connections of Council members to gather together speakers from around the world to deliver an online programme that will be applicable to anyone interested in cardiology. Sukh said “Cardiology changes so rapidly – there are so many trials and studies every few months, it can be a challenge to keep up.”
Reflecting on his time as an RSM member, Sukh says: “People in the NHS tend to be tribal and get very fixated on their own hospital and their particular way of doing things. It’s a bit like football teams and football supporters. The RSM represents a more neutral place where people can come together and discuss things in a way that is not judgemental or tribal. And that can only be a good thing.”