Richard Alan Smallwood was a leader in clinical practice, medical research, education and administration, who made outstanding contributions, to the broad and long term issues of health care in Australia. He passed away on the 1st June, 2024.

Born in 1937 in pre-war Batu Gajah, Malaya, Richard’s mother Margaret was a doctor with the Malayan Medical Service and father Ian, an insurance executive. Both parents were interned by the Japanese after the fall of Singapore in 1942 but their two sons, Robin and Richard, were evacuated prior to the invasion and cared for by relatives in Australia.

“both my parents felt that they had to stay, my mother because she was a doctor working in the Malayan Medical Service. My father because he joined... I think it was called the Malay Volunteer Rifles. And of course, they were both then prisoners of war or internees.”

Reunited with his parents in late 1945, Richard knew from an early age that he would follow in his mother’s footsteps and become a doctor.

"we were exposed to medical discussions, medical things, friends of the family who were doctors. So it's probably not surprising that we were interested in, in pursuing a medical career"

He was known as "the Doc" from a young age, and both brothers studied medicine "as the natural thing to do".

Educated at Ivanhoe Grammar, Geelong Grammar and the University of Melbourne, where he graduated MBBS in 1960, Richard's postgraduate training included appointments at the Alfred Hospital, Melbourne (1961-63) and the Royal Melbourne Hospital (1964-65) and being awarded a Doctorate of Medicine from the University of Melbourne (1964). He became a member of the RACP in 1964 and was soon awarded an RACP Travelling Scholarship, which enabled him to travel to London to undertake a research fellowship with the Department of Medicine at Royal Free Hospital (1966-68) working with the legendary Sheila Sherlock.

Prior to going to London, he met and married nurse Carol Taggart, whom he met on the Alfred Hospital Psychiatry ward. In 1966 they sailed for London on the Waroonga, with Richard crewing as ships doctor.

Smallwood chose to specialise in gastroenterology, focusing on hepatology, studying diseases of the liver and biliary system, which was at that time an emerging specialty. He would go on to play a pivotal role in advancing the specialisation and its practice in Australia.

"Before I arrived there, the notion of a disease such as hepatitis didn't exist, let alone three varieties and the viruses causing them [as we now know]. We only knew various sorts of jaundice and knowledge was primitive. Sherlock got liver biopsies started and the resulting pathology produced a great leap of understanding…I got into laboratory research as well as having a clinical involvement.”

A Fellowship in Gastroenterology at the Boston University School of Medicine, U.S.A. (1968-69) followed.

In the early 1970's he returned to Melbourne and was appointed to the staff of the University of Melbourne at the Austin Hospital, eventually becoming Director of Gastroenterology, (1973-1990) where he helped to establish academic medicine and the first gastroenterology unit in Melbourne.

“And it was that nucleus of people in their early thirties around the Professor of Medicine, Austin Doyle, who transformed the culture and the whole milieu of that institution [The Austin] and converted it to probably arguably the, the premier research hospital in the country, you know, inside 10 years.”

He was also appointed as a visiting Physician at the Heidelberg Repatriation Hospital (1973-1980) and Consultant Gastroenterologist at the Fairfield Infectious Diseases Hospital.

In 1990 he was appointed Professor of Medicine at the University of Melbourne and Chairman of Gastroenterology at the Austin and Repatriation Medical Centre.

Professor Smallwood's enormous energy, commitment and enthusiasm was amply demonstrated within The Royal Australasian College of Physicians. He was an active member of the Victorian State Committee from 1972, holding positions as a member of the Committee, Honorary Secretary (1972-74) and Chairman (1989-1990).

Federally, he would hold many positions – he was a member of the Committee for Physician Training, becoming Chairman from 1982 to 1986 - as well as a number of its sub-committees including training committees in Infectious Diseases, Immunology, Gastroenterology, Rheumatology and Intensive Care Medicine. In 1984, he was appointed as Chairman of the Board of Censors, arguably the most important and influential position in the College other than the Presidency. He held that appointment with distinction and was responsible for several initiatives aimed at improving the standards of training and examination within the College.

In addition to being on the Council of the College and its Executive Committee, from 1985 to 1992 Professor Smallwood was Chairman of the Social Issues Committee steering its broad agenda to provide physician input into major health issues in the community. Under his chairmanship, lay input from consumer organisations was introduced and position statements on many issues were developed and promulgated within the profession and the community.

“That particular committee, I chaired it, the Social Issues Committee, and established it...it was seen as a bit of an oddity for a medical college to have a Social Issues Committee at that time...but my sense was that the college, as with other colleges, was far too internally focused. That they really had to start to interact with government. They had to start to think about the world outside and the impact that specialist medical bodies should be having on the world outside. So it was much more than navel-gazing and looking at their own clientele, as it were, of budding specialists or wannabe specialists. They needed to be looking out further at the broader health issues. And I think that's a theme that I've pursued over quite a period."

His consultative and inclusive style earned him the respect of both the Council and the Fellowship. In 1994 he was elected Vice-President for Australia and in 1995, President-elect, taking up the Presidency in May 1996. He was regarded as an outstanding College leader with his vision in promoting the role of the College to government and the community.

In addition to The Royal Australasian College of Physicians, Professor Smallwood was a leader in the Gastroenterological Society of Australia, holding the positions of a member of Council, Chairman of the Education Committee and Honorary Secretary of the Society, as well as Vice-Chairman of the Australian Gastroenterological Institute.

Professor Smallwood's contributions to medical research generally were substantial. In 1994 he was appointed Chairman of the Council of the National Health & Medical Research Council as well as holding various Committee memberships. He was a member of the Australian Health Minister's Advisory Council from 1993 and a member or office bearer of a variety of other government and medical research organisations.

His attributes and accomplishments were further recognised by the Federal Government when he was seconded to be Commonwealth Chief Medical Officer (1999-2003). By drawing on his experience in medical administration and from his involvement in a wide range of professional bodies, he engaged with others to tackle issues such as the protection of Australia from communicable diseases and pandemics, including mad cow disease, anthrax, smallpox and SARS.

“..my view of it was that there are a number of areas of interest: patient care, safety and quality. I had a particular interest, which later flourished, in infectious disease and I thought we were being far too complacent about infections in, in their various forms. There was interest in chronic disease and the national health priorities.... I was hooked into the world of electronic health records and, and national health information. And I was particularly keen to foster the relationships between government and the clinical world... and the clinical science world that, that each group had miniscule understanding of how the others ticked, or how the others functioned or were able to function.”

Although planning to retire post-CMO role, Smallwood was then seconded to be the Inaugural chair of a new body, the National Blood Authority where his aim was to have "the whole system regularised and running much more efficiently."

From 2008 he was appointed President of the Australian Medical Council where he became the key representative of the regulated health professions in negotiations with the Commonwealth Government during the introduction of the National Registration and Accreditation scheme for the regulated health professions.

“...I think our role has been to assist government to not make horrific mistakes in setting up this whole new scheme”

As a Professor of Medicine, mentor and educator he dedicated more than 30 years to teaching undergraduates and postgraduates, including co-authoring a textbook with Professor Richard Larkins, FRACP, entitled Clinical Skills: the medical interview, physical examination and assessment of the patient's problems.

Underwhelmed by his own undergraduate medical education he sought to equip his students with skills beyond rote learning:

“it's a mixture in teaching the young in, in medicine of, of giving them some solid core information. But if that's all you do, if you don't get them thinking beyond that and understanding that they have to deal with uncertainty for the rest of their lives, then they need to work out how to deal with it, then you're not doing your job. And you've also got to enthuse them and, and, and give them some basic skills of how to take a history, how to examine somebody. But then how do you put it together is, is... requires a synthesis which won't come from just rote, 'This is this, that's that,' and everything's set in stone…”

In addition to being a member of the Editorial Board of the Journal of Gastroenterology and Hepatology, the Canadian Journal of Gastroenterology, Gastroenterology International, the European Journal of Gastroenterology and Hepatology, the American Journal of Gastroenterology and current Therapeutics, Richard Smallwood's legacy continues through his own extensive publications primarily in the field of the liver and its diseases. He had an outstanding international reputation and was acknowledged widely in a very broad range of fields including hepatology, public health, medical education and professional regulation.

His dedication earned him national recognition, named an Officer of the Order of Australia (1997) for service to medicine, particularly in the field of gastroenterology, to research, through the National Health and Medical Research Council, and to education. He was awarded the Centenary Medal in 2001 for "service to public health especially as the Chief Medical Officer" and in 2013, the Sir William Upjohn Medal, which recognises distinguished service to medicine in Australia.

Earlier this year, the College was pleased to welcome Richard's son, Michael Smallwood to 145 Macquarie St. to view the presidential portrait of his father featured in the banner image of this post. Usually based in Berlin, Michael was passing on his 'way to work' performing as Tamino in Opera Australia's the Magic Flute, when he took the opportunity to view the portrait after a long absence from Sydney. The portrait was painted by Robert Hannaford in 1998, following Richard's tenure as President of the RACP.

Richard Smallwood is survived by his wife Carol and their three children David, Michael and Penny and their families.

*Blockquotes are taken from the National Library's recorded interview with Richard Smallwood - listen to the full interview here